Editorial
“I look young, but I am actually quite old”, pronounced WHO Director-General Margaret Chan at the first Ministerial Conference on Global Action Against Dementia, hosted by WHO, the Organisation for Economic Co-operation and Development (OECD), and the UK Department of Health in Geneva on March 16–17. Dr Chan continued, with great clarity and sincerity, to describe her own desire to grow old gracefully and with dignity, contrasting her own aspirations with the plight of 47 million people worldwide who struggle to cope with the debilitating effect of dementia, a disorder that is expected to double in prevalence over the next two decades, and that comes with an estimated health bill worldwide in excess of US$600 billion. These shocking statistics, although not new, serve as a startling reminder that urgent and coordinated action to formulate and implement national and global dementia plans represents one of the most overlooked and pressing health priorities of our time. The WHO meeting, which took place 15 months after the landmark G8 dementia summit, created much heat and noise. There were proposals (although no formal agreements) to share dementia research data globally; Jeremy Hunt, the UK Government’s Secretary of State for Health, announced a $100 million Dementia Discovery Fund to re-ignite waning interest from industry into the search for a disease-modifying treatment by 2025 (restating a key target of the 2013 G8 summit); there was knowledge sharing of contrasting approaches to dementia care, highlighting innovations including dementia villages in the Netherlands and Japan’s extensive dementia friends programme; and there were calls for dementia to become integrated in wider programmes for non-communicable diseases, and to create a new global fund for dementia. In the meeting’s call to action, WHO announced bold intentions to create a dementia observatory to track progress on future research, drug development, and in the sharing of dementia care models across different economic settings. This enormous task—for which WHO will have to commit substantial resources—will be essential if this new global health initiative is to form a platform for the basis of future success. A key next step will be for WHO to articulate how it intends to position dementia as a World Health Assembly priority, if not this year, then in 2016. www.thelancet.com Vol 385 March 28, 2015
Also apparent in Geneva last week was a focus on the pressing need for effective dementia care, given that new clinical therapies remain a long-term hope. For countries with developed health systems, this means an urgent debate about how to organise and fund existing and future dementia care services. The UK, rightly congratulated in Geneva for its championing of dementia leadership under Prime Minister David Cameron’s stewardship, is uniquely positioned to lead the way ahead in care provision. The National Health Service (NHS) Five Year Forward View, published last autumn, sets out a new vision of integrated health and social care, and focuses on specific dementia priorities, including new plans for primary care to increase diagnosis; greater support for half a million unpaid dementia carers and for those with a diagnosis of dementia; and the pledge of a consistent standard of support, utilising named clinicians and advisers, with proper care plans developed in partnership with patients and families. At the WHO meeting, Stefan Kapferer from the OECD emphasised the future priority of organising innovations in dementia care; and Jeremy Hunt highlighted the crucial role of the voluntary sector in helping to raise awareness and to provide support services in the dementia field. True enough, but in the UK and other settings, it is worth remembering that it is the statutory responsibility of governments to fund health and social care programmes, which will ultimately determine whether there are enough family doctors to help address the shortfall in diagnoses, or the funding of dementia nurses in the community. A climate of ongoing austerity and further cuts to local government budgets does not fit with the aspirational dialogue evident in Geneva last week. To this end, the outcome of the May 7 UK general election could resonate on the stage of international health. If future UK Governments can properly fund a changing NHS and deliver new integrated health and care models for dementia, and WHO’s new dementia observatory is effective, then a blueprint for the delivery of sustainable dementia care services based on a UK model could drive consensus in how to deliver improved dementia care in the future, on a global scale. The Lancet
Science Photo Library
Dementia: turning fine aspirations into measurable progress
For the WHO meeting see http:// www.who.int/mediacentre/ events/meetings/2015/globalaction-against-dementia/en/ For the NHS Five Year Forward View see http://www.england. nhs.uk/ourwork/futurenhs/
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“I look young, but I am actually quite old”, pronounced WHO Director-General Margaret Chan at the first Ministerial Conference on Global Action Against Dementia, hosted by WHO, the Organisation for Economic Co-operation and Development (OECD), and the UK Department of Health in Geneva on March 16–17. Dr Chan continued, with great clarity and sincerity, to describe her own desire to grow old gracefully and with dignity, contrasting her own aspirations with the plight of 47 million people worldwide who struggle to cope with the debilitating effect of dementia, a disorder that is expected to double in prevalence over the next two decades, and that comes with an estimated health bill worldwide in excess of US$600 billion. These shocking statistics, although not new, serve as a startling reminder that urgent and coordinated action to formulate and implement national and global dementia plans represents one of the most overlooked and pressing health priorities of our time. The WHO meeting, which took place 15 months after the landmark G8 dementia summit, created much heat and noise. There were proposals (although no formal agreements) to share dementia research data globally; Jeremy Hunt, the UK Government’s Secretary of State for Health, announced a $100 million Dementia Discovery Fund to re-ignite waning interest from industry into the search for a disease-modifying treatment by 2025 (restating a key target of the 2013 G8 summit); there was knowledge sharing of contrasting approaches to dementia care, highlighting innovations including dementia villages in the Netherlands and Japan’s extensive dementia friends programme; and there were calls for dementia to become integrated in wider programmes for non-communicable diseases, and to create a new global fund for dementia. In the meeting’s call to action, WHO announced bold intentions to create a dementia observatory to track progress on future research, drug development, and in the sharing of dementia care models across different economic settings. This enormous task—for which WHO will have to commit substantial resources—will be essential if this new global health initiative is to form a platform for the basis of future success. A key next step will be for WHO to articulate how it intends to position dementia as a World Health Assembly priority, if not this year, then in 2016. www.thelancet.com Vol 385 March 28, 2015
Also apparent in Geneva last week was a focus on the pressing need for effective dementia care, given that new clinical therapies remain a long-term hope. For countries with developed health systems, this means an urgent debate about how to organise and fund existing and future dementia care services. The UK, rightly congratulated in Geneva for its championing of dementia leadership under Prime Minister David Cameron’s stewardship, is uniquely positioned to lead the way ahead in care provision. The National Health Service (NHS) Five Year Forward View, published last autumn, sets out a new vision of integrated health and social care, and focuses on specific dementia priorities, including new plans for primary care to increase diagnosis; greater support for half a million unpaid dementia carers and for those with a diagnosis of dementia; and the pledge of a consistent standard of support, utilising named clinicians and advisers, with proper care plans developed in partnership with patients and families. At the WHO meeting, Stefan Kapferer from the OECD emphasised the future priority of organising innovations in dementia care; and Jeremy Hunt highlighted the crucial role of the voluntary sector in helping to raise awareness and to provide support services in the dementia field. True enough, but in the UK and other settings, it is worth remembering that it is the statutory responsibility of governments to fund health and social care programmes, which will ultimately determine whether there are enough family doctors to help address the shortfall in diagnoses, or the funding of dementia nurses in the community. A climate of ongoing austerity and further cuts to local government budgets does not fit with the aspirational dialogue evident in Geneva last week. To this end, the outcome of the May 7 UK general election could resonate on the stage of international health. If future UK Governments can properly fund a changing NHS and deliver new integrated health and care models for dementia, and WHO’s new dementia observatory is effective, then a blueprint for the delivery of sustainable dementia care services based on a UK model could drive consensus in how to deliver improved dementia care in the future, on a global scale. The Lancet
Science Photo Library
Dementia: turning fine aspirations into measurable progress
For the WHO meeting see http:// www.who.int/mediacentre/ events/meetings/2015/globalaction-against-dementia/en/ For the NHS Five Year Forward View see http://www.england. nhs.uk/ourwork/futurenhs/
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