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EDITORIAL
Year : 2017  |  Volume : 7  |  Issue : 4  |  Page : 73-75

Response to the Burden and Impact of Dementia Through Policy and Innovation


WISH Center, Qatar Foundation, Doha, Qatar

Date of Web Publication6-Nov-2017

Correspondence Address:
M Walid Qoronfleh
WISH Center, Qatar Foundation, P.O. Box 5825, Doha
Qatar
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijnpnd.ijnpnd_71_17

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How to cite this article:
Qoronfleh M W. Response to the Burden and Impact of Dementia Through Policy and Innovation. Int J Nutr Pharmacol Neurol Dis 2017;7:73-5

How to cite this URL:
Qoronfleh M W. Response to the Burden and Impact of Dementia Through Policy and Innovation. Int J Nutr Pharmacol Neurol Dis [serial online] 2017 [cited 2017 Nov 18];7:73-5. Available from: http://www.ijnpnd.com/text.asp?2017/7/4/73/217558

The World Innovation Summit for Health (WISH), an initiative of the Qatar Foundation for Education, Science and Community Development (QF for short), brings together a community of policymakers and healthcare leaders to help solve the most urgent global health challenges while capturing and disseminating the best evidence-based ideas. Generally, WISH convenes a summit every 18 months on various topics highlighting key areas for research and collaboration, including dementia.

With regard to dementia, WISH organized in Doha, Qatar the “WISH Dementia Forum 2015” chaired by Ellis Rubinstein, the President and CEO of The New York Academy of Science, and produced “A Call to Action” report.[1] Later, WISH organized a dementia side meeting in Doha, Qatar with technical support from the World Health Organization (WHO) and issued a meeting report in 2016.[2] The purpose of this meeting was to bring together stakeholders to facilitate shared learning regarding various responses of countries to the increasing burden associated with dementia in the Eastern Mediterranean region as well as the other parts of the world. The meeting facilitated the development of coordinated regional- and country-level actions through policy and social innovation to improve the care and monitoring of dementia.

In this editorial, we provide a summary and direct excerpts from these events as well as outline a path forward for this disease from a healthcare perspective.

The challenge

Dementia is the umbrella term for a number of symptoms relating to decline in memory and other cognitive functions. Dementia has severe effects on the quality of life of individuals and causes tremendous strain on caregivers and healthcare systems. Worldwide, 44 million people live with dementia, and this figure is expected to reach 135 million by 2050. Meanwhile, worldwide, the cost of care reached an estimated $604 billion in 2010, equivalent to 1% of global gross domestic product, and costs are expected to exceed $1 trillion annually in the United States alone by 2050.[1],[2]


   The Middle East and North Africa Burden Top


Dementia currently affects 2.3 million living in the MENA region. This figure is expected to rise to 4.4 million by 2030. It is true that there is often a lack of awareness and an understanding of dementia, resulting in stigmatization and barriers to diagnosis and care. However, the situation is more acute and pronounced in the MENA region. Dementia leads to increased long-term care costs for governments, communities, families, and individuals, in addition to losses in productivity for economies. Nearly 60% of the people with dementia currently live in low- and middle-income countries, and most new cases (71%) are expected to occur in those countries. In the Eastern Mediterranean region, 70% of the countries fall within the low- and middle-income categories. Data from low- and middle-income countries are scarce; the little evidence available suggests that up to 90% of people with dementia living in these countries do not receive anything in the way of diagnosis, treatment, or care. The Eastern Mediterranean region currently has the highest age-standardized prevalence of dementia for people aged 60 years and over (8.7%) compared to all other regions. This coincides with the highest estimated cost increase over time from $4.5 billion USD in 2010 to $16.7 billion USD in 2015 (271% increase) compared to other regions. Just over 50% of this cost is estimated to be through direct medical care. Direct social care costs (7%) pale in comparison to informal care costs (42%), which predominate.[2]

Despite this, dementia is not yet a national priority in most countries, which has led to a lack of systematic development, monitoring, and the evaluation of dementia efforts and to fragmented social and health services for people with dementia and their caregivers. For example, none of the member states from the Eastern Mediterranean region has a national plan to address dementia, and only 30 of the 194 member states globally have one.[2]

WHO initiative

The Global Dementia Observatory (GDO) is a web-based data and knowledge exchange platform of key dementia information that is currently being developed by WHO. The primary objective of the GDO is to collate and disseminate key dementia data from member states to support evidence-based service planning and the strengthening of policies as well as health and social care systems. The conceptual framework includes the following three strategic domains: policies; service delivery; and epidemiology and research. In addition, it includes the following seven cross-cutting thematic areas:[3]

Dementia as public health priority.
  • Dementia awareness and dementia friendliness.
  • Dementia risk reduction.
  • Dementia diagnosis, treatment, care, and support.
  • Support for dementia caregivers.
  • Information systems for dementia.
  • Dementia research and innovation.


In 2016, Qatar was invited to be a pilot country in the WHO’s GDO. The GDO is the result of growing international interest on the topic, as demonstrated by several high-level meetings gathering world leaders and the heads of states between 2011 and 2015, including a G8 Dementia Summit. The GDO project gathers data on dementia policy and care provision internationally, with the aim of shaping a World Health Assembly draft global action plan on dementia, which is expected in 2017.


   Dementia and Qatar Top


WISH has been active in advancing the dementia agenda in Qatar. To address dementia in a comprehensive way, the WISH Dementia Forum Framework presents three pillars that lead to improved outcomes for economies, society, and individuals living with dementia. The three primary themes to consider are the following: prevention and risk reduction, diagnosis and care, and cure [Figure 1].[1] The report presentation outlines key issues in understanding dementia, and the need to tackle the burden globally. It looks at solutions that are currently available and makes recommendations to policymakers to accelerate prevention, improve care and treatments, and potentially cure the diseases that lead to dementia.[1]
Figure 1: Dementia Framework Pillars. The shading gradation of the four cross-cutting bars in the figure reflects the applicability for each area.

Click here to view


The policy recommendations described in this report aim to achieve improved outcomes for individuals living with dementia, for economies struggling to pay for the cost of care, and for society at large, facing the increasing prevalence and the burden of dementia. The following recommendations are directed at policymakers, outlining what can be done today to decrease the present and future burden caused by dementia.[1]
  1. Develop a plan to address dementia nationally.
  2. Increase the awareness of dementia.
  3. Expand healthy living to include brain health.
  4. Improve the evidence base for prevention.
  5. Improve dementia care.
  6. Strengthen integrated and coordinated health and social care systems.
  7. Institute and fund longitudinal studies.
  8. Reduce barriers to drug development.
  9. Commit government investment of at least 1% of a country’s cost of care.
  10. Facilitate innovative finance mechanisms.


The Eastern Meditation Region meeting was divided into two sessions designed to encourage an exchange of ideas and best practices.[2] The first session provided a spotlight on dementia initiatives occurring nationally in Eastern Mediterranean region member states, including four from outside the region across the following four broad themes listed below:
  • Putting dementia on the national agenda.
  • Supporting people with dementia and their families.
  • Improving service delivery.
  • Investing in dementia research and innovation.


The second session consisted of breakout groups that discussed explicit implementation successes, challenges, and lessons learned within each of the above themes in the context of developing national dementia strategies or plans as well as operationalizing the draft global dementia action plan.

The path forward regionally

The WISH dementia forum and side meeting served to foster an increased awareness of the public health challenges posed by dementia in the region and to support the development of a dementia response through policy and social innovation. It also served to highlight the good progress made in dementia planning and service delivery within the region, in particular providing a platform for information exchange on national and regional initiatives, ideas, and strategies such as best practices regarding the assessment of dementia care and the monitoring of progress.[1],[2]

The following were identified as next steps to move the dementia agenda forward within the region as well as globally:
  • Leverage the Draft Global Action Plan on the Public Health Response to Dementia to support the development or the enhancement of national dementia strategies.
  • Strengthen partnerships with civil society for the provision of services for persons with dementia and their caregivers and safeguarding their rights.
  • Build on the implementation mechanisms put into place for the existing mental health, noncommunicable disease, and ageing strategies, action plans and frameworks needed to scale up care for dementia.
  • Collaborate on the GDO, which can serve as a tool to setup or enhance monitoring and dementia surveillance and strengthen knowledge sharing on evidence-based policy and service development.


In the spirit of public outreach and education, WISH recently hosted an interactive public event − an awareness day − at Education City, in association with Hamad Medical Corporation (HMC) and the Ministry of Public Health, to address the challenges faced by the people in Qatar who suffer from various types of dementia, notably Alzheimer’s disease, and their caregivers. Presentations were made by Dr. Hanadi Al Hamad, Chair of Geriatrics and Long-term Care Department at HMC; experts from Ehsan, Center for Empowerment and Elderly Care; and researchers from Qatar University. Additionally, a moving personal testimony from a participant, whose spouse suffers from Alzheimer’s disease, was given. Many of those who spoke referred to the need for further focus on research and outreach programs. The event ended on an encouraging note, with Dr. Walid Qoronfleh, Director of Policy and Research at WISH, highlighting the positive collaborative work being undertaken by various stakeholders in Qatar, and the efforts being made to engage with the community.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
WISH Dementia Forum. A Call to Action: The Global Response to Dementia through Policy Innovation, Doha, Qatar; 2015.  Back to cited text no. 1
    
2.
WISH Meeting Report. Enhancing the Response to the Burden and Impact of Dementia, Doha, Qatar; December 1, 2016.  Back to cited text no. 2
    
3.
WHO-Global Dementia Observatory. Available from: http://www.who.int/mental_health/neurology/dementia/GDO/en/. [Last accessed on 2017 Oct 01].  Back to cited text no. 3
    


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