WHO Director-General addresses G8 dementia summit

Dr Margaret Chan
Director-General of the World Health Organization

G8 dementia summit
London, United Kingdom

11 December 2013

Excellencies, honourable ministers, distinguished delegates, ladies and gentlemen,

It is a great honour for me to address a summit that holds so much promise for the many millions of people affected by dementia. I am equally honoured to share this speaking opportunity with Yves Leterme, OECD’s Deputy Secretary-General. WHO and OECD are frequent partners, especially on health and technology issues with a strong economic dimension.

Dementia is one of these issues. Dementia is a costly and heart-breaking epidemic with an immense impact, medically, psychologically, emotionally, and financially.

I can think of no other condition that has such a profound effect on loss of function, loss of independence, and the need for care. I can think of no other condition that places such a heavy burden on society, families, communities, and economies. I can think of no other condition where innovation, including breakthrough discoveries, is so badly needed.

Worldwide, most care for dementia takes place in family homes. This care is immensely challenging, physically, psychologically, and financially. People with dementia need services and support. Caregivers also need services and support.

On current estimates, dementia affects more than 35 million people worldwide. This number is expected to almost double every 20 years as populations undergo rapid and nearly universal ageing. The annual costs of dementia, estimated at US$ 604 billion, are growing even faster than its prevalence.

Populations in low- and middle-income countries are ageing the fastest and are projected to bear the biggest burden of dementia in the near future. They are ill-prepared to cope, medically, socially, and economically. In many developing countries, modernization and high population mobility have unravelled the extended family networks that traditionally cared for the elderly.

Last year, WHO and Alzheimer’s Disease International jointly issued a report that explained why dementia must be treated as a global public health priority. That report also set out the many things that can be done to improve the lives of people with dementia and support their caregivers.

The situation is by no means hopeless, but the alarming trends, in numbers affected and the soaring costs, will only get worse in the absence of better tools. In terms of a cure, or even treatments that can modify the disorder or slow its progression, we are empty-handed. Innovations to improve care and social support are equally needed.

Research on the best preventive strategies remains inconclusive. But some evidence suggests that behavioural modifications, like a healthy diet, regular exercise, and cessation of smoking, may help support brain health and have a protective effect. We know that early diagnosis and early intervention are associated with better outcomes. But here, too, the tools for early diagnosis are imperfect.

In some cases, existing medicines, notably antipsychotics, are being misused, especially when they are overprescribed in ways that do more harm than good. I was glad to see this problem recognized in the summit’s declaration and communique.

As we all know, research on dementia has not been proportionate to the huge burden caused by this condition, the numbers affected and the human and fiscal costs.

Studies in wealthy countries show that the social and economic costs of dementia exceed those of other chronic diseases, like cancer and heart disease. Yet far less is invested in dementia research than in research on cancer and heart disease. The number of researchers investigating dementia is also much smaller.

Over the past decade, experimental therapies have failed, one after another. As we all know, research projects are being postponed or shelved because of the technical and financial risk of failure.

Frankly, we should show much more faith in the power of scientific investigation. That is what this summit aims to do. In a spirit of collective social responsibility, political leadership must step in to take up the slack when market forces fail to deliver for a burden of this magnitude.

Ladies and gentlemen,

This summit is a ground-breaking event, with a powerful set of proposals and a strong sense of urgency to catch up with a runaway human tragedy. Acting together, G8 countries aim to transform the current approach to dementia, which is often summarized in four words: Nothing can be done.

This summit, and its proposals, take a dramatically different approach. High-level leadership and commitment can defeat dementia. WHO fully supports the three-pronged approach that you will be considering. That is, to step up research for new interventions, to find ways to improve the quality of life and care, and to do more to support caregivers and families.

To defeat dementia, we need a leadership platform to maintain the high-level of political commitment expressed here today. We need to map out the precise policies and incentives that can be applied to accelerate research and discovery. OECD is well-placed to provide this kind of support in the innovation environment.

Dementia is a global challenge and a public health priority. WHO is ready to step up to this challenge. Dementia has a strong focus in the WHO Comprehensive Mental Health Action Plan, which was launched earlier this year with enthusiastic support from all Member States.

On the technical side, we are helping countries develop their dementia strategies. We have issued evidence-based recommendations on dementia care in the primary care setting.

We are now developing an online platform to provide better support to dementia caregivers that can be used in multiple countries, in multiple languages, and using a variety of computing and mobile phone devices.

But that is not enough. Dementia research and care need money, incentives, and coordination.

WHO and its Member States have been addressing these issues through work done by the Consultative Expert Working Group on Research and Development: Financing and Coordination. The options for finding money, crafting incentives, and coordinating R&D are multiple, but challenging.

If we want to catch up, we cannot afford to waste resources, duplicate efforts, or lose time. You recognize the need for a better bridge between research conducted in publicly-funded academic institutes and research undertaken by industry.

You are looking at ways to coordinate research undertaken by different groups in different countries. For publicly-funded research, you want to see broad but safe access to findings, methodologies, promising leads, and data on investments.

You are challenging civil society organizations to engage in a broad initiative to reduce stigma and fear. Dementia is caused by a progressive disease of the brain. It is not a normal, or an inevitable, part of the aging process. People with dementia have a right to be treated with dignity and respect. Most people with dementia cannot be their own advocates. They need civil society to do this job for them.

During this summit, you will also explore the feasibility of establishing a global network to support and connect families as a way of identifying and solving everyday challenges of care. Such a network could also stimulate needs-driven, simple, and affordable innovations that ease the burden of care. As studies have shown, interventions that support, educate, and train caregivers can delay the need for costly, and dreaded, institutionalized care.

Ladies and gentlemen,

These are exciting, ground-breaking proposals that give a vast and heart-breaking human tragedy good reason for hope. For dementia, we have been running behind the curve for way too long. This summit can turn things around.

WHO, and the many millions of people affected by dementia, thank you for your leadership. I wish you a most productive meeting.