Demographic change has moved up the agenda in European health policy making, and there it is likely to stay as Europe’s population grows older. If one single disease area is a manifestation of this phenomenon, it is dementia. A health focus of last year’s Luxembourg presidency and the lead of this week’s Netherlands presidency event “Living well with(out) Dementia”, this syndrome is set to remain a priority at the European Council for the years to come.
This blog was written by Helmut Brand, President of the EHFG, and first published on New Europe.
Such attention to dementia is encouraging. However, we have not yet witnessed the widespread policy reform needed to adequately combat this illness. Alzheimer’s disease and other forums of dementia are by all accounts a European public health problem, but barriers remain to true European leadership in research and care.
Quiet and pervasive: Europe’s dementia epidemic
Though not a normal part of ageing, old age is a primary risk factor for dementia. Today, 1.5-2% of people in the EU are living with dementia, severely impacting on their health, independence and quality of life, with spill-over effects upon their families, carers and society as a whole. As demographic change in Europe results in more and more people living into old age, the number of people living with dementia in Europe, 10.5 million people, is set to double by 2050.
In view of the lack of cure for dementia, as well as gaps in our understanding of the disease, the cost of medical care and societal impact of dementia threatens in the near future to become unsustainable. The direct and indirect costs in wider Europe stand each year at roughly €300 billion. This astronomical number is only set to rise.
What can we do better?
In the most recent issue of Lancet Neurology, Defeating Alzheimer’s disease and other dementias, together with colleagues I outline a number of recommendations for researchers, policymakers and advocates to move the needle on dementia research.
First, a critical word for our own community of researchers: we need to be better communicators. Scientists can often use a language that is highly technical, and disconnected from policy needs. Scientists need to simplify their message, to learn about their political contexts, and convey their findings to policy makers and the media in a method better packaged to assist health system reforms.
Policy makers, too, can do more to spur impactful action against dementia. They can push for continued and heightened attention, and promote public awareness. Small policy steps have their value, but should be complemented by more ambitious reforms. The Dutch campaign launched at the presidency’s conference this week, “Dementia-Friendly Together”, and corresponding boost of funding for research, is welcomed news.
In addition to financial and human capital investment at national level, European research infrastructures need to be strengthened. As stated in the Lancet Neurology, “Today, roughly 85-90% of public funding for researchers is still allocated at a national level and not transnationally by the EU– a situation complicated by the absence of synchronisation between national funding programmes.” No single country can stand up to the challenge of dementia alone, and so we need to reduce fragmentation and promote collaboration across sectors and – EU Member States.
Last, advocacy networks should be cultivated. Groups of people living with dementia, or caring for people with dementia, are those most capable of conveying the urgent need for better medical interventions and public policies against these diseases. Many of these “champions” already work tirelessly to keep dementia top-of-mind on the political agenda, and through coalition building with policy makers or more space to engage in the beginning of research of political processes, their impact could increase substantially.
Discussing dementia at EHFG
Better cross-sectoral and cross-border collaboration in public health is the raison d’etre of the European Health Forum Gastein (EHFG), taking place this year 28-30 September. EHFG is the only conference dedicated solely to European public health, and provides a chance for discussions between the various Directorates of the European Commission, national administrations, academia, industry and NGOs. This is the chance to talk “health in all policies”, from economics and taxation to digital technologies and social inclusion.
This year, the conference will explore as part of its wider theme of demographics and diversity, improving treatments and governance to care for patients already living with dementia, as well as the future patients that loom on the horizon. We hope to make our mark on dementia policy across Europe.
Dr Helmut Brand is president of the European Health Forum Gastein (EHFG). He is Jean Monnet Professor of European Public Health and head of the Department of International Health at Maastricht University and co-chair of the European Alliance for Personalised Medicine (EAPM). Brand serves on the European Advisory Committee on Health Research (EACHR) of WHO Europe and on the Expert Panel on “Investing in Health” (EXPH) for the European Commission.