The Global Action Plan on Dementia extension to 2031 has provided renewed momentum, with 25% of countries now having standalone dementia plans and 20% in development, but significant implementation gaps remain. Key challenges include workforce disparities (3 neurologists per 100,000 in high-income vs. 3 per million in low-income countries), the need for integration across NCD, mental health, and aging strategies, and the critical importance of capturing the voices of people living with dementia and caregivers throughout policy development. Risk reduction through shared NCD risk factors (diabetes, hypertension, obesity, physical inactivity) offers a strategic entry point for integration, with WHO's updated guidelines emphasizing that 45% of dementia cases could potentially be prevented or delayed. Success requires partnerships, collaboration, and coordination among all stakeholders to address the urgent 2030 forecast of 78 million people globally living with dementia.
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ADI IN CONVERSATION WITH WHO | At the launch of From Plan to Impact 2026Added:
Uh good morning. Welcome to Geneva and to the 2026 World Health Assembly. My name is Chris Lynch and I am the acting CEO at Alzheimer's Disease International ADI. And it is my absolute pleasure to welcome Dr. Tarun Dua. She's the unit head for non-communicable disease and mental health here at WHO. Tarun, welcome. Thank you for joining us.
Thank you, Chris. And my pleasure to join you today and talk about dementia.
Uh wonderful, wonderful.
Um so it's a poignant day for us. World Health Assembly always is. We are launching today our Front Alzheimer's Impact Report.
This report we bring out on the anniversary every year of the the Global Action Plan on Dementia. And this year is a really succinct infographic-based report.
Um and it's just four pages. It's going to be available for download from today going forward. And it really is just a snapshot of where governments are in terms of the development and deployment of their plans.
But we're always really keen to do this in terms of how we work with you and on all of the stakeholders cuz you've reminded me time and time again that even though WHO are the creators of the national of the Global Action Plan, we're all responsible for delivering it. So um having gone through the extension last year to 2031 and also getting dementia into the the NCD UN Declaration as well, we thought this would be a perfect opportunity just to ask you a few short questions if that's all right. That's great.
>> That's great and congratulations on launching the report. It's looking very nice. I was reading through it in the morning and uh infographic is really telling a story. Yeah, it really is.
It's an easy to see the the the change in the momentum that's starting to happen now. Well, look, let me dive in and ask you a few questions. So, we're 1 year on from the the extension to the global action plan, and how would you describe the overall progress?
The extension of the global action plan last year, I think it provided a renewed momentum, and that was needed. Uh but, we you know, when we looked at the achievement of the targets, we were very much far behind.
And the one of the major things that we are all proud of, and I think it is extremely important, is the UN political declaration on NCDs and mental health in uh last year in 2025.
Uh it provided the strategic agenda. You know, there was explicit inclusion on You see mental health in the uh the title. You read about dementia and the integrated system-wide approach that is needed. So, so that's that's one thing uh you know, where we are, and I think that's that's political prioritization, strategy setting is extremely important.
And then, the commitment of translating innovation into action.
>> Yes. I think in our lifetimes, we are at the stage where there is we are looking at the innovation in diagnosis. We are living looking at innovations in treatment. And for us as WHO is that, how do we get these innovations at scale to people who need the most and where there are inequities. Yeah, I I totally agree. And and you're hitting on something that's I think incredibly poignant for us, which is this implementation gap at the moment. Um what what's the the bridge in terms of getting from really strong policy into this implementation space?
So, you know, as I you know, I translate this into three things. You know, there are countries that have policies that have plans or dementia strategies and they're doing something about it, right?
Which is really good. But they we also note that they need to do more, you know. Many of the countries, you know, they have new plans and they update their plans, which is which is good. Then we have some other countries which do have plans, but there is a lot of implementation gap.
And then we have countries where there are no plans that are existing. Now, the point that is I would like to emphasize here is that a stand you know, we talk about a stand-alone plans. You know, when most of the time we think about stand-alone dementia plans.
But in today's world, there are lots of entry points. You know, we already talked about the NCDs, non-communicable diseases. That's an entry plan. In many countries, dementia is part of mental health. You know, that's an entry plan.
Entry point. Then we also have aging, right? So so we we do have the the gap to bridge that implementation gap is through integration. Yes. The second way to grip that bridge that gap is through health system strengthening and looking at workforce at community level.
The reason being that we are lacking specialists. You know, if for example, if you look at the number of neurologist in high-income countries, let's say it is three per 100,000. In low-income countries, it is three per million. Yes.
There are huge gaps. And when we are talking about a condition like dementia, the community mobilization, the community strengthening of community health worker is very important because a person with dementia is not often going to come to the health facilities.
We need to go >> So go to the to them to them to them.
That's extremely important. And third and the most important thing and where actually ADI can play plays an important role and can play a further role is in terms of addressing the you know, the awareness gap.
>> Yes. Yeah.
And that's a that's a major part of the implementation gap because if you don't know you can do something about it, you're not going to do it.
>> Yeah, I totally agree. I totally you make such a good point about awareness raising. And for the last 10 years ADI has been doing this awareness and attitude to dementia survey which we started to see you know, there is perceptual change as well. But it needs to be at absolutely every step of the way not just in the general population but with the health care practitioners.
And it made me think something that came up quite strongly from the the report this year was about 25% of of countries now have dedicated standalone plan.
There's another 20 in development. But you hit on something really important which is this integration. I think if you had asked me this seven or eight years ago we'd have been very entrenched and said a standalone plan is the best tool available. But in reality it has to be integrated. And I think what happened in New York last year at the UN with the new declaration with NCDs has opened up an entirely different opportunity for us particularly around risk reduction. Can you can you tell us a little bit more about how that that declaration is going to prove useful in the dementia space?
Right. Now I that's a very important point. You know, when we think about dementia and uh we are at that age right Chris. We you know, we want to think about preventing dementia, reducing the risk of dementia.
And we all think about it even if we don't say it. I'm saying it on camera.
You you may not say about it. Right? And as you know, many of these risk factors are NCD related.
>> Yes. Like diabetes, hypertension. Then some of some of the NCD risk factors and dementia risk factors are shared. If you talk about obesity or we talk about physical inactivity.
>> Yes. Right? So, there is I think this UN declaration and otherwise it tells us that we need to reduce the risk of dementia and working on these NCD risk factors, interventions for reducing the risk of NCD risk factors will help us in reducing the risk of dementia. And this is important because in 2019 WHO has come out with their first-ever guidelines on dementia risk reduction and I'm very pleased to tell you that we are updating our guidelines looking at new risk factors, new evidence and we would be launching them in couple of months.
So, so stay tuned to see what what countries should be doing, what civil society should be doing because then there are other risk factors that are important like you know, in terms of your cognitive stimulation, air pollution, social connection. And there's a really good bit here for a policy that we're finding is so when we're talking to ministries of health, there's often a level of intimidation around dementia and the potential cost of it. But when you open the conversation with risk reduction and talk about potentially preventing or delaying 45% all of a sudden the conversation's moved into a proactive positive area and it's a really good door opener. Exactly. So, we talked about integration and this this is our kind of like the second point that I would like to make is the entry point, right? This is the risk reduction provides us an entry point for that integration that we talked about.
Perfect.
If I can, let me deviate very slightly cuz in the global action plan, one of the core areas is capturing the voice of people living with dementia and equally of carers as well.
Um for us what we found over the years is that that's not about validation.
It's it's about involvement right from the very beginning.
Um and from from WHO's point of view, what's the the kind of the the value and the mechanism for capturing that that lived experience? That's a that's a very important point that you are making. You know, we we say that um nothing for us without us. Not nothing for them without them. And it should not be a tokenism.
And I And that's what WHO firmly believes in. And And that's kind of as an embedded as a principle of the work that we do uh not only for dementia but for other disorders. So, for example, we have a framework on engage- engagement of people with NCDs and mental and neurological disorders. So, something that is very extremely important. And And I think what we need to When we think about engagement is that they are engaged from beginning to the end. They are from the design to implementation to monitoring. And that participation Again, coming back to that tokenism, there it has to be decided a priori.
It has to be formalized. It There has to be uh For example, they have to be you are And there has to be some transparency. There has to be an accountability.
And last point that I would make that we need to uh uh build the capacity of policy makers on how to better engage because very often we talk about Okay, build the capacity of people and their families to engage uh with policy makers. But also, we need to tell policy makers how to better engage. Completely agree. And And we have something We do this. You know, I talked about my guidelines. I start with that. We have people living with dementia and their caregivers as members of our guideline development group. Uh you know our the audience would know about our global dementia observatory where we have our data platform, our knowledge exchange platform. And we have people living with dementia and their caregivers as peer reviewers. So, they review everything that is put on put on that platform. In fact, our the I support the caregiver support tool that we have is is all about for caregivers. So, many many examples. I mean, like even the plan and that we developed, we heard the voices. So, so So, as I said, they are part of the whole process, part of the journey.
>> The entire journey. And I think what we're finding as well with capturing that that experience, that expertise, is you can see a change in a transition from a heavily stigmatized area.
And now we're moving [clears throat] into a space of proactivity. And obviously now with some treatments, some new diagnostics, that there's an attitudinal shift. So, I'm hopeful that capturing that voice is going to become easier. Exactly. I'm going to ask you one more question if it's okay. Yeah, but before Yeah, yeah. I I I truly wanted to emphasize another thing is participation, participation in research. You know, very often when we talk about research participation, it is about okay because they are the kind of the people you know, for the clinical trials and biomarkers. But how are they part of those research agenda setting? So, my final question is is probably the the policy galvanization momentum question.
We're a year into the 6-year extension.
How do we as our stakeholder group galvanize that the governments around the world, but all those key stakeholders. So, in 2031 when we look back, we can genuinely say we did make a big leap forward and we used this global plan to the best of its ability.
So, I think Chris as I as I see it, the important thing is no one stakeholder can do it alone.
So, the important thing is that we need partnerships. We need collaboration and we need coordination. I think that's that's that's an important message. And everybody has to work towards that common goals and and you know, we have the targets. The action plan has come up with the targets. The global status report on the dementia and the you know, and the GDO data, the global dementia observatory data tells us where we are.
You know, for example, the last round when we collected the data from the countries, only 100 countries submitted their data. Now, you can look at glass half full, half empty.
The first round we only had 62 countries. So, there is a big improvement, but we are still not there.
The but the good thing about the data this time was there were more countries from under you know, low and middle income countries, more countries from Africa region. So, there is that momentum that is that is extremely important. I think what we need to think in terms of, you know, as we are thinking about the exciting innovations and I mentioned that this are the we should not be creating divide that these innovations are only available for high income countries. We need to think about how do we take them to scale also in low and middle income income countries and how do we strengthen the health systems you know, to provide care and services. And each of us has a has a role to role to play and if we work together, I'm sure we would we would be able to if not all targets, majority of the time.
And yeah, and something is kind of a perfect way to to finish, I think, which is back in 2019, we were looking at 2030 and at and at 2050 in terms of the prevalence forecasts.
And it always felt like it was somewhere far in the future. And all of a sudden, the 78 million forecast globally by 2030 is 4 years away. Um it feels like it's on our doorstep now. So, I think what we're trying to do at ADI is to work alongside you to get that galvanization going and really keep this momentum going. So, um it's been Dr. Tarundu, an absolute delight talking to you this morning in this beautiful sunshine in Geneva. Um the report is available um to download from the ADI website.
Um and this video will be made available on the ADI website and YouTube channels um um in the next few days.
Thank you so much.
>> Thank you, Chris. You're welcome.
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