11.02. Policy gaps | South Africa

11.02. Policy gaps | South Africa

15 Aug 2022

There is no national or provincial dementia plan or strategic framework in South Africa that guides the care, treatment and support needs for persons living with dementia and their families. There is however an Older Person’s Act (no.13 of 2006) and an Older Persons’ Programme, but these are not dementia-specific. Policy developments for dementia also needs to include a focus on HIV-associated dementia (HAD) that, due to the high prevalence of HIV/AIDS in South Africa, changes the landscape of age-associated dementias to include persons 40 years and older (Robbins, Remien, Mellins, Joska, & Stein, 2011; Kalaria et al., 2008). Another important policy gap relates to the legal environment in South Africa that does not cater for dementia-specific needs such as enduring power of attorney and ‘living wills’ for persons living with dementia. South Africa lacks legislation that support decision-making in persons with impaired capacity and needs assisted decision-making provisions or a provision for an enduring power of attorney (Marilyn, 2015). The latter is practiced in other parts of the world, however, does not currently form part of South African law despite being recommended (just over 3 decades ago) in 1988 by the South African Law Commission (Meyer, 2016).


Kalaria, R. N., Maestre, G. E., Arizaga, R., Friedland, R. P., Galasko, D., Hall, K., Luchsinger, J. A., Ogunniyi, A., Perry, E. K., Potocnik, F., Prince, M., Stewart, R., Wimo, A., Zhang, Z. X., & Antuono, P. (2008). Alzheimer’s disease and vascular dementia in developing countries: prevalence, management, and risk factors. The Lancet Neurology, 7(9), 812–826. https://doi.org/10.1016/S1474-4422(08)70169-8

Marilyn, H. (2015). Alzheimer’s – “The window of opportunity.” YE! Available from: https://youve-earned-it.co.za/finance/alzheimers-the-window-of-opportunity/

Meyer. (2016). Legal positions of persons incapable of managing their own affairs.

Robbins, R. N., Remien, R. H., Mellins, C. A., Joska, J. A., & Stein, D. J. (2011). Screening for HIV-Associated Dementia in South Africa: Potentials and Pitfalls of Task-Shifting. AIDS Patient Care and STDs, 25(10), 587–593. https://doi.org/10.1089/apc.2011.0154