DESK REVIEWS | 04.02.01.01. Is there a dementia-specific national document (policy or plan) either in place or under development?

DESK REVIEW | 04.02.01.01. Is there a dementia-specific national document (policy or plan) either in place or under development?

Yes. There is the Law project number 4364/2020 (PL 4364/2020), which institutes the “National Policy for Integrated Care for People Living with Alzheimer’s Disease and other Dementias”. This law project has been approved by the Brazilian Federal Senate and waits for approval from the Chamber of Deputies to be implemented (Brazilian Federal Senate, 2021). Members of STRiDE-Brasil have been advocating for a more comprehensive and person-centred care approach in this law. Some achievements have already happened; however, more changes can be done to improve the law. Therefore, the STRiDE-Brasil team continues to advocate for improving the law.

Apart from that, some municipalities have developed regional plans for dementia. For instance, the Federal District approved in 2021 the law 6.926 regarding the policy for prevention, treatment, and support for people living with Alzheimer’s disease and other dementias and their family carers (Federal District Government, 2021). In the same trend, the city of São Paulo approved also in 2021 the PL 769/2019 (São Paulo Chamber of Deputies, 2019) in the state of Rio Grande do Sul there is the PL 131/2018 (Projeto de Lei n 131/2018, 2018) and in the city of Novo Hamburgo there is the PL 12/2020 (Novo Hamburgo Municipal Chamber, 2020). All of them aim to support people living with dementia and their carers. Besides, some politicians have shown a growing interest in dementia and discussions have been taking place in the Brazilian government. For example, the Professor Ricardo Nitrini (member of the STRiDE-Brasil steering committee) was invited to a meeting in the Chamber of Deputies in 2019 to discuss the creation of a possible dementia plan in Brazil, at that time. In addition, Professor Cleusa Ferri was invited to a meeting in 2020 in the Ministry of Health to discuss strategies for dementia care.

References:

Brazilian Federal Senate. (2021). Aprovado projeto que institui política de enfrentamento ao Alzheimer. https://www12.senado.leg.br/noticias/materias/2021/11/16/aprovado-projeto-que-institui-politica-de-enfrentamento-ao-alzheimer

Federal District Government. (2021). LEI No 6.926—Política distrital para prevenção, tratamento e apoio às pessoas com doença de Alzheimer e outras demências. https://www.tjdft.jus.br/institucional/relacoes-institucionais/arquivos/lei-no-6-926-de-02-de-agosto-de-2021.pdf

Novo Hamburgo Municipal Chamber. (2020). Projeto de Lei Municipal 12/2020—Novo Hamburgo. Camara Municipal. https://portal.camaranh.rs.gov.br/pm3/informacao_e_conhecimento/noticias/novo-hamburgo-podera-ter-politica-de-enfrentamento-ao-alzheimer

São Paulo Chamber of Deputies. (2019). Projeto de Lei da Câmara Municipal de São Paulo, n 769, de 2019. https://splegisconsulta.camara.sp.gov.br/Pesquisa/DetailsDetalhado?COD_MTRA_LEGL=1&COD_PCSS_CMSP=769&ANO_PCSS_CMSP=2019

There is no dementia-specific national document in place or under development to our knowledge by the Government of India. However, the Alzheimer’s Related Disorders Society of India (ARDSI) had prepared a draft strategy document, which was handed over to the Health Minister in 2018 for consideration of adoption by the MoHFW (Alzheimer’s Related Disorders Society of India [ARDSI], 2018).

References:

Alzheimer’s and Related Disorders Society of India.  (2018). Dementia India Strategy Report. Alzheimer Disease International. Available from: https://ardsi.org/pdf/Dementia%20India%20Strategy%20Report%202018.pdf

A dementia-specific national strategic plan was launched by the Ministry of Health in March 2016 (Ministry of Health Republic of Indonesia, 2015).

References:

Ministry of Health Republic of Indonesia. (2015). Strategi Nasional Penanggulangan Penyakit Alzheimer dan Demensia Lainnya: Menuju Lanjut Usia Sehat dan produktif. Jakarta: Ministry of Health Republic of Indonesia. Available at: https://www.neurona.web.id/paper/Rencana%20Aksi%20Nasional%20Demensia%202015.pdf

There is currently no national plan or policy on dementia. The STRiDE project in collaboration with the Ministry of Health (collaboration between department of mental health and ageing unit – non-communicable diseases) aims to lay the foundations for a national plan.

In 2011, the National Institute of Geriatrics (INGer) was instructed by the Minister of Health to create an action plan on AD and other dementias and with this, INGER brought together the efforts of different researchers, National Institutes, and NGOs going back at least 20 years into the planning and publication of the National Plan in 2012. Some of the main stakeholders participating in the design and publication of the Plan were the Mexican Alzheimer’s Federation, FEDMA, the National Institute of Neurology and Neurosurgery, the National Institute of Public Health, and the National Institute of Elderly People, INAPAM. The main objective of the National Plan is: “To promote the well-being of people with Alzheimer’s disease and related diseases, and their families, by strengthening the response of the Mexican Health System, in synergy with all responsible institutions”. It is a plan that aims at setting out a strategy to achieve awareness of the problem, de-stigmatise AD and dementia, promote adequate care of older adults with dementia and to generate actions to prevent the disease. Specifically, in the population of older adults with dementia, it aims to: decrease comorbidities, increase functionality, decrease behavioural problems, prevent accidents, improve quality of life, and decrease caregiver stress (Gutiérrez-Robledo & Arrieta-Cruz, 2014).

References:

Gutiérrez-Robledo, L., & Arrieta-Cruz, I. (2014). Plan de Acción Alzheimer y otras demencias, México 2014. http://diariote.mx/docs/plan_alzheimer_WEB.pdf