DESK REVIEWS | 04.05.01. Is there dementia-specific legislation either at the national or sub-national level?

DESK REVIEW | 04.05.01. Is there dementia-specific legislation either at the national or sub-national level?

Yes, the national laws are described as follows:

  • National Law No. 11.736 establishes the 21 September as the national day of the Alzheimer’s disease, which aims to increase people’s awareness of the condition (Presidency of Republic of Brazil, 2008).
  • National Law No. 5.233 states that people with cognitive impairment, such as Parkinson’s disease, are eligible for keeping their entire salaries as retirement pensions.
  • There is the Ordinance No. 703 that establishes a “Program for Supporting People with Alzheimer’s Disease” (Programa de Assistência aos Portadores da Doença de Alzheimer, Portaria número 703) in the Brazilian Unified Healthcare System (SUS). According to this programme, the Reference Centres for Older People’s Healthcare (belonging to SUS) are responsible for diagnosing, treating, and accompanying people with Alzheimer’s Disease as well as supporting their families and carers (Presidency of Republic of Brazil, 1967). These Reference Centres are hospitals with physical infrastructure, equipment, and human resources adequate to provide healthcare to older people in an integrated way. Besides that, these centres should have, an outpatient clinic specialized in older people, geriatric day hospital (it is a kind of hospital that offers healthcare services to older people who are able to return home at the end of the day), and should provide homecare services of medium complexity for older people. A total of 74 Reference Centres are distributed among the 26 Brazilian federal states and the federal district (Brazilian Ministry of Health, 2002).

In addition, there are many “Law Projects” (Projeto de Lei no Senado or Projeto de Lei, in Portuguese) that are submitted to the federal congress for assessment and vote before becoming legally binding. This process may last years until completion. Some of the law projects are related to dementia. These are:

  • PLS No. 4364 (2020): aims to create The National Policy for Integrated Care for People Living with Alzheimer’s Disease and other Dementias (Brazilian Federal Congress, 2020).
  • PLS No. 30 (2018): aims to allow people living with dementia to manage a Brazilian financial fund (FGTS) at any time, which they would otherwise only be allowed to manage after retirement or under specific circumstances (Brazilian Federal Congress, 2018).
  • PLS No. 61 (2017): people with Alzheimer’s disease to receive income tax payment waiver (Brazilian Federal Congress, 2017).
  • PLS No. 523 (2011): provides subsidised medicine for people with Alzheimer’s disease, Parkinson’s disease, depression, diabetes etc. (Brazilian Federal Congress, 2011b).
  • PLS No. 412 (2011): supports campaigns advising prevention and timely diagnosis of Alzheimer’s disease (Brazilian Federal Congress, 2011a, p. 412).

References:

Brazilian Federal Congress. (2011a). Projeto de Lei do Senado n° 412, de 2011—Pesquisas—Senado Federal. https://www25.senado.leg.br/web/atividade/materias/-/materia/101226

Brazilian Federal Congress. (2011b). Projeto de Lei do Senado n° 523, de 2011—Pesquisas—Senado Federal. https://www25.senado.leg.br/web/atividade/materias/-/materia/101821

Brazilian Federal Congress. (2017). Projeto de Lei do Senado n° 61, de 2017—Pesquisas—Senado Federal. https://www25.senado.leg.br/web/atividade/materias/-/materia/128350

Brazilian Federal Congress. (2018). Projeto de Lei do Senado n° 30, de 2018—Pesquisas—Senado Federal. https://www25.senado.leg.br/web/atividade/materias/-/materia/132157

Brazilian Federal Congress. (2020). Projeto de Lei do Senado 4364, de 2020. https://www25.senado.leg.br/web/atividade/materias/-/materia/144381

Brazilian Ministry of Health (Ed.). (2002). Redes estaduais de atenção à saúde do idoso: Guia operacional e portarias relacionadas. Editora MS. http://bvsms.saude.gov.br/bvs/publicacoes/redes_estaduais.pdf

Presidency of Republic of Brazil. (1967). Lei 5233. http://www.planalto.gov.br/ccivil_03/LEIS/1950-1969/L5233.htm

Presidency of Republic of Brazil. (2008). Lei 11736. http://www.planalto.gov.br/ccivil_03/_ato2007-2010/2008/lei/L11736.htm

 

There is no dementia specific legislation at a national level.

There has not been dementia-specific legislation at the national level. However, there are a number of legislations that support older people’s health and welfare in general:

  • Constitution No. 13/1998 on Older People’s Welfare (Undang-Undang Republik Indonesia No. 13 Tahun 1998 Tentang Kesejahteraan Lanjut Usia (Constitution of Republic of Indonesia No. 13/1998 on Older People’s Welfare), 1998)
  • Constitution No. 39/1999 on Human Rights (UU No. 39/1999 Tentang Hak Asasi Manusia (Law No. 39/1999 on Human Rights), 1999)
  • Constitution No. 11/2009 on Social Welfare (Undang-Undang Republik Indonesia No. 11 Tahun 2009 Tentang Kesejahteraan Sosial (Constitution of Republic of Indonesia No. 11/2009 on People’s Welfare), 2009)
  • Constitution No. 36/2009 on Health (Regulation No. 36/2009 on Health (UU No. 36/2009 Tentang Kesehatan), 2009).

The Ministry of Health also issued several regulations on healthcare:

  • Ministry of Health Regulation No. 75/2014 on Community Health Centre (Primary Care) (Ministry of Health Republic of Indonesia, 2014)
  • Ministry of Health Regulation No. 79/2014 on Geriatric Care in Hospital (Ministry of Health Regulation No. 79/2014 on Geriatric Services in Hospitals (Permenkes No. 79/2014 Tentang Pelayanan Geriatri Di RS), 2014)
  • Ministry of Health Regulation No. 67/2015 on Healthcare of Older People in Community Health Centre (Ministry of Health Republic of Indonesia, 2015a)
  • Ministry of Health Regulation No. 25/2016 on National Strategy on Older People’s Health 2016-2019 (Ministry of Health Regulation No. 25/2016 on National Action Plan on Older People’s Health (Permenkes No. 25/2016 Tentang Rencana Aksi Nasional Kesehatan Lanjut Usia 2016-2019), 2016a)

In addition, there are regional efforts:

  • The governor of Bali has issued a legislation on older people’s welfare (No. 11/2018). However, it does not mention dementia explicitly (Bali Regional Regulation No. 11/2018 on Older People’s Welfare (Peraturan Daerah Provinsi Bali No. 11/2018), 2018).

None of the legislations and regulations above mentions dementia explicitly.

References:

Bali Regional Regulation No. 11/2018 on Older People’s Welfare (Peraturan Daerah Provinsi Bali No. 11/2018), (2018) (testimony of Governor of Bali Province).

Ministry of Health Regulation No. 25/2016 on National Action Plan on Older People’s Health (Permenkes No. 25/2016 tentang Rencana Aksi Nasional Kesehatan Lanjut Usia 2016-2019), (2016) (testimony of Ministry of Health Republic of Indonesia).

Ministry of Health Regulation No. 79/2014 on Geriatric Services in Hospitals (Permenkes No. 79/2014 tentang Pelayanan Geriatri di RS), (2014) (testimony of Ministry of Health Republic of Indonesia).

Ministry of Health Republic of Indonesia. (2014). Ministry of Health Regulation No. 75/2014 on Public Health Center (Permenkes No. 75/2014 Tentang Pusat Kesehatan Masyarakat).

Ministry of Health Republic of Indonesia. (2015a). Ministry of Health Regulation No. 67/2015 on Geriatric Services in Public Health Center (Permenkes No. 67/2015 Tentang Penyelenggaraan Pelayanan Kesehatan Lanjut Usia Di Pusat Kesehatan Masyarakat). Kementrian Kesehatan Indonesia, 1–140.

Regulation No. 36/2009 on Health (UU No. 36/2009 tentang Kesehatan), (2009) (testimony of Republic of Indonesia).

Undang-Undang Republik Indonesia No. 11 Tahun 2009 Tentang Kesejahteraan Sosial (Constitution of Republic of Indonesia No. 11/2009 on People’s Welfare). (2009).

Undang-undang Republik Indonesia No. 13 tahun 1998 tentang Kesejahteraan Lanjut Usia (Constitution of Republic of Indonesia No. 13/1998 on Older People’s Welfare). (1998).

UU no. 39/1999 tentang Hak Asasi Manusia (Law no. 39/1999 on Human Rights), (1999) (testimony of Republik Indonesia).

No. However, Kenya ratified the Convention on the Rights of Persons with Disabilities (‘CRPD’ of ‘the Convention’) in 2008. Subsequently the law was absorbed (Article 2(6)) in the Constitution of Kenya 2010 (Government of Kenya, 2010). However, people with disabilities including people with dementia, are still not able to enjoy the same benefits as non-disabled people (The Open Society Initiative for Eastern Africa, 2013).

References:

Government of Kenya. (2010). The Kenya Constitution, 2010. Kenya Law Reports. http://www.kenyalaw.org/lex/actview.xql?actid=Const2010

The Open Society Initiative for Eastern Africa. (2013). How to implement article 12 of convention on the rights of persons with disabilities regarding legal capacity in Kenya: A briefing paper. Nairobi, Kenya. https://www.knchr.org/Portals/0/GroupRightsReports/Briefing%20Paper%20on%20Legal%20Capacity-Disability%20Rights.pdf

In Mexico, so far, there are no specific laws on dementia. However, there is the Law on the Rights of Older Persons (Congreso General de los Estados Unidos Mexicanos, 2002), which is based on the principles of autonomy and fulfillment, participation, equity, co-responsibility, and preferential attention. It also aims at  guaranteeing the rights of integrity, dignity and preference, legal certainty, protection of health, alimentation and family, education, employment and economic capacities, social assistance, participation, popular denunciation, access to services. However, it does not mention dementia specifically.

References:

Congreso General de los Estados Unidos Mexicanos. (2002). Ley de los Derechos de las Personas Adultas Mayores. Diario Oficial de La Federación, 38, 38–52. http://www.diputados.gob.mx/LeyesBiblio/ref/ldpam/LDPAM_orig_25jun02.pdf