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Analysis

Building Brain Health at the G20 Health Ministers Meeting

Vladimir Hachinski, Antonio Federico and John Kirton
September 4, 2021

On the eve of the G20 Health Ministers' meeting in Rome on September 5-6, 2021, three authoritative voices have convincingly called for the ministers gathered there to do more on mental health than the G20 has ever done before.

The first call came from the World Health Organization (WHO) in its news release on September 3 on "World failing to address dementia challenge." It highlighted the rising global cost of dementia: the 55 million people, mostly women, who suffer from it now and the 78 million who will by 2030; and the 2019 financial cost of US$1.3 trillion, rising to US$1.7 trillion by 2030. It pointed to the need for a clear direction, improved coordination, and new initiatives, including the Dementia Research Blueprint that the WHO is developing.

The second call came from the G20 Side Event on Mental Health on September 3, opened by Italy's Minister of Health Roberto Speranza and followed by his colleague in the G20 troika from Indonesia. They were followed by experts from the WHO, OECD and UNICEF, and the G20 Engagement Groups, including the Women's 20 and Civil 20.

The third came on September 3 from the Think 20 (T20) Engagement Group's Task Force 1 "Global Health and Covid-19." Its brief, "Health at the Centre Stage" called for "greater attention to the underlying health and social conditions that have aggravated the impact of the pandemic" and for "strengthening the World Health Organization" and investment in the "foundational drivers of health equity" to tackle the "root causes."

This is all wise advice that the G20 health ministers should act upon now, including endorsing and supporting the WHO's work on a Dementia Research Blueprint. However, given the scale of the current and coming mental and brain health crises, they should do even more. They should start by affirming that "We are our brains. Human health is brain health. Build better brain health for all." They should then agree on the key principles:

1. Brain health needs to become the top priority given that it is the key to the increased cognitive competence demanded by the new economy and the subject and mediator of mental and social health.

2. Brain health needs to be part of all policies, given that there is no health without brain health.

3. We are preventing some dementias now, but do not know how. We need to find out and apply the lessons promptly and widely given the growing global burden of dementia.

They should also immediately give these principles practical effect by taking the following six affordable steps.

1. Adopt brain health as a priority to combat two of its major threats, mental illness and dementia/Alzheimer's.

2. Develop common definitions and measures to advance research and policy.

3. Identify what we know and need to know by integrating all relevant disciplines, including by supporting the WHO's Global Action Plan on Neurological Disease and Epilepsy and an expanded Mental Health Atlas, and especially by convening a meeting of high level, multidisciplinary experts on brain health.

4. Fund and foster start-up transdisciplinary research on the next steps.

5. Fund and foster research to identify urgently why dementia, stroke and heart disease incidence (cases per 1,000) are decreasing in some countries and apply the lessons throughout the G20.

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Vladimir Hachinski is a Distinguished University Professor at Canada's Western University and the former president of the World Federation of Neurology.

Antonio Federico is a professor of neurology and director of the Unit Clinical Neurology and Neurometabolic Diseases at the University of Siena, chair of the Scientific Committee of the European Academy of Neurology, president of Neuromediterraneum Forum, and president of the XXV World Congress of Neurology of the World Federation of Neurology in Rome on October 3-7, 2021.

John Kirton is director of the G20 Research Group, G7 Research Group and Global Health Diplomacy Program and co-director of the BRICS Research Group, all based at the University of Toronto where he is a professor of political science.