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12 December 2013

Who will care for Alzheimer’s sufferers in low income countries?

In 2050, 71 per cent of Alzheimer's patients will be in low to middle income countries. Will they be able to access medical care?

By Sophie McBain

The G8 summit in London yesterday, which pledged to develop a cure or treatment for dementia by 2025, was seen by many as a welcome recognition of a public health problem that has been overlooked for too long. According to the Alzheimer’s Society, 44 million have Alzheimer’s globally, and this is expected to increase to 135 million by 2050.

Alzheimer’s is already having a painful impact on the UK, where around 80,000 people suffer from the disease, and many more are affected. Rose George wrote a moving piece for the New Statesman yesterday about the impact that Alzheimer’s can have both on the victim and on their loved ones. For me, as for many readers, it struck a chord – reminding me of my grandfather’s illness, and my grandma’s valiant struggle to cope when social services failed and close friends stayed away. In Europe we struggle to care for dementia sufferers and their families – and in much of the rest of the world, things are much worse.

The Alzheimer’s Society estimates that 71 per cent of dementia sufferers in 2050 will be in poor to middle income countries. While rates of dementia in high income countries are set to rise by about 30 per cent, in China this is 70 per cent and in Sub-Saharan Africa the estimated rise is by 257 per cent. In low to income countries this also means that the ratio of dependents to non-dependents is set to rise more sharply than in the wealthier countries.

On top of this, Alzheimer’s sufferers  in low income countries are even less likely to be diagnosed than their counterparts in wealthier countries. In high income countries only between 20 and 50 per cent of cases are diagnosed, but one study in India suggested that around 90 per cent of cases are not officially recognised. This is another barrier to low-income dementia suffers accessing medical care, and means that their condition is likely to deteriorate faster.

The Alzheimer’s Society estimates that the overall cost of the disease in 2010 amounted to one per cent of global GDP (equivalent to the economy of Indonesia or Turkey) or $604bn. Most of this money is currently being spent in high-income countries (where admittedly, there are currently more diagnosed cases).

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In the future, what will matter is not only that G8 countries pledge to research new treatments and provide more support to Alzheimer’s sufferers at home, but also that they address the overlap between Alzheimer’s and poverty. Will Alzheimer sufferers in low-income countries access the next-generation of drugs? Who will support those living in countries with little public healthcare, in households below the poverty line? Anyone who’s been affected with Alzheimer’s in the UK will struggle to imagine things being harder, but in parts of the world the impact of dementia will be even worse. 

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