Peru initiates the IMPACT project

By 2050, low-income and middle-income countries will be home to about 68% of the projected 139 million people with dementia worldwide.1Alzheimer's Disease InternationalWorld Alzheimer Report 2015: the global impact of dementia—an analysis of prevalence, incidence, cost and trends. Alzheimer's Disease International, London2015Google Scholar The fragmented health systems of many such countries are ill-prepared to prevent, diagnose, and manage this increase in prevalence of dementia and its comorbidities in their rapidly ageing populations.2Pattabiraman M A perspective of dementia health care delivery in the LMIC context.https://www.worlddementiacouncil.org/sites/default/files/2022-01/DLP%20-%20Essays%20-%20LMICs.pdfDate: 2022Date accessed: May 9, 2023Google Scholar The COVID-19 pandemic has drastically compromised health-care delivery and health security in low-income countries, especially among marginalised groups, further deepening pre-existing inequities.3Okereke M Ukor NA Adebisi YA et al.Impact of COVID-19 on access to healthcare in low- and middle-income countries: current evidence and future recommendations.Int J Health Plan Manag. 2021; 36: 13-17Crossref PubMed Scopus (77) Google Scholar Innovations using mHealth for people with dementia and co-morbidities (IMPACT) is a 4-year project, funded by the UK National Institute for Health and Care Research. The project's objectives are: (1) to evaluate the readiness of the health system to provide care for people with dementia and their carers; (2) to develop and implement a digital platform for dementia case-finding by community health workers; (3) to adapt and identify the feasibility of a mobile health (known as mHealth)-delivered and community health worker-supported intervention to improve health-related quality of life for people with dementia and their carers; and (4) to estimate the economic burden of dementia and assess the cost-effectiveness of case-finding. The project has recently been launched in Peru, a country severely affected by the COVID-19 pandemic. IMPACT's research activities, alongside an extensive capacity-building and community engagement programme, will be implemented across four geographically and culturally diverse regions: Lima, a megacity of over 10 million inhabitants; Tumbes, a semi-urban coastal region in the north of the country; Huancayo, an Andean city at 3200 m above sea level; and Iquitos, the main population centre of the Peruvian jungle. IMPACT's multidisciplinary team includes neurologists, family doctors, psychologists, epidemiologists, anthropologists, engineers, health economists, policymakers, and community representatives. We view this diversity of sites, scientists, and stakeholders as essential for the co-creation of sustainable solutions that go beyond traditional clinical spaces, leverage the community, drive policy reform, and ultimately transform health systems, societies, and the lives of people with dementia and their families. CRB declares grant support from the UK National Institute for Health and Care Research, Alzheimer's Drug Discovery Fund and Alzheimer's Association; honoraria from UCB Pharmaceuticals and Roche Pharmaceuticals; membership of advisory boards for the Latin American Brain Health institute (BrainLat), Universidad Adolfo Ibáñez (Chile), the UK National Institute for Health and Care Research and Roche Pharmaceuticals.JJM declares grant support from the Alliance for Health Policy and Systems Research (HQHSR1206660), Bloomberg Philanthropies (grant 46129, via University of North Carolina at Chapel Hill School of Public Health), FONDECYT via CIENCIACTIVA/CONCYTEC, British Council, British Embassy and the Newton-Paulet Fund (223-2018, 224-2018), DFID/MRC/Wellcome Global Health Trials (MR/M007405/1), Fogarty International Center (R21TW009982, D71TW010877, R21TW011740), Grand Challenges Canada (0335-04), International Development Research Center Canada (IDRC 106887, 108167), Inter-American Institute for Global Change Research (IAI CRN3036), National Cancer Institute (1P20CA217231), National Heart, Lung and Blood Institute (HHSN268200900033C, 5U01HL114180, 1UM1HL134590), National Institute of Mental Health (1U19MH098780), Swiss National Science Foundation (40P740-160366), UKRI BBSRC (BB/T009004/1), UKRI EPSRC (EP/V043102/1), UKRI MRC (MR/P008984/1, MR/P024408/1, MR/P02386X/1), Wellcome (074833/Z/04/Z, 093541/Z/10/Z, 103994/Z/14/Z, 107435/Z/15/Z, 205177/Z/16/Z, 214185/Z/18/Z, 218743/Z/19/Z) and the World Diabetes Foundation (WDF15-1224). Also, declares unpaid participation on a data safety monitoring or advisory board with DSMB, Trial Steering Committee, INTEnsive care bundle with blood pressure Reduction in Acute Cerebral haemorrhage Trial (INTERACT 3), International Advisory Board, Latin American Brain Health institute (BrainLat), Universidad Adolfo Ibáñez (Chile), Consultative Board, Programa de Gastronomía, Facultad de Estudios Interdisciplinarios, Pontificia Universidad Católica del Perú, Advisory Board, InterAmerican Heart Foundation (IAHF). Finally, declares a role as co-Chair, Independent Group of Scientists (IGS), 2023 Global Sustainable Development Report, United Nations; being a Member, Scientific Expert Committee, Global Data Collaborative for CV Population Health, World Health Federation, Microsoft, and Novartis Foundation, membership to the Scientific and Technical Advisory Committee (STAC), Alliance for Health Policy and Systems Research, World Health Organization; membership to WHO Technical Advisory Group on NCD-related Research and Innovation (TAG/RI), Noncommunicable Diseases Department, World Health Organization and membership to the Advisory Scientific Committee, Instituto de Investigación Nutricional (Peru). All other authors declare no competing interests. Time to get serious about the Global Action Plan on dementiaThe slow progress made by WHO and national governments on meeting the key targets of the Global Action Plan on the public health response to dementia is disappointing. The targets—which were published by WHO 6 years ago, in 2017—should have been reached in 2025, just 2 years from now, but progress has been woefully off track for several years . From Plan to Impact VI, a report from Alzheimer's Disease International (ADI)—a federation of national Alzheimer's disease associations—released to coincide with the Seventy-Sixth World Health Assembly (May 21–30), highlights the dire situation. Full-Text PDF