Brain diseases are on the rise and we need to find out why. Leveraging the heightened global interconnection from the pandemic, the G20 can work towards making brain health a top priority
We are our brains. All our actions, our experiences and our sense of self itself are mediated through the brain. COVID-19 has shown dramatically and tragically how closely cognition, mental and social health are related. Someone agitated by anxiety or slowed by depression cannot perform well intellectually. Similarly, someone befogged by long COVID cannot enjoy mental or social health, and isolation enfeebles the will and cognitive powers. One silver lining of the pandemic comes from understanding that the brain is about balance among its cognitive, emotional and social functions.
The pandemic has affected everyone, but the young and the old disproportionately: the young in lost opportunities of education, socialisation and employment, and the old in isolation and loneliness. Brain health in its full cognitive, mental and social dimensions has become essential for a robust and growing post-pandemic economy. Economic policy should embrace neuroscience research, especially brain health. Mental health and social well-being are prerequisites for optimising the cognitive capacity for the continuous learning demanded by the knowledge economy. Investing in brain health is the best single investment that an individual, society and the world can make.
The G20 – which accounts for 80% of global gross domestic product and much of its population – is the most appropriate institution to make brain health a top priority.
At their Rome Summit, G20 leaders can:
- Adopt brain health as a priority to combat two major threats, mental illness and dementia/Alzheimer’s.
- Develop common definitions and measures to advance research and policy. ‘Mental health’ and ‘brain health’ are two sides of the same coin: mental health is the observed behaviour and experienced and/or expressed feelings; brain health is the study of the brain and how neurological disease can affect its functions. Repeated behaviours change the brain and an afflicted brain changes behaviour. Both behaviour and the brain can change each other and have to be understood together.
- Identify what we know and what we need to know by integrating all relevant disciplines, including by supporting the World Health Organization’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.
- Fund and foster start-up transdisciplinary research on the next steps.
- Fund and foster research to identify urgently why dementia, stroke and heart disease incidence is decreasing in some countries and apply the lessons throughout the G20 and beyond. Canada is pioneering such an approach.
These actions represent an innovative advance from G20 health ministers’ actions since they first noted “mental health needs” in 2018. In 2019 they affirmed mental health as a human right and focused heavily on dementia, making five commitments on integrated multi-sectoral national action plans; risk factors and social determinants; early detection, diagnosis and interventions; dementia-inclusive environments; appropriate multi-stakeholder care; and research and development. In 2020 ministers recognised that COVID-19 harmed mental health and that all countries must prepare and respond. All ages have been affected directly through long COVID, hence the need for a life course approach as advocated by the WHO.
At Rome G20 leaders should commit to promote mental health and reinforce their ministers’ major commitments from 2019 on dementia. Those would be the G20’s first commitments on both of the major components of mental health and brain health.
Taking these actions would address the large present and future needs of all G20 members. COVID-19 has created grief and anxiety, delays in mental health treatments in overcrowded healthcare systems and the mental health harms from lockdowns and isolation. There will be proliferating strains on governments’ soaring deficits and obligations to provide healthcare and societal security for their ageing populations with increasing dementia, Alzheimer’s and other brain diseases. Italy, Germany, Japan and Korea are in the vanguard of both the dementia and Alzheimer’s burdens, but most other G20 members are close behind, especially emerging and developing countries where cases are rising fastest now.
The increased interconnectedness, communication and collaboration arising from the COVID-19 pandemic can be leveraged to curb the growing pandemic of mental health harms to children and youth and the diseases of ageing, especially dementia. Importantly, the incidence of dementia has been decreasing in some countries. We need to find out why and use those lessons to begin delaying, making less severe and preventing some dementias with pandemic-like urgency. Brain health is the key to achieving health, productivity and well-being and, hence, a global priority.