A World Health Organization (WHO) report on global incidence of dementia raises serious concerns of society's ability to care for the growing aged population due to declining fertility and changing population demographics. The report, "Dementia: a public health priority", co-produced by the WHO and Alzheimer's Disease International, cautions governments that programs must be developed to meet the needs of the growing numbers of people with dementia who cannot rely on traditional systems of support because valuable family members were never born.

The WHO estimates there are currently 35.6 million cases of dementia around the world and expects the number to double by 2030 and triple by 2050. Dementia-including Alzheimer's disease-is a progressive syndrome that affects a person's mind, memory and ability to function in everyday life. It is challenging and traumatic for those afflicted and for family caregivers. The WHO estimates that families spend $604 billion a year caring for a family member with dementia, and the costs for care and number of cases are expected to rise globally.

The burden on governments in low-and middle-income countries (LMIC) is expected to significantly increase as improved healthcare and life spans result in more cases of dementia while the consequences from declining fertility and changing population demographics results not only in smaller families but in fewer family caregivers. The result will impact elderly women and men who have no family member to care for them and who must rely on governments for assistance. Presently, the report warns, most governments are ill-equipped to meet these needs and presents a growing challenge that directly affects the dignity, protection, and survival of millions.

The message to developing nations which may believe they are exempt from these concerns is blunt, "In many LMIC the belief persists that these needs can and are being met through family support, despite growing evidence to the contrary." The report warns, "In LMIC, despite a greater reliance on the family unit as a resource, family support is neither ubiquitous nor comprehensive. Traditional forms of support are being undermined by greater internal and international migration, declining fertility, higher levels of education and the increased participation of women in the workforce which reduces the availability and willingness of children (principally daughters and daughters-in-law) to provide care."

In some LMIC, governments are attempting to place responsibility for the financial support and care of older parents firmly upon families. India is cited as an example. In 2007 the Parliament passed a law "requiring children to support their parents, with those who fail to do so facing a fine or brief prison term. The law was passed in response to concerns that older persons are being neglected both physically and financially by family members. The legislation also provided for the state to set up old-age homes, access being limited to the poor and the childless. Such legislation is likely to be only partially effective in extending and deepening social protection."   

According to the report, less than a dozen countries currently have national programs addressing care for dementia and warns that to ensure that ageing populations are given the proper care and respect they deserve, steps need to be taken now. The health agency urges increased awareness of dementia, improved diagnosis, and the creation of support programs in societies worldwide.    

Governments should also be advised to consider the true cost of population control. The denial of life to children in the womb combined with a pervasive anti-child mentality results in the loss of valuable family members who provide love and care for parents and grandparents at the end of life. The family is the foundation of society and all its members have great worth and dignity.  

Smart and sustainable development recognizes that people are part of the solution, not the problem.