Health » Overview

Salzburg Global Seminar has long been a leading forum for the exchange of ideas on issues in health and health care affecting countries throughout the world. At these meetings agendas have been re-set affecting policy and practice in crucial areas, such as patient safety and the engagement of patients in medical decision making. In 2010, Salzburg Global Seminar launched a multi-year series of seminars to crystallize new approaches to global health and health care in the face of emerging challenges affecting us now and set to continue on through the coming generation.


Interviews and coverage from our Health programs

DY Suharya - My Work is a Thank You to My Mom
DY, pictured above, has more than 20 years of experience in public health, public private partnerships and communication
DY Suharya - My Work is a Thank You to My Mom
Mirva Villa 

“Soulful calling.” That’s how DY Suharya describes her work in raising awareness on dementia and working toward improving the quality of life of people with dementia and their caregivers. She is the founder of Alzheimer Indonesia, and the regional director of Alzheimer’s Disease International (ADI) Asia Pacific Region, overseeing 17 countries.

“I have this lifetime commitment to share with people, especially in the Asia Pacific, how you deal with it, how you prevent, reduce your risk, and how you empower, equip and provide support for people with dementia and caregivers, and advocate for person-centered care,” says Suharya. She raises the point while speaking at the Salzburg Global Seminar session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities.

The Asia Pacific countries are diverse, but there are some commonalities in terms of challenges with dementia care. One of the biggest challenges is providing support for people with dementia and their caregivers, which Alzheimer’s Disease International is trying to solve through Dementia Care skills training modules, supported by Master Trainers from Alzheimer’s Disease Association Singapore and other ADI members. The program gives local carers tools with which to provide high quality care.

“If you ask me about challenges, these countries are in a very different place in terms of where they are, and what they need varies. But one thing for sure is they need a pool of talent or a pool of experts or trainers.”

Suharya’s mother has been the inspiration behind her work. She was diagnosed with dementia in 2009, but now Suharya knows that her mother was displaying typical symptoms long before that without anyone realizing it. It caused a lot of tension between Suharya and her mother. “We had our arguments in the past because I did not know what’s going on in her brain.”

It drove her to look for work opportunities abroad, so she wouldn’t have to spend time at home. She ended up working as a journalist, and later as a public health communication consultant for organizations like the World Bank, WHO and UNICEF. She says, “I did everything that would take me away from Indonesia.”

One day, she received a call from her father, informing Suharya of her mother’s diagnosis. In 2012, she decided to come back home after 15 years of living abroad, gathered together her friends and asked them for help in setting up Alzheimer Indonesia, which launched in 2013, on her mother’s birthday. Campaigning to raise awareness of the early symptoms of Alzheimer’s has remained a prominent part of her work.

Suharya’s mother passed away six months ago, but her legacy continues in her work. “If not for my mom, I wouldn’t be here. It’s a thank you to her. Because of my experience, I feel like I can activate people’s highest potential, because my potentials were activated through my mom and inspired through the journey of caring for her with the support of my dad and siblings.”

In four years, Alzheimer Indonesia has grown in size and stature. This has included a comic book launch, film festival and choir concert being some of the highlights. There are now support groups in 21 cities in Indonesia, a WhatsApp support group and more than 1,000 volunteers. “Everything I dreamed of four years ago,” remarks Suharya.

The newest campaign, called “Love Your Parents,” wants to remind young people to be understanding toward the struggles their parents with dementia might have, to respect their parents and spend quality time with them.

“You cannot raise your voice to a person with dementia. You cannot make the same mistakes that I did. You cannot be angry because you’re accompanying your parents to a bank, and they don’t know where their ATM card is or how to use the telephone.”

Suharya describes herself as a big believer in collaboration and partnerships. As the session progresses, she hopes to see some of the discussion and initial plans held during the session realizing themselves in the future. She says, “I’m expecting a concrete collaboration that works as a platform to people who share similar goals – whatever they are good at. I like to connect people, and I like to make things happen."


The session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice and The Mayo Clinic. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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Innovations in Dementia Care - Reducing the Stigma
Innovations in Dementia Care - Reducing the Stigma
Salzburg Global Seminar 

Stigma is difficult to define, but you know it when you feel it. That was the message which started the second day of the Salzburg Global session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities.

The message was delivered by William Hu, assistant professor of neurology at Emory University, as he moderated a discussion which explored how stigma around dementia varies from country to country and the different ways it is being addressed.

Raising awareness of dementia and improving education is not just about providing communities with a greater understanding. It’s also about changing the self-perception of those living with dementia.

Chris Roberts, a Dementia Friends Champion and Ambassador for the Alzheimer’s Society, said parts of the media had accentuated the stigma around dementia, and that society had reached a point where people failed to realize there was a beginning and a middle to every illness.

Roberts, who has a diagnosis of mixed dementia, vascular damage and Alzheimer’s, suggested people should stop using the word “dementia” and start referring to the different conditions by their own names.

Participants considered the different ways in which the stigma around dementia is reinforced. They reflected on the misuse of language and the patient and carer roles which are often assigned at the point of diagnosis.

One participant said stigma should be challenged from the ground up through education. This point was echoed by another participant who called for a change in curriculum that would provide more opportunities for students to interact with people living with dementia.

Participants shared experiences between themselves throughout the session. The group heard how one man living with dementia in Nigeria was unable to openly share his experience, despite wanting to. The people around him would not let him. The stigma was so strong they feared they would be accused of witchcraft.

To reduce the stigma, a new behavioral change will have to be generated. In Indonesia, the media has played an important role in this regard. A series of multimedia campaigns have increased interest in the subject and has led to requests for more people with dementia to tell their stories.

Advocates and people living with dementia can continue to breakdown barriers by engaging with people from their own countries and communities.


The session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice and The Mayo Clinic. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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Innovations in Dementia Care - Making a Difference in People's Lives
Albert Mulley, Veronique Roger, and John Lotherington set the scene on the first day of the session
Innovations in Dementia Care - Making a Difference in People's Lives
Salzburg Global Seminar 

Policymakers, clinicians, carers and service users from around the world have convened at Schloss Leopoldskron, Salzburg, to tackle one of the most serious and growing health challenges for health care.

Around 40 participants from 14 countries met on Tuesday afternoon for the start of the Salzburg Global session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities.
This session is part of Salzburg Global’s multi-year series Health and Health Care Innovation in the 21st Century. It is being held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice, and the Mayo Clinic.

For the next few days, participants will discuss the challenges people living with dementia experience and explore ways in which to better support them and their families.

To set the scene, the six-day program began yesterday with a panel discussion involving session co-chairs Albert Mulley and Veronique Roger.

Roger, director of the Mayo Clinic Center for the Science of Health Care Delivery, described Salzburg Global as a “unique setting” to reflect on “really important critical health issues.” She suggested global well-being would require more than the input of the health care system. This view was echoed by Mulley, managing director for global health care delivery science at The Dartmouth Institute, when he suggested there were other factors to consider.

Mulley said there was a false assumption that the more money spent and the more done on health care interventions would lead to better health and well-being for all. Mulley said social determinants, behavior and genes provided a far greater contribution.

Taking these views into account, participants began to consider questions they would like answered during this week’s program. This included: What do we mean by a dementia-friendly community?

While the meaning and term continue to be debated among participants, several did agree any chance of making progress in this field was dependent on political will and that people living with dementia also had to be involved in the process.

In many countries, there is still much to be done in building awareness around dementia and helping people understand the seriousness of the issue. Cultural differences have to be taken into account when reviewing what actions might be effective in different regions.

These talking points, and more, will continue to be analyzed in the days ahead as the session continues.


The session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice and The Mayo Clinic. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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Changing Minds – Innovations in Dementia Care and Dementia-Friendly Communities
Changing Minds – Innovations in Dementia Care and Dementia-Friendly Communities
Tomas De La Rosa 

Dementia, according to the US-based Mayo Clinic, is not a specific disease but rather “a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with daily functioning.” Due to the variety of health issues that involve memory loss, ensuring people with dementia receive the correct support is often a challenge, as each case possesses a different cause. Additionally, traditional health care models often fall short for people and families affected by dementia, due to the co-morbidities experienced in later life and because these models focus primarily on the physical health process and not on the full lived experience.

Dementia is considered to be as one of the most serious and growing health challenges for health care services, social care, and communities and families, especially in countries with aging populations. The high costs that come with the care required by people with dementia also represent a significant challenge, as according to the 2015 World Alzheimer Report, worldwide costs of dementia in 2015 represented nearly 1.1% of global GDP.

From Tuesday, and for the next five days, approximately 40 participants from 14 different countries, will convene at Schloss Leopoldskron, in Salzburg, Austria. The Salzburg Global Seminar session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, will see policymakers, clinicians, carers and service users discuss the challenges and stigmas people with dementia go through, ways of offering better support for them and their families, as well as how the concept of dementia-friendly communities and their innovations can vary from a country to another, and the importance and potential advantages, or harms, of early diagnosis.

Part of the multi-year series Health and Health Care Innovation in the 21st Century, it is expected the session will build on the discussions of past sessions, as well as yield new cross-border collaborations between participants to share their best innovation practices in dementia care and dementia-friendly community, create action plans devised for specific country or thematic contexts, and work on a Salzburg Statement on principles that should guide innovation in dementia care.

Previous sessions have resulted in successful campaigns such as the Salzburg Statement On Shared Decision Making from the 2010 session, The Greatest Untapped Resource in Health Care? Informing and Involving Patients in Decisions about Their Medical Care and the nine “Salzburg Questions” that came as a result of last December’s session, Rethinking Care: Toward the End of Life. Using the hashtag #allmylifeQs, participants, peers and interested members of the general public joined together on Twitter on a monthly basis to answer challenging questions about how we wish for ourselves, patients and loved ones to be treated in our dying days. It is expected that this year’s session will provoke similar difficult yet productive debate.

On the importance of this year’s session and its discussions, Salzburg Global Program Director John Lotherington said, “As populations age, more and more of us will live with dementia, with the still very limited prospects of health care interventions even just slowing its progress. But initiatives around the world to create dementia-friendly communities have sprung up to support people with dementia to continue living their lives to their full potential.

“This session will bring together people from around the world to exchange ideas, debate what works best in responding to dementia in diverse contexts, and clarify how to extend and deepen dementia friendly communities.  And a hypothesis is that such efforts in relation to dementia are also enhancing the humane values at the heart of communities in general.”


The session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice and The Mayo Clinic. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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Irene Higginson - What future research is needed to improve care for people with advanced illness & towards the end of life
Irene Higginson - What future research is needed to improve care for people with advanced illness & towards the end of life
Irene Higginson 

This article first appeared on the EAPC blog, which will continue to publish more posts on the Salzburg Question series. It refers to the ninth Salzburg Question: What future research is needed to improve care for people with advanced illness & towards the end of life. Irene Higginson, Professor of Palliative Care & Policy and Director of the Cicely Saunders Institute, King’s College London, explains why research is so important, and what people can do to support it.

Palliative care puts the person before the disease. (View our video here). Our role is to look after the whole person and those close to them, and this means assessing and offering the very best in therapies, treatment and care, to help people live well despite their illness as well as controlling symptoms at the end of life. The person-centred approach does not mean that we have it right yet; it should mean striving to improve what we do.

As a doctor trained dually in palliative medicine and public health medicine, I have long been concerned that the treatments, therapies and services that we can offer patients and families need to improve. In the future, I want to be providing patients and families with better treatments, therapies and care, especially in the hard to manage areas.

Research needs to test and discover better treatments for the many complex physical problems and symptoms that people have, such as breathlessness, fatigue, frailty, pain and nausea, as well as for emotional, social and spiritual issues. There is a need for research into better ways to support those who currently miss out on the best in palliative care, especially those groups that form part of growing populations (such as older people with multiple morbidity) who are most likely to require palliative care in the future. We also need to be realistic. Health and social care resources are constrained in many countries, so we need research into solutions that are cost-effective. Research into better services is also vital, as services are a key component to influencing quality of life for people.

Those close to the patient often provide so much, and research into ways to support them is urgently needed. We work closely with our Patient and Public Involvement (PPI) group, whose feedback and insights enable us to steer our research according to the needs and concerns of the people who will directly benefit from advances in palliative care practice and provision. Pam Smith, one of our PPI members, describes her reasons for becoming involved in the work of the Institute:

“Without ongoing research into palliative care, the lives of the people suffering from advanced illness, and also the lives of their carers, will never be improved. A compassionate society cares about the people who live in it!”

Scientific discovery takes time to progress. Palliative care has had some major successes over the years, but now we need to be thinking about what people will need in five to ten years’ time, and what research, investment, workforce and capacity are required to deliver this. So with this #allmylifeQs, I am asking all of you who read this to speak to four other people today about why you think that research is important, and what you can do to support it.

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Ninth Salzburg Question to Launch on World Science Day for Peace and Development
Irene Higginson, the director of Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, speaking at Salzburg Global
Ninth Salzburg Question to Launch on World Science Day for Peace and Development
Salzburg Global Seminar 

An online conversation about end of life care will continue on Friday when the ninth Salzburg Question is launched.

The last question in the series will ask people to consider what future research is needed to improve care for people with advanced illnesses and those toward the end of their lives.

The
Salzburg Questions series started earlier this year on February 20 and has engaged people from all around the world.

Those who have been participating in the discussion have been using the #allmylifeQs hashtag. Between the launch of the series and November 10, the hashtag received more than 10 million impressions on Twitter and was used in more than 3,300 tweets.

The launch of the ninth question will coincide with World Science Day for Peace and Development.

November's question is - What future research is needed to improve care for people w advanced illness & towards the end of life?

Irene Higginson, the director of Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, will help lead the discussion.  

The Salzburg Questions series has nine questions on matters involving palliative care. Each month, different individuals and institutions at the heart of the debate have shared a different question coinciding with an international day.

These individuals and institutions were involved in Session 562 - Rethinking Care: Toward the End of Life. Other Salzburg Global Fellows who have led discussions so far include Agnes Binagwaho, Lynna Chandra, Suresh Kumar, Sheila Payne, Emmanuel Luyirika, Richard Harding, Bruce Chernof, and Stephen Connor.

Salzburg Global Fellows are encouraged to take part in the conversation on Twitter on the day and afterward. They can also take part by sharing blog posts around each question.

Blog platforms could include ehospice, the EAPC blog, Palliverse, and the IAHPC Newsletter.

Participants on Twitter have already linked to research, podcasts, and papers during their discussions.

If you hold a debate, workshop or Q&A event on a Salzburg Question, please film it so it can be uploaded to a dedicated YouTube channel. Send your video to katie.witcombe@kcl.ac.uk.

A Twitter list of Salzburg Global Health Fellows has been created. If you would like to be added to this list, please let us know by subscribing or contacting us on Twitter at @SalzburgGlobal.

List of dates, questions, and people leading discussions

20 February 2017 - World Day of Social Justice - Why aren't countries accountable to commitment on #EOL care for vulnerable people? - Agnes Binagwaho

20 March 2017 - World Happiness Day - Is dying well as important as living well? - Lynna Chandra

07 April 2017 - World Health Day - How have you prepared for your death? - Suresh Kumar

15 May 2017 - World Family Day - Will caring for your dying loved one bankrupt you emotionally and financially? - Sheila Payne

20 June 2017 - World Refugee Day - 145 countries signed bit.ly/2ah31bH why do refugees have limited access to quality health care and #EOL care? - Emmanuel Luyirika

11 July 2017 - World Population Day - How and what do you measure to ensure quality palliative & EOL care? - Richard Harding

28 September 2017 - International Right to Know Day - Doctors, Nurses, do you want to die the way your patients die? - Bruce Chernof

13 October 2017 - World Hospice and Palliative Care Day* - Do you know how to access #palliative care when you need it? - Stephen Connor

10 November 2017 - World Science Day for Peace and Development - What future research is needed to improve care for people w advanced illness & towards the end of life? - Irene Higginson

*This year's World Hospice and Palliative Care Day is taking place on Saturday, October 14. We will launch the question the day before to generate more discussion.

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Chochoe Devaporihartakula – A clean and green Asia needs compliance and transparency
Unhealthy levels of air pollution affect the lives of millions living in Asian mega-cities like Shangai, pictured, writes Chochoe Devaporihartakula
Chochoe Devaporihartakula – A clean and green Asia needs compliance and transparency
Chochoe Devaporihartakula 

Devaporihartakula will be a participant at the upcoming session in the series The Asia We Want: Building Community Through Regional Cooperation. All participants were invited to share their own vision for “the Asia we want.”

Urbanization is increasingly perceived as a serious issue that threatens to undermine recent advances towards sustainable development in Asia. Currently, 48 percent of the population in Asia is living in urban areas and is expected to grow to 64 percent by 2050 according to the United Nations. The highest rate of urban population growth is predicted to take place in Asia and Africa, which will have significant consequences on natural resources, energy consumption, greenhouse gas emissions and climate change, while air pollution levels attributable to urban development already far exceed World Health Organization (WHO) standards and are likely to rise substantially in the coming decades.

While other regions are exposed to unhealthy levels of air pollution, Asia accounts for the largest share of ambient PM2.5 and is responsible for millions of deaths. In Southeast Asia, urban air pollution is ranked among the highest in the world with many cities showing pollution levels five to 10 times above WHO limits. Those of us who live in Southeast Asia’s mega-cities know that air pollution is a problem. But the public is only now beginning to learn just how dangerous this problem has become. A recent study by the University of Chicago found that air pollution is shortening the lives of Vietnamese citizens by 1.16 years. Earlier this year, Harvard University and Greenpeace estimated that air pollution from the region’s coal-fired power plants could be killing 20,000 people per year. It is often the poor who suffer disproportionately from environmental health risks associated with air pollution effects.

The Asia we want can only be made clean and green by ensuring the effectiveness of environmental compliance and increasing transparency and accountability of all stakeholders. Every country has limited resources that must be used effectively to foster greater compliance with the law and improved protection for people and the environment. National governments, city officials, local communities, and regional cooperation through networks such as the Asian Environmental Compliance and Enforcement Network (AECEN) must collaborate to make sure steps are taken in order to regulate and monitor pollution sources at the very early stage. This would ensure fewer polluting sources, reduced health impacts, more efficient economic growth, and greater economic returns to the country. Most Asian countries currently lack advanced technology used for pollution monitoring. Therefore, proper mechanisms such as prioritizing high risk threats through regulations, incentive programs to motivate compliance, and advanced technology for more accurate and less expensive monitoring can help all countries leap forward in the effectiveness of their compliance and enforcement efforts.

Dealing with air pollution is a global challenge but the good news is that during the first Asia-Pacific Ministerial Summit on the Environment held in Bangkok in September 2017, 30 countries in Asia-Pacific committed to move towards a clean and green Asia-Pacific with highlights on the urgency of addressing environmental health risks associated with pollution and promoting resource efficiency measures and practices. Let’s hope and see if this initiative can really lead to sustainable urban development and nature-based solutions – and not just another commitment that is left on the shelf.

Chochoe Devaporihartakula is the program manager for the Institute for Global Environmental Strategies (IGES) and the Training Event Specialist for the Regional Resource Center for Asia and the Pacific at the Asian Institute of Technology (AIT).


Session 591 - The Asia We Want: Building Community Through Regional Cooperation I - A Clean and Green Asia - is the first session of a new multi-year series held in partnership with the Japan Foundation. For more information on the Session, please click here. To keep up to date with the conversations taking place during the session on social media, follow #SGSasia.

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