The Gambia sets a regional precedent with its first dementia strategy
The Gambia has validated and adopted its first National Dementia Plan 2027–2031, becoming the first country in the WHO African Region to do so. The plan was finalized in Banjul on 29 September 2026 after a two-day stakeholder workshop that brought together government representatives, health professionals, development partners, civil society, academia and other stakeholders.
For a condition that often remains hidden until families are already coping with advanced disability, the policy shift is clinically consequential. Dementia affects memory, thinking and the ability to carry out everyday activities, yet symptoms are frequently misread as normal ageing. When that happens, diagnosis slips, support arrives late and families absorb the burden without guidance, training or formal backing.
A public health response built around earlier recognition
The plan is designed to move dementia out of the margins of health planning and place it inside a structured public health response. Its priorities include public awareness, risk reduction, early detection, diagnosis, treatment, care and support. It also calls for stronger health workforce capacity, better health information systems, more research, caregiver support, and mechanisms for coordination, accountability and monitoring.
In practical terms, the plan links dementia care with mental health, noncommunicable disease services, disability, social protection and healthy ageing initiatives. That broader integration matters because dementia does not sit neatly inside a single specialty clinic. It cuts across primary care, mental health, chronic disease management and social support, especially in settings where specialized services are limited.
A national framework can only work if clinicians, communities and policymakers are pointed in the same direction. The new strategy tries to do exactly that.
The burden is already measurable, and it is rising
Dementia is a growing public health challenge worldwide, affecting an estimated 57 million people. In The Gambia, modelled estimates place the number of people living with dementia at about 3,800 to 4,000, with projections rising to nearly 13,000 by 2050. As the population ages, the burden is expected to increase further.
Those numbers translate into repeated bedside consequences: delayed recognition, missed counseling opportunities, caregiver exhaustion and preventable crises when cognitive decline is identified too late. In systems without a clear pathway, patients may move between services without a diagnosis, while families remain responsible for everything from supervision to medication management to behavioral support.
Stigma compounds the problem. Misconceptions can isolate people living with dementia and intensify pressure on caregivers, who often shoulder the work informally and with limited assistance. The plan aims to counter that pattern through awareness campaigns, earlier identification and more reliable access to appropriate care closer to communities.
Policy coordination now carries clinical weight
The Ministry of Health’s National Mental Health Programme led development of the plan with financial and technical support from WHO at country, regional and headquarters levels. Officials framed the document as part of a larger mental health agenda already shaped by the Mental Health Policy 2025 to 2035, the Mental Health Investment Case and the Mental Health Bill awaiting passage into law.
Mr. Lamin Dampha, Permanent Secretary at the Ministry of Health, called for a whole-of-government effort to deliver the plan. He warned that a national plan has little value if it is left idle on a shelf. The point is not ceremonial adoption; it is whether the health system can convert policy language into routine recognition, referral and support.
Health systems often struggle most at the transition points: the first suspicion of cognitive decline, the first disclosure to a family, the first referral, the first explanation of prognosis. A strategy like this is meant to close those gaps by defining who does what, where care should begin and how patients should be followed over time.
Workforce training and caregiver support sit at the center
Dementia care depends heavily on front-line health workers, many of whom have limited access to specialized training. The plan emphasizes the need for knowledge and skills that allow workers to recognize dementia, support diagnosis and provide compassionate care. It also places caregivers squarely inside the response, recognizing that they often need reliable information, counseling and psychosocial assistance.
The WHO Representative’s office in The Gambia said the real measure of success will be whether the plan improves the lives of people living with dementia and those who care for them. Jarra Marega, Programme Manager of the National Mental Health Programme and National Technical Lead for the plan’s development, said many people remain undiagnosed or unsupported and that the framework should strengthen awareness, improve early identification and bring care closer to communities.
That clinical logic is hard to miss. Dementia does not improve through awareness alone, and diagnosis has little value if there is no pathway to follow. Communities need practical access points, and health workers need guidance that can be applied outside tertiary hospitals.
A regional model, but implementation will decide the outcome
The Gambia’s plan is being positioned as an example for other countries in the WHO African Region. It brings the seven action areas of the WHO Global Action Plan into four national priorities, offering a structured template for countries that have not yet established their own dementia strategies.
Even so, the central challenge lies ahead. Implementation will require sustained government leadership, adequate resources, collaboration across sectors and continued engagement with communities. Without those ingredients, awareness campaigns can fade, workforce training can stall and monitoring systems can remain underdeveloped.
The new plan gives The Gambia a policy framework; it does not yet deliver services by itself. What happens next will determine whether dementia care becomes a routine part of national health planning or remains a document with limited reach. The clinical stakes are straightforward: earlier recognition, better support and more coordinated care can change the experience of families already living with a condition too often mistaken for ageing.