By Joseph Chamie
PORTLAND, USA, Apr 15 2025 – As the world’s population of 8.2 billion people increases in size and becomes older due to demographic ageing, the number of people experiencing the long goodbye, or dementia, is rapidly rising.

In 2025, the number of people living with dementia worldwide is estimated to be approximately 60 million. That global number is expected to more than double by 2050, reaching approximately 153 million. That rise presents considerable challenges to social care and health systems as well as families over the coming decades. Again, dementia is rising largely due to world population’s growth and demographic ageing (Table 1).

Source: United Nations and World Health Organization.

By mid-century, the world’s population is expected to gain an additional 1.5 billion people, increasing to 9.7 billion with its median age increasing from 31 years to 36 years. Also over the next twenty-five years, people are expected to live longer with the world’s life expectancy at birth projected to increase from approximately 73 years to 77 years.

Over that same twenty-five-year time period, the world’s population is expected to experience demographic ageing. The proportion of the world’s population aged 65 years or older, for example, is projected to increase from 10% to 16% and the proportion aged 80 years or older is expected to more than double from 2% to 5%.

Dementia is the leading cause of disability and dependency among the elderly. Without individuals, families, communities and governments earnestly addressing and implementing the modifiable risk factors for dementia, the numbers of men and women living with dementia are expected to increase significantly throughout the 21st century.

Despite the expected worldwide rise in dementia, people living with the syndrome should continue to have the same human rights as other members of a population. Among those rights include the right to dignity, autonomy and participation in decision making about their lives.

Unfortunately, however, it is often the case that people living with dementia are denied the basic human rights and freedoms available to other members of a society.

It is also important for the general public, business leaders, healthcare providers and government officials to recognize and understand that dementia is NOT a part of the normal ageing process (Table 2).

Source: World Health Organization and Alzheimer’s Disease International.

Dementia is a syndrome caused by diseases that affect the brain. The condition is not just about memory loss but also affects thinking, behavior and emotion.

Dementia is a general term that results from a variety of diseases and injuries that affect the brain and affect memory, thinking and the ability to perform daily activities. Although many people with dementia can live reasonably well, the condition tends to get notably worse over time and is a significant cause of death among older adults.

Dementia may develop after a stroke or in the context of certain infections such as HIV; as a result of harmful use of alcohol; repetitive physical injuries to the brain; and nutritional deficiencies.

While currently there’s no cure for the long goodbye, various services and support are needed for people living with dementia and their caregivers.

Also, it is NOT the case that nothing can be done to prevent or reduce one’s chances of experiencing the long goodbye. The Lancet Commission on Dementia estimated that approximately 45% of all dementia cases worldwide could be prevented or delayed by addressing 14 modifiable risk factors.

Among the modifiable risk factors are alcohol abuse, smoking, obesity, physical inactivity, social isolation, hearing loss, lower levels of education and vision loss. Other modifiable risk factors for dementia include diabetes, high blood pressure, air pollution, brain injury, depression and high LDL cholesterol (Table 3).

Source: The Lancet Commission on Dementia.

Dementia mainly affects the elderly and is generally more common among women than men. Women tend to live longer than men, thereby increasing their risk of developing dementia. In addition, biological reasons differing between men and women are believed to contribute to the differences in the chances of having dementia.

Surveys indicate that nearly 80% of the general public are concerned about developing dementia at some point in their lives. However, it is important to recognize that not everyone will experience dementia as they age.

Alzheimer’s disease is the most common form of dementia, accounting for approximately 60% to 70% of the cases. Also, the large majority of those with Alzheimer’s disease are estimated to be women. Other types of dementia include vascular dementia, Lewy body dementia that may occur with Parkinson’s disease, frontotemporal dementia and mixed dementia.

The Lancet Commission on Dementia estimated that approximately 45% of all dementia cases worldwide could be prevented or delayed by addressing 14 modifiable risk factors

While Alzheimer’s disease is not a part of normal ageing, the chances of getting the disease rises as one grows older. Also, having a family history of Alzheimer’s increases one’s risk of contracting the disease. Some preliminary research suggests that antivirals, antibiotics, vaccines and anti-inflammatory drugs could possibly help to treat, prevent or reduce the risk of dementia.

Among the common symptoms of dementia are: confusion; memory loss; needing help with daily tasks; problems with language and understanding; changes in personality including unusually anxious or irritable; getting lost when walking or driving; and having trouble following a conversation.

Although consciousness is not affected by dementia, the decline in cognitive function is common and may also be accompanied by changes in emotional control. In addition, sometimes changes in mood and behavior may precede the loss of memory.

In the early stages, the symptoms of dementia may be small, irregular and subtle. Over time, however, the symptoms tend to get worse and become more noticeable. Most people with dementia end up needing others, especially family members, to provide them assistance for their daily activities.

The various consequences of the long goodbye are considerable, impacting individuals, families, local communities and societies. The general lack of awareness and understanding of dementia by the public and government officials delays timely diagnosis and the provision of appropriate care as well as taking preventive actions.

If an individual is experiencing cognitive changes, that person should seek medical evaluation. It is also important to understand that many people with dementia can still live well.

However, it is estimated that up to three quarters of those living with dementia worldwide have not received a diagnosis. Moreover, those individuals that have a dementia diagnosis tend to be reluctant to indicate their condition because of the stigma associated with it. Also, surveys have estimated that approximately one-third of care givers worldwide report that they have hidden the diagnosis of dementia of a family member.

Besides dementia leading to dependency for the individual having the syndrome, it typically substantially increases the emotional burdens and health consequences on caregivers. Moreover, dementia often results in considerable economic costs relating to the provision of needed healthcare services.

The highest levels of dementia around 2024 are typically reported among the older populations of more developed countries. Finland and the United Kingdom have the highest reported rates of dementia of 55 and 43 per 100,000 population, respectively. The proportion of those aged 65 years or older having dementia is about 7% in both countries. In eighth place is the United States with a rate of dementia of 33 per 100,000 population, with approximately 10% of its population aged 65 years or older having dementia (Figure 1).

Source: CEOWORLD Magazine.

While dementia is rapidly rising worldwide, it is important for people to understand that dementia is NOT a normal part of ageing. Dementia is a syndrome caused by diseases that affect the brain and a number of things can be done to prevent or reduce an individual’s chances of getting the long goodbye.

In brief, staying mentally, physically and socially active, not smoking, eating a balanced healthy diet, keeping alcohol consumption within recommended limits, reducing hearing and vision loss, and keeping blood pressure and cholesterol levels in check contribute to maintaining healthy brains as men and women age.

In conclusion, the continuing growth of the world’s population and demographic ageing during the 21st century are contributing to the expected rise of dementia that present considerable challenges to social care and health systems as well as families. If individuals, families, communities and governments earnestly address dementia’s various modifiable risk factors, their collective efforts can contribute significantly to reducing the worldwide rise of the long goodbye.

Joseph Chamie is a consulting demographer, a former director of the United Nations Population Division and author of numerous publications on population issues, including his recent book, “Population Levels, Trends, and Differentials”.

By Andrew Firmin
LONDON, Apr 15 2025 – The recent US court case that ordered three Greenpeace organisations to pay damages of over US$660 million to an oil and gas company was a stunning blow against civil society’s efforts to stop runaway climate change and environmental degradation. The verdict, following a trial independent witnesses assessed to be grossly unfair, came in reaction to Indigenous-led anti-pipeline protests. It’s vital for any prospects of tackling the climate crisis that Greenpeace’s appeal succeeds, because without civil society pressure, there’s simply no hope of governments and corporations taking the action required.

Civil society is more used to winning climate and environmental court cases than losing them. As CIVICUS’s 2025 State of Civil Society Report outlines, litigation has become a vital part of civil society’s strategy. Just last year, a group of Swiss women won a groundbreaking precedent in the European Court of Human Rights, which ruled the government was violating their rights by failing to cut greenhouse gas emissions. South Korea’s Constitutional Court found that the lack of emissions reduction targets breached young people’s constitutional rights. Other positive judgments came in countries including Ecuador, India and Italy. At the last count, climate lawsuits had been filed in 55 countries.

But fossil fuel companies have noticed civil society’s litigation successes and are also taking to the courts. They have the deep pockets needed to hire expensive lawyers and sustain legal actions over many draining years. Fossil fuel companies have filed over 150 lawsuits intended to silence criticism in the USA alone since 2012.

Protest restrictions

Civil society is doing all it can to demand climate action that matches the scale of the crisis, winning victories by combining tactics such as street protest, non-violent direct action and litigation, but it’s coming under attack. Peaceful protesters are being jailed and activists are facing violence in many countries. Alongside the chilling effect on protests of lawsuits such as the one against Greenpeace, governments in several countries are criminalising legitimate forms of protest. Globally, climate activists and defenders of environmental, land and Indigenous rights are among the groups most targeted for repression.

Security force violence and mass arrests and detentions, particularly of protesters, are in danger of becoming normalised. Last year in the Netherlands, authorities detained thousands for taking part in mass roadblock protests demanding the government keep its promise of ending fossil fuel subsidies. In France, police used violence at a protest against road construction in June and banned another in August. In Australia, activists opposing a huge coal terminal and a gas project were among those arrested in 2024.

In Uganda, campaigners against the East African Crude Oil Pipeline continue to face state repression. Last year, authorities arbitrarily arrested 11 activists from the campaign. These activists have faced intimidation and pressure to stop their activism.

Campaigners from Cambodia’s Mother Nature group paid a heavy price for their work in trying to stand up to powerful economic and political interests seeking to exploit the environment. Last July, 10 young activists were given long jail sentences after documenting river pollution.

Some states, like the UK, have rewritten protest laws to expand the range of offences, increase sentences and strengthen police powers. Last July, five Just Stop Oil activists were handed brutally long sentences of up to five years for planning a roadblock protest. The UK now arrests environmental protesters at three times the global average rate.

Italy’s right-wing government is introducing new restrictions. Last year, parliament passed a law on what it calls ‘eco-vandals’ in response to high-profile awareness-raising stunts at monuments and cultural sites. Another repressive law is being introduced that will allow sentences of up to two years for roadblock protests.

The struggle continues

Yet civil society will keep striving for action, which is more urgent than ever. 2024 was the hottest year on record, and it was crammed with extreme weather events, made more likely and frequent by climate change. Far too little is being done.

Fossil fuel companies continue their deadly trade. Global north governments, historically the biggest greenhouse gas emitters, are watering down plans as right-wing politicians gain sway. International commitments such as the Paris Agreement show ambition on paper, but not enough is achieved when states come together at summits such as last December’s COP29 climate conference.

There’s a huge funding gap between what’s needed to enable countries to transition to low-carbon economies and adapt to climate change. Global south countries want the most powerful economies, which have benefited from the industries that have caused the bulk of climate change, to pay their share. But of an estimated annual US$1.3 trillion needed, the most global north states agreed to at COP29 was US$3 billion a year.

Nor are fossil fuel companies paying their share. Over the past five decades the oil and gas sector has made profits averaging US$2.8 billion a day. Yet companies are currently scaling back renewable energy investments and planning still more extraction, while using their deep pockets to lobby against measures to rein them in. Making the global tax rules fairer and more effective would help too: US$492 billion a year could be recovered by closing offshore tax loopholes, while taxes on the excessive wealth of the super-rich could unlock US$2.1 trillion a year, more than enough to tackle the climate crisis.

Civil society will keep pushing, because every fraction of a degree in temperature rises matters to millions. Change is not only necessary, but possible. For example, following extensive civil society advocacy, last September the UK shut down its last coal-fired power station.

Civil society played a major role in campaigning for the EU’s Corporate Sustainability Due Diligence Directive, which requires large companies to align with the Paris Agreement. And last December, the International Court of Justice began hearing a case brought by a group of Pacific Island states, seeking an advisory opinion on what states are required to do to address climate change and help countries suffering its worst impacts. This landmark case originated with civil society, when student groups urged national leaders to take the issue to the court.

Trump’s return to the White House has made the road ahead much rockier. The world’s biggest historical emitter and largest current fossil fuel extractor has again given notice of its withdrawal from the Paris Agreement, torn up renewable energy policies and made it easier to drill for fossil fuels. In response, other high-emitting nations must step up and show genuine climate leadership. They should start by committing to respecting the right of civil society to hold them to account. States and companies must cease their attacks on climate and environmental activists and instead partner with them to respond to the climate emergency.

Andrew Firmin is CIVICUS Editor-in-Chief, co-director and writer for CIVICUS Lens and co-author of the State of Civil Society Report.

For interviews or more information, please contact [email protected].

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By Gareth Evans and Jennifer Welsh
NEW YORK, Apr 15 2025 – April marks Genocide Prevention and Awareness Month, a time to reflect on the history, causes and victims of past genocides and to mobilize the necessary resolve to confront risks facing populations around the world today who face the threat of genocide and other mass atrocity crimes not for anything they have done, but for who they are.

As we solemnly observe this month of commemoration, we also reflect on the 20th anniversary of the UN General Assembly’s unanimous adoption of the Responsibility to Protect (R2P) principle – a concept which emerged in particular response to the international community’s failure to prevent the atrocity crimes committed in Rwanda and the former Yugoslavia.

By shifting the focus to every state’s ‘responsibility to protect’ rather than the big powers’ ‘right to intervene,’ by emphasizing prevention as well as reaction, and by committing to international collective action – including, when necessary, through the collective security provisions of the UN Charter – R2P made possible a global consensus completely lacking in previous decades.

The 2005 World Summit brought us closer than ever to translating the post-Holocaust dream of “never again” into a meaningful reality. It was a significant diplomatic achievement for all heads of state and government worldwide to acknowledge that genocide, crimes against humanity, war crimes and ethnic cleansing – even when committed within a sovereign state – are matters of international concern and thus demand timely and decisive response.

But 20 years later – with all too obvious horrors and civilian suffering still occurring in Gaza, Sudan, the DRC, Myanmar and elsewhere – it is clear that R2P is still at best a work in progress. It is time to reflect on what we have learned about preventing and responding to the atrocity crimes outlined in the World Summit Outcome Document, and to focus on how we can do better.

On the plus side, considerable progress has been made in our collective knowledge of the risk factors, causes and dynamics that drive mass atrocity crimes and in enhancing our responsiveness to warning signs, including through the development of the UN’s Framework of Analysis for Atrocity Crimes. There is now a solid understanding of the wide range of preventive measures available, which includes not only a response to imminent and emerging risks, but also instituting policies, practices and structures that build long-term societal resilience to atrocity crimes.

Alongside these advances is a growing awareness that the different tools available for changing the behavior of would-be perpetrators, or for making victims less vulnerable, must be situated in a more coherent preventive strategy that is tailored to each context.

Moreover, the atrocity prevention agenda has been operationalized across the UN system. The creation of the Joint Office on Genocide Prevention and the Responsibility to Protect has been central to strengthening the UN’s early warning capabilities, as well as for developing the conceptual and practical aspects of R2P.

Since the inception of the Special Adviser on the Responsibility to Protect role, successive Special Advisers have been instrumental in identifying risk factors and clarifying best practices by states, regional organizations and the UN system in response to the threat of atrocity crimes.

In addition, the regular cycle of UN Secretary-General reports and General Assembly debates has reinforced the principle and fostered greater consensus and shared understanding within the UN system. The Group of Friends of R2P, with over 55 members from across all regions, is an important mobilizing force within the UN to advance effective atrocity crime prevention and response.

Over 60 countries from all regions of the world, along with the European Union and Organization of American States, have also appointed an R2P Focal Point, an important step for institutionalizing atrocity prevention at the national level. The appointment of a national R2P Focal Point is crucial for strengthening domestic capacity to fulfill the responsibility to protect, including by improving intra-governmental and inter-governmental efforts to prevent and halt atrocity crimes.

Furthermore, the international community has also made strides in its willingness and capacity to hold perpetrators responsible through international investigative bodies and mechanisms, international courts and tribunals, and in national courts under the principle of universal jurisdiction. Transitional justice and memorialization also remain hallmarks of a broader commitment to deal with the past and promote truth, justice and non-recurrence.

Nonetheless, for all these significant institutional advances, we are all acutely aware that, 20 years on from the World Summit, the principle of R2P is under acute strain. There is a deeply troubling disconnect between the unanimous commitment to protecting populations from atrocity crimes and achieving consistent implementation and concrete preventive action.

All too often, effective national, regional and international action is inhibited by self-interested political arguments advanced in key institutions with a capacity to make a difference, including the UN Security Council. When principles and their practical application are contested it is time, more than ever, for UN member states to stand firm and do the hard work of continuing to find and build the consensus needed to protect populations at risk.

Moreover, there is a worrying decline in attention to atrocity crime prevention and the role of the Special Adviser on R2P within the UN Secretariat. This stands in stark contrast to the still very strong support from the great majority of UN member states and from civil society, human rights defenders, affected communities and victims’ and survivors’ groups around the world.

To consolidate the effectiveness of R2P, there is much more that needs to be done, and the work needs to start at home – not least at the UN Headquarters, but also on a national and regional level. At the core of R2P is a responsibility to invest in the institutional architecture to prevent the drivers of atrocity crimes from emerging or intensifying.

This anniversary year presents a crucial opportunity for the UN system, and particularly the UN Secretary-General and the Secretariat, to demonstrate ongoing commitment to fulfilling the responsibility to protect across all regions of the world.

The UN has proven time and again that it can mobilize resources and expertise to safeguard those at risk, with a notable track record of defending human rights and protecting vulnerable populations despite facing immense challenges. Rather than retreating from these efforts, it is critical that the UN and its member states redouble them, by honing and strengthening the capabilities needed to deliver effective prevention and response. Political and ideological differences must not be allowed to distract us from identifying signs of increased risk, wherever they may be, and taking early action to prevent atrocity crimes.

The strong commitments made in 2005 are as relevant today as they were 20 years ago. At a time of escalating conflicts, as well as threats to multilateralism and international justice, the UN Secretary-General and the UN must provide an alternative vision for the future in which a key element is the consistent implementation of R2P.

The future of R2P will only be secured if we – the UN system, intergovernmental and regional organizations, governments, civil society organizations and affected communities – fight for it and generate the political will to act. It would be a tragedy to give in to cynicism and skepticism, to overlook the continuing power of R2P as an inspiring ideal and to abandon the goal of seeing it fully and effectively implemented in all its dimensions.

This month of commemoration must serve as a reminder that indifference and inaction should never be an acceptable response whenever and wherever populations face the threat of genocide and other atrocity crimes.

Professor Gareth Evans is Co-Chair, International Advisory Board, Global Centre for the Responsibility to Protect; Dr. Jennifer Welsh is Chair, International Advisory Board, Global Centre for the Responsibility to Protect.

IPS UN Bureau

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By Jomo Kwame Sundaram
KUALA LUMPUR, Malaysia, Apr 15 2025 – US President Donald Trump has again seized global attention by arbitrarily imposing sweeping tariffs on the rest of the world. He reminds us America is still boss, claiming to ‘make America great again’ (MAGA) by ensuring ‘America first’ at everyone else’s expense.

Jomo Kwame Sundaram

Liberation Day?
His April 2 Liberation Day announcement triggered wild speculation over his proposal’s final form, implications, significance, and likely impacts, not only for the near future but also well beyond.

Since then, the world has been scrambling to understand better the president’s intentions to protect their interests. This has also triggered much talk about managing adjustment and enhancing resilience.

Shocked by his unilateral abandonment of the revised free trade agreement renegotiated during Trump 1.0, its North American neighbours were the first to engage publicly.

More recently, China’s ironically reciprocal response gave Trump another excuse for more punitively escalating his ‘reciprocal tariffs’. With little left to lose even before Trump’s latest tariffs against China, it said No to the Orange Emperor, switching the impact from manufacturing to agriculture.

Only major economies dare to retaliate. However, due to its geopolitics, including Trump’s demands for more ‘equitable’ NATO cost-sharing, an appropriately strong European response seems unlikely.

Many prioritise the Western alliance, while a few prefer other options. Sensing the ‘silence of the lambs’, the president has gloated over the steady stream of foreign leaders coming to ‘kiss my arse’.

Trump’s tariff fetish
The tariff announcement was not set in stone. It remains to be seen how much Trump’s support base, especially from the US corporate elite, will succeed in revising his measures.

He is unlikely to respond positively to opposition from abroad or even within the US. The tariffs will be tied up in legal and legislative procedures for some time, even after they go into effect.

The dissent of some Senate Republicans suggests the US Congress may reject the tariffs as a significant infringement on their Constitutional prerogatives.

Announced as executive orders, they are subject to judicial scrutiny. Of course, the White House will have to reconsider which battles to fight and which to concede without appearing to do so.

A face-saving compromise between the Republican-controlled Congress and the White House is increasingly likely. Attention can thus be diverted abroad to preferred targets such as China and Iran.

Some other countries, especially the BRICS, may also be hit to ‘save face’. The president can then claim he tried his best to MAGA but was foiled by foreign-connected opponents.

While Trump critics are making much of his subsequent revisions, concessions, amendments and postponements, the greater significance of his announcement lies elsewhere.

Divided we fall
Trump 2.0 will dictate the terms of US engagement with the world. He has already reminded everyone he is The Great Disruptor. Dismissing cooperation as for losers, his team’s purpose is to put others down.

Trump has subverted the World Trade Organization and all US-negotiated trade agreements except when it best serves its interests. He has given notice of selectively invoking multilateralism and the rule of law to serve his preferred interests best.

Although all European countries will be affected by Trump’s tariffs, each will be hit differently. Hence, developing a strong, unified European position will be difficult. This will deter other regional and plurilateral groupings from collective action.

In one stroke, Trump reminded the world that America remains number one and that he means business. Critics overlook his purpose and strategy by dismissing his methods and tactics as transactional, stupid or irrational.

Method to the madness?
Trump’s Council of Economic Advisors chairman, Stephen Miran, has offered an economic rationale for Trumponomics 2.0. He argues the world must pay for the ‘global public goods’ the US ostensibly provides, especially US military spending.

He also insists the US is doing the world a favour by allowing the US dollar to serve as the world’s reserve currency. He ignores how it earns seigniorage and the ‘exorbitant privilege’ of being able to issue debt to the rest of the world without having to repay.

His so-called Mar-a-Lago Accord purports to offer more financial stability through US dollar currency pegs and related digital currency arrangements, requiring payment flows to the US Treasury and Federal Reserve.

Trump has promised even more regressive tax reforms for the super-rich who generously funded his re-election campaign. As before, this will be obscured by some tax relief for the ‘middle class’.

The shift from potentially progressive direct taxation to more indirect taxation has already begun, with the proposed tariffs impacting purchases of merchandise imports.

Industrial policy redux?
Tariffs cannot simply restart long-abandoned production overnight. Earlier manufacturing jobs were lost to imports and the automation of production processes.

Reviving abandoned productive capacities and capabilities will mainly create poor jobs. ‘Fortress USA will attract some investments, mainly for the limited US market, but it cannot transform itself into the world’s manufacturing powerhouse it once was.

Recent reshoring efforts have proved embarrassingly unsuccessful. This has been evident with the difficulties of the forced relocation of the world’s leading (Taiwanese) semiconductor manufacturer to the US.

Trump’s turn to industrial policy is more backward-looking than progressive. It seeks to save uncompetitive old capacities rather than advance potentially competitive new investments, technology, productive capacities, and capabilities.

Also, investment and technology promotion need supportive policies, especially in human resources, research, and development, which are increasingly undermined by Musk-led government spending cuts.

IPS UN Bureau

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