Brain Health Policy in Europe

00:00:03: Welcome to the Brain Health Mission Podcast.

00:00:05: Exploring how science, policy and everyday choices shape the health of your brain... ...and what you can do to protect

00:00:12: it!

00:00:14: Hello and welcome back to The Brain Health mission podcast where we explore the science strategies & stories behind brain-health in neurology.

00:00:23: I'm your host Dr Janna Middelford Hof neurologist and treasurer at the European Academy of Neurology.

00:00:30: In today's episode, we will talk about what happens when we are lobbying for the brain.

00:00:36: When brain health is to become an issue in European politics.

00:00:41: Joining me as our special guest is Fred Desterbeck directly from the European Brain Council in Brussels!

00:00:49: To start us off, Fred can you tell a little bit of yourself?

00:00:55: Hello Yana thanks for your invitation.

00:00:57: So I'm Fred Destrobeck, I am the Executive Director of an organisation called The European Brain Council which is based in Brussels and well running advocacy work for brain health, brain innovation and brain research with EU institutions.

00:01:14: I'm trained as a political scientist In international relations, European affairs... ...I also specialised in association management.

00:01:22: And well, yeah.

00:01:24: I've been around in EU circles and what we call the Brussels bubble for twenty-five years now which is obviously making fields older by today

00:01:34: For the European Brain Council?

00:01:36: To the listeners to me aswell What's actually the European brain council ?

00:01:42: Who does it consist of?

00:01:45: Well historically The European brain councils so the EBC was born from this idea that we needed to bring the community together and speak, so-to say with one voice.

00:01:59: Because there was a lot of fragmentation in the ecosystem... ...and the claims by all the organisations involved in the brain space when it came to the first programmes providing public funding for neuroscience In the context of framework programmes for research innovation developed by the European Commission.

00:02:22: So that was, I would say in the late nineties.

00:02:26: And The European Commission themselves recognized there were needs to try and harmonize together key societies because they had too much dissonance with their message being brought In a sense where they recognize the need to prioritize better brain research or neuroscience as it were, but they didn't really understand how to do that and in how to achieve this.

00:02:57: And it was at a time where neuroscience was considerably lagging behind compared to fields like cancer research, diabetes, cardiovascular... There was actually this vision by the president of EFNS back then, predecessor of Yen So, Professor Olesen who brought together then not only neurologists but also psychiatrists neurosurgeons basic neuroscientist and Also invited the patients Recognizing that the voice of the patient's in this equation was extremely important as well As than the industry because we really had This idea of embracing The whole of value chain And try to understand what was the unmet need and how we could be then convincing to EU institutions.

00:03:47: So that's all.

00:03:48: the EBC got structured around patient organizations, And we now represent of the federations people living with a neurological condition as well as the federation of people with mental disorder.

00:04:01: Then next through the patient groups We have professional and scientific societies among which the EN but also EPA for the psychiatrist ECNP, neuropsychopharmacologists and neurosurgeons as I said basic neuroscientists.

00:04:16: So really like the big disciplines having a stake in this change is promotion of brain research and positive brain health And obviously we also work with industry partners via an industry board and mechanism for financial support activities.

00:04:34: But again having these vision to how we advance brain research How we incorporate innovation in healthcare systems and how we defend brain health for the European population.

00:04:46: And I would say defending that at national, European and international level.

00:04:52: So it's actually... It was a small revolution.

00:04:55: i would say That for the first time all forces are joined together For The Brain.

00:05:00: There had been sporadically separate alternatives, neurologists patients the industry and so on.

00:05:08: And I think that the genius striker is dead in a European brain council or not gathered.

00:05:14: would you agree with me?

00:05:15: On that

00:05:16: two hundred percent it's interesting to say uh... It's a revolution.

00:05:21: we very often mention that the model is relatively unique.

00:05:26: i mean there are lot of organizations present in Brussels bubble.

00:05:30: You can imagine a European organization for anything that you come across in your life.

00:05:34: I mean cars, computers or whatever doctors obviously the brain then the heart and what ever but an organisation bringing together these different components as i described.

00:05:49: there are none that is still existent.

00:05:52: so in activity we're about to celebrate our twenty fifth anniversary next year.

00:05:57: So, it's quite indeed a revolution and an achievement to not only have created the organization but also maintaining it alive.

00:06:06: And I would say that we are making in terms of each organization keeping its autonomy in defending their remit and geographies or constituencies But at EBC is still able create this enabling framework where as these beautiful expressions says trying to create a tide that lifts all the boats at the same time.

00:06:32: And it's not because one is being lifted, but instead of another.

00:06:36: there are these overarching objectives supporting every member organisation and society in everything they do.

00:06:46: Yeah!

00:06:47: It's an amazing achievement.

00:06:48: I also think what you're saying... One thing is founding an organisation while other things maintaining it for twenty-five years really something to be proud about.

00:06:59: Then Fred, to give our listeners a peek behind the curtains.

00:07:02: How do you actually work... ...to get brain health recognised as an important health issue in the EU?

00:07:10: What are your target groups for your work...?

00:07:12: Who are you sort of lobbing up too?

00:07:17: Okay I've got the impression this question is bit like Matrioshka.

00:07:21: so there's two or three sub-questions that're extremely interesting.

00:07:27: So a primary target group, and again I come back to history now was the European Commission.

00:07:33: And in particular the Directorate General what we call the DG responsible for research and innovation that was in charge of developing What i mentioned earlier?

00:07:46: The framework programs for research & innovation which are seven years plan funding and launching off-calls etc.

00:07:53: But whats interesting is with time we realized that it was not enough to say basically, We need more money for researchers.

00:08:01: There is always the question of why we need this and what's the purpose?

00:08:06: And hence The work that EBC had initiated on demonstrating the societal burden Of brain disorders.

00:08:14: so a lot of work being Being done back in today.

00:08:17: So the first one was in two thousand four if memory serves me and then in different sequences trying To demonstrate like epidemiological but also economic cost and burden to Europe of brain conditions.

00:08:31: And then it really peaked with what has been probably recognized as the most comprehensive study there, which was a study released in twenty eleven where we had the whole of neurological disorders back when I recognize that such an end the hall of psychiatric diseases is probably I mean, having a few gaps if we look at it now but still.

00:08:54: We are coming up with the narrative of eight hundred billion euros being the cost for managing brain conditions every year in Europe.

00:09:03: If you ask me i cannot relate what eight hundred million actually represents.

00:09:07: But if you start making comparison and even if you remember The financial crisis that have gone through And need to support Greece back then, it's the equivalent of bailing out the Greek debt seven times.

00:09:22: And we are doing this every year.

00:09:25: so simply in terms of magnitude It is extremely important.

00:09:30: I know that EEN and other societies are now revisiting these figures etc.

00:09:35: So i think We need to maintain the level of awareness there.

00:09:38: but The point Is To say That when we compare When i said that neuroscience was lagging behind In comparison to other fields Of biomedical research We are not here to say that it's not important to invest into cancer research or the research on heart diseases, but we just need this right proportion between the burden of disease and the cost to society.

00:10:00: The challenge in which we give our researchers or clinicians is to address those societal challenges.

00:10:09: So basically there you have a framework for telling stories not only to civil servants but with time you know, any policymaker and even now the public.

00:10:24: To try raise this awareness about like why we are standing there?

00:10:28: To say that in context of a framework program for research We need more resources or let's say better strategic vision as what is necessary I mean at end-of-the day a public interest And transforming that narrative, because now I'm coming to another sub-question of how we are doing it.

00:10:52: We have also been transforming that narratives.

00:10:55: Because when i say you know eight hundred billion is the cost It's highly impacting.

00:11:01: You know back then were saying its one in three.

00:11:04: These were WHO figures ,we knew this was way more than two in tree and potentially every one of us is experiencing if we think about mental health issues for instance relate that it is omnipresent in society.

00:11:20: So highly impacting.

00:11:21: but still we need more money, there were new cures back then so developing a narrative that was extremely negative negatively connoted but still with... We're hoping to convince policymakers give money to researchers.

00:11:37: So we have completely flipped that into.

00:11:39: how are building this advocacy work?

00:11:43: I think now we really need to emphasise what is working.

00:11:46: Biology's delivering, you were talking about the revolution earlier... ...I think that the revolution in the brain space is in the making and we need to actually emphasise it more as much as possible.

00:11:57: And of course there are still huge unmet needs.

00:11:59: There're many issues which we have to address but if we take it by what works We can attract better attention, create this kind positive message and hopefully this is driving, let's say a new agenda or new wave that can help us address still the pain points to bottlenecks.

00:12:20: And what actually is necessary to continuously drive positive outcomes for people living with brain condition in Europe?

00:12:30: I think that it's extremely interesting.

00:12:31: we are going away from the narrative which was very important to establish how much it actually costs than i once heard you saying at the lecture, that one should turn to right and then left.

00:12:42: Look at the neighbour on both sides... One of them would have a brain disease during his or her life span!

00:12:48: That was quite touching because billions is so hard to grasp I think but look at person two-right and person three-left and you'll be affected by brain diseases which are quite heavy too.

00:13:04: Then i also see there's shift very useful towards a more positive, constructive way of handling this.

00:13:15: And let me go right into the Brain Awareness Week in Brussels which we just experienced and that was a fantastic experience.

00:13:23: I have to tell my listeners.

00:13:25: there were neurologists psychiatrists patients People like you, Fred who are superb in conveying a message to the public and politicians.

00:13:36: They were students all gathered at European Parliament... ...in order to promote the brain as well as give politicians and other policymakers insight into what possibilities can be done?

00:13:53: And how we also enable people take care of their own brand health And you already mentioned that Fred, but to what were the key messages or themes that stood out this year?

00:14:06: Well if I look back at the brain awareness week it has been a success in so many ways.

00:14:13: It's difficult.

00:14:14: maybe grab them all quite a few.

00:14:20: that really struck me.

00:14:22: And I should probably start first and foremost by what i would call an internal achievement, which has been the fantastic collaboration between organizations... ...and I'll take this opportunity also to thank and provide kudos to the team at EAN but equally also at FENSE because EBC, FENCE & EN were working together to really work towards this successful achievement, because by that we demonstrated how multifaceted the story we are telling is.

00:14:56: To begin with but also complementary The work of all these organizations.

00:15:02: and it would be difficult to think as one can succeed without another one succeeding.

00:15:08: And here again I will make a link between you clinical neurologists needing basing neuroscience knowledge in order to then be able to implement it on your day-to-day work, look after people living with the condition.

00:15:23: And these people very often are being supported by caregivers.

00:15:28: so when you say that they're right or left if there were no patients very often looking after or being caregiver for someone they know, a child's apparent partner.

00:15:42: So it really demonstrates how again the topic we are talking about is so impacting and important.

00:15:50: there's us where more attention... And this is definitely what we achieved at the Brain Awareness Week event because that collaboration in that crave gave I would say, friction in terms of the political message.

00:16:07: The exhibition that the Brain Health Mission organized in the European Parliament was to me absolutely fantastic having the president of the European parliament and some of vice presidents coming... It's massive!

00:16:21: ...the support she expressed And i think we should really cherish and nurture is absolutely fantastic.

00:16:32: invited a Nobel Prize winner to come for the lecture in the afternoon.

00:16:36: I mean, to us is again you know a peak in terms of the momentum... ...the need for action and getting policy support.

00:16:46: And this really what we should capitalise upon Because the Brain Awareness Week event was organised really few days or couple weeks after a public hearing in the European Parliament, and the Committee on Public Health where the strategy for neurological health was discussed.

00:17:08: So the importance of this event is really that not only itself it's important but also its momentum as well.

00:17:16: And we need to look at these issues in a holistic way across the life course, that we could not recreate or re-create the silos that were trying to break over history.

00:17:31: I mentioned the history of EBC but it's something we have been doing alone.

00:17:35: so this kind of overarching and inclusive understanding about issues that are being addressed is not because you know its romantic and beautiful to do that.

00:17:45: But if you want to address dementia in the late course of your life, you need to look at it as early as possible.

00:17:55: And that trauma and childhood can be impacting for the rest of our lives!

00:18:00: If we don't grasp this message then we would really miss out on this opportunity I believe is what we confirmed with the Brain Awareness Week event.

00:18:12: Yeah, I think so too.

00:18:13: It was fantastic and to the listeners i have to tell that it also showed how brain diseases affect us all because Angelica Winter one of the parliamentarians she was actually hosting their event at EU Parliament.

00:18:26: She's from Austria and politician from Austria And she had a touching speech where she told about her husband suffering From very rapidly progressing Alzheimer.

00:18:36: now he died eventually, and that was extremely touching.

00:18:41: And also other politicians told us about their family histories where they had family members suffering from brain disease... That was rather strong!

00:18:51: I mean i've been working with patients for so long but every time you hear these strong stories your still very moved and touched by it.

00:18:59: It shows there is a personal reason this willingness to accept brain health as a very important term.

00:19:12: So that was the personal aspect of that, and I said it's very moving.

00:19:16: but

00:19:17: let us talk about something else because we talked about the personal aspects on the cost.

00:19:23: But you have also said Fredette invest in Brain Health is not only good for individual but also smart economic move for Europe And that was also something I heard from others at the disbrain event.

00:19:37: What do you mean by that?

00:19:39: Well, what we mean is a real demonstration of return on investment whenever we invest into improved outcomes for people living with brain condition.

00:19:54: It means very often money's allocated to healthcare.

00:20:00: spending was a cost.

00:20:02: You know, mention even our own study back in twenty eleven.

00:20:05: we say it's the cost and the burden of brain disorders And actually one of the first pitfall that we needed to correct when we released this study.

00:20:14: because Of course We said like look its massive prioritized brain research and so on and So far.

00:20:19: but then there were Even some governments who turned to ebc or two some other colleagues In The national networks.

00:20:26: We said, look we are in the middle of a healthcare reform.

00:20:29: We need to make savings.

00:20:31: Thanks for pointing out that it is so expensive To deal with brain disorders.

00:20:36: So we're going to cut there first because That's the most expensive item.

00:20:41: And I said no actually its mistake Recognize as an investment Because It would be worse if you were not spending that money

00:20:48: Exactly.

00:20:49: and we came up With this concept No longer The cost of treatment but the cost Of non-treatment The cost of not investing.

00:20:59: And this was the starting point and it collided with me joining ABC where we had to rethink a little bit, let's say our strategy or positioning... ...and I mentioned the change in narrative.

00:21:10: but that idea about non-treatment as a starting point has been really the start of reflection process on how do you demonstrate that?

00:21:21: Again, a positive story.

00:21:23: And the cost of non-treatment became the start of our value treatment study.

00:21:27: so where we identified the moment when there was an issue with access to care what is called the Treatment Gap?

00:21:34: back then We had couple case studies ranging from Alzheimer's Parking Sun To Schizophrenia in the psychiatric space but also less known conditions like restless legs disorder normal pressure hydrocephalus.

00:21:50: So things that were a little bit, let's say more niche or special less unknown.

00:21:55: but what was fantastic is again with the member societies and member organisations of EBC we managed to pull the expertise in each case studies identified.

00:22:07: We had patient-centred approach understanding What was the patient journey across the system?

00:22:14: And where there was a gap in access whilst in most of the cases, intervention actually existed but patient didn't have access.

00:22:23: And we started calculating what does it cost or would be investment necessary to bridge gap and allow for that access?

00:22:31: so investing into multi-disciplinary teams, reinforcing workforce the number of beds in hospitals or whatever.

00:22:41: it was ranging again from epilepsy migraine dementia and all rest.

00:22:46: But what we demonstrated is that whatever the condition was investing into improved outcomes was cost saving or cost efficient And there we had a compelling evidence that we brought forward in our report.

00:23:02: Again, it was the outcome of fantastic work with all member organisations of EBC being involved and not having this study which is now almost ten years old but still extremely relevant to today's conversations In making them understand the economic aspect of brain conditions.

00:23:22: as you were saying It's left, right and centre in our society.

00:23:26: It is immensely impacting personally for families... ...for societies, for employers but I would say at a macroeconomic level as well.

00:23:37: And here it isn't an icing on the cake.

00:23:41: But next level of recognition of need-for action Is that international circles or international think tanks have been made aware and I've really seized that momentum of saying okay there is no priority needs, we need to do something about it.

00:23:58: And lately was the World Economic Forum who actually started a reflection on the concept of brain economy starting off with the burden for disease, positive brain health, investment into brain innovation in our healthcare systems making our system more robust but also investing in brain skills, in neuro-development and skills for the future.

00:24:27: Because this is creating a virtuous circle of workplace productivity... ...but also economic growth and economic development.

00:24:35: And it's very much US driven and Anglo-Saxon if you ask me But still!

00:24:42: It's enabling us to make the point that we are not only calling for improved or positive brain health just from a healthcare perspective.

00:24:51: There is broader societal dimension which at the end of day, it's making us realize that if we do not have productive workforce We cannot sustain model and I can even expand by saying with other challenges That currently has on security in defence for instance.

00:25:08: It exactly same.

00:25:09: i mean If you don't have healthy population You cannot face the challenge.

00:25:14: a very, let's say instable geopolitical context.

00:25:19: So all of that boils down to what is the capacity for our society?

00:25:24: To function and be able to sustain itself... Be healthy!

00:25:30: Be wealthy and productive and integrated in society to support one another.

00:25:38: Yes That was so nicely put And I agree hundred percent.

00:25:45: then.

00:25:46: To have a robust brain health make also societies robust is so important to emphasize.

00:25:52: I think that was nicely done and we had for the listeners just very concrete example two rides.

00:26:01: an e-bike without the helmets at a very fast speed and then to injure your brain has consequences for the rest of your life but not only for you, but also those around you.

00:26:12: And of course for your capacity to participate as citizen.

00:26:17: so these are small things that can be done in daily lives by society because previously Fred said Brain health is not only responsibility of the healthcare system or the neuroscientists, or the neurologist, psychiatrists, patients whatever.

00:26:34: It's a society thing because it's society that's going to profit from that especially in these turbulent times.

00:26:41: I thought that was very nicely said.

00:26:44: Yeah and... That probably also creating degree of complexity.

00:26:49: how to address that And enter positive narrative making everyone aware, but also responsible of their potential outcomes further down in life.

00:27:02: But indeed there is a question as to what the exact percentage of brain disorders or neurological diseases that you can prevent with your healthy lifestyle?

00:27:15: When we think about simple things day-to-day lives.

00:27:18: now our questions are how do we make this message approachable, understandable but also embedded into everyone's daily life.

00:27:28: And I think that the work you have been doing with engaging young generation in this awareness is absolutely fantastic and was extremely needed.

00:27:39: so congratulations for it!

00:27:41: It makes so much fun, actually.

00:27:43: And I'm also very impressed by the colleagues who are doing these school challenges and so on where children are involved in how to take care of their brain?

00:27:52: Of course it's a positive effect because not only do they go home but tell their parents!

00:27:58: They ask their grandparents... Absolutely!

00:28:00: ...it is sort of a very positive effect for society as well.

00:28:04: This is what we need.

00:28:09: important, it's a different aspect but also to say that okay you have neurological disease.

00:28:14: You have brain disease uh... But there are still things you can do in order to prevent from getting worse or in order increase your quality of life and also be more independent which is for most an effect on the individual.

00:28:33: Let's go back a little bit to policy because this is so interesting, we sort of get very much lost.

00:28:39: Can you explain to me Fred and the listeners how decisions make at the policy level actually affect our daily lives or access to care?

00:28:49: What is the link between policy in my life so-to say.

00:28:54: Well that's a very interesting question Janna putting forward to even colleagues on a regular basis, and it basically boils down to say the work we are doing in an office across the European Commission to convince them to prioritize their brain or provide more money for researchers.

00:29:22: It only makes sense if sooner or later it impacts the daily life of people experiencing that, or the daily lives of clinicians looking after them.

00:29:34: The daily life for researchers struggling to maintain their research and teams in producing work.

00:29:42: So direct impact is extremely difficult to measure.

00:29:47: but if we look at some figures etc... The framework programs when EBC was created were completely under prioritizing brain research.

00:29:58: The multiplicator since then has been absolutely fantastic and enormous, I would be foolish to say it's only due the work of EBC... ...I think is due to the like-mindedness that was created within the community And in turn has really pushed or has build over to civil servants and policy makers.

00:30:21: Hey look, there is a community over here that's trying to say something.

00:30:25: We should probably listen and actually they are not that wrong when you know... They're asking for more support and stuff like that.

00:30:31: so You know?

00:30:34: There is movement we can generate but also an articulation between what we do in Brussels with what has been done at the national level and I would even say at a local level in some countries, that's creating the chain of implementation but also of resonance between what is being done on this kind of European mothership.

00:30:58: But i will even say scaling up to international levels because we have organisations such as the WHO, even the UN.

00:31:06: I mentioned the World Economic Forum earlier.

00:31:09: they are all also navigating above us but i think it's important that we feed them with what do we experience?

00:31:16: But also how...the way we're supporting national societies, national brain councils local organizations not only in their advocacy work supporting sometimes like peer group for patients or local healthcare institutions, networks of facilities.

00:31:39: So there is really that vision as to what the impact is?

00:31:43: How do we measure it ?

00:31:44: It's extremely difficult but creating those interconnections and interpenetrations are absolutely necessary.

00:31:51: otherwise you know... We can continue drinking coffee with civil servants in the European Commission.

00:31:57: What's the point at the end of today?

00:31:59: That is true.

00:32:00: But actually you are providing hope as well, because what happens on EU level has consequences for citizens living in Germany and France or even Norway where we're not part of the EU but still very closely connected.

00:32:18: This gives a little hope to European partnership which these days is extremely important not only in brain cases I have to add.

00:32:29: No, i think we should spare maybe your listeners too the complexity of the EU institutional model because it could be endless and probably the topic of ten other podcasts but just to say that there is still a repartition of power between like the member states dealing with the organization and the financing of healthcare systems.

00:32:49: But still they are let's say strategies or ways by which coordinate or act at a European level.

00:32:57: And that has been the vision of EBC in the context of last EU elections to emphasize that notion of coordination and establishing our coordination plan, try get all different initiatives by stakeholders' institutions but synergize better.

00:33:15: We have fantastic momentum now because I mentioned this hearing on Public Health Committee.

00:33:21: Well, President-elect actually contributed and a few of other members, member of the EN also was then of EANS or Association of Neurosurgeons each providing I would say a lens in focus on how to advance an European strategy for neurological care.

00:33:42: And so we are now touching what could become something that can inspire the implementation of national strategies, and a way by which countries will need to respond... ...to common objectives.

00:33:57: And potentially also encouraging them to collaborate on certain issues like we experienced with the European reference networks for instance in the context of rare disorders.

00:34:07: So we have this mechanism how collaboration can actually leverage profits.

00:34:16: You mentioned the European partnership.

00:34:18: so it is fantastic milestone in us being able to structure the work across countries, across funding agencies within countries that put money together in order to support research in the brain space and collaborative research.

00:34:37: It's like whole teams – In Norway, in France, in Germany, Spain are actually invited to work together.

00:34:48: structuring a research ecosystem in the brain space is an ultimate outcome.

00:34:56: So it's great momentum, really a turning point for organisations like EBC and all of our societies amongst which we are here to be able to influence that move but hoping this will be their first step towards the right direction.

00:35:13: To us its not an achievement seen as let's say the potential to move ahead and develop additional mechanisms, additional sources of funding etc.

00:35:25: for the objectives that we mentioned.

00:35:28: So to sum up that... We could say three things.

00:35:31: first of all Collaboration is good at the European level and it's happening, probably even more so in recent years than previously.

00:35:42: And finally what happens in Brussels definitely has consequences between Berlin London Oslo Copenhagen and other cities of Europe which are not only divided from real life.

00:35:56: but Fred to make politics is to prioritise And the most important things must come first.

00:36:03: Yes, I always...I see you laugh here!

00:36:06: But if UFRED could be one to prioritise one or two changes at a European level that would make the biggest difference for brain health?

00:36:14: What will it be ?

00:36:18: I'd say that big issue and one of issues we are struggling with is still a tendency to go back to a degree of fragmentation and silo thinking.

00:36:34: So we are back, what I'm calling the kind of pre-EBC era in the sense that you know when i mentioned about history or organization is there was this sense internally and externally That working together actually necessary but would be instrumental and pays off at end.

00:36:58: you know, in many different circles if we see politics above us and stuff like that.

00:37:04: There is probably the tendency of wishing to go alone because there are thoughts.

00:37:10: going along enables us to achieve more for all little buckets but it's not sustainable at this time.

00:37:20: so I can relate with that.

00:37:27: But the fact that we are now advocating for a cohesive vision of what it... What do you mean with brain health is definitely an example.

00:37:37: We need to really be aware this notion of fragmentation, and I was in the European Congress of Psychiatry lately making exactly the same point.

00:37:48: Brain Health needs to be seen as these cohesive points where all the disciplines represented within EBC whether medical or non-medical, have an interest in understanding how they benefit from this common agenda.

00:38:03: And it's not because we talk about brain health that again is to the detriment of any subcomponent of what would mean with brain health.

00:38:13: so division really try and create this enabling framework where can support all organizations patient groups clinical professional scientific societies even the industry to some extent, because at the end of day we need everyone to succeed if we want to address or be able to address the challenges that we have identified collectively.

00:38:35: And it's not something that we can do on our own.

00:38:37: It is nothing like what you see in a country alone and it isn't just one discipline alone.

00:38:44: And predecessors of EBC and forward thinkers as Yesel Osen I have understood that and there is definitely a legacy there, we need to maintain it.

00:38:56: So unity would be your former priority?

00:39:00: I'd say like the European motto... Unity in diversity!

00:39:05: We should actually be aware of the heterogeneity of brain disorders by definition, of the etiology or diseases but also our community and how our ecosystem is structured with organisations etc.

00:39:18: And its fine.

00:39:19: There is a richness in this diversity and this heterogeneity.

00:39:22: But the thing is that we should really find those connecting points, those synergies... ...and nurture them!

00:39:29: And I come back to what I said about the Brain Awareness Week event.

00:39:33: It's a fantastic demonstration of what i mean here.

00:39:36: We should nurture our success and again... ...nurture it so there are potentials to repeat it.

00:39:44: Unity and Diversity?

00:39:45: I like that.

00:39:47: Time flies when you're in good company.

00:39:50: We

00:39:50: are reaching the end of this podcast, but finally Fred

00:39:54: a message

00:39:55: to me and the listeners

00:39:57: what

00:39:57: can European citizens do?

00:39:59: To support brain health across Europe?

00:40:01: if somebody's sitting here listening and saying What Can I Do How Can i Sort Of Be Promoting Brain Health What Would You Recommend Them?

00:40:13: That'S A Very Interesting One.

00:40:16: Lately, I've been a critical analyst of the finger model.

00:40:23: The finger model that was developed for prevention of dementia where we say you need to look at your nutrition, cardiovascular health do physical activity be cognitively immobilized on regular basis?

00:40:39: and then social engagement.

00:40:40: but i think there are some fingers missing in our hands, you know if we think of for instance sleep and other components.

00:40:50: But again I think that we should be aware not giving too many instructions so they would be difficult to fill up.

00:40:59: but even then let's say play-off cards...I'd rather take that metaphor.

00:41:06: That play off card is if i need one where an impact also for young people, I would really emphasise the social engagement.

00:41:17: The fact of being socially active in person... I think that via social media etc.

00:41:23: it's fine but hidden behind a screen.

00:41:26: we are all aware of long lasting consequences on mental and physical health so that notion Being able to engage, being able to socialize.

00:41:41: Being able be exposed also to contradictory thoughts in order to develop critical thinking and analytic thinking but also independence of minds because society now we are very much aware the rise of fake news that we see in society to critically analyze what we're exposed too.

00:42:07: Because at the end of day, if we talk about like citizens what we wish for citizens of today it's to be able to exercise their rights.

00:42:16: Their right in democracy and that belongs too.

00:42:20: positive brain health or bolts down into a positive brain healthy but is not only about uh... The disease lens are prevention over diseases But its also capacity functioned in society And be fully integrated.

00:42:36: I think they were so nicely put.

00:42:39: So to the listeners out there, go out and interact with others.

00:42:44: That's probably the best thing you can do for your own brain health And also for the Brain Health of Your Society.

00:42:51: Thank You so much Fred For joining this podcast!

00:42:55: A very interesting discussion

00:42:57: and a lot

00:42:57: of important reflections.

00:42:59: Very happy that you are one main persons in the European brain castle taking charge of enlightening our politicians and policy makers Europe wide.

00:43:13: So thank you for joining, And Thank You for our listeners For joining us on The Brain Health Mission Podcast!

00:43:21: If you enjoyed this episode then are interested in brain health Follow Us On Your Preferred Podcast Platform.

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00:43:30: Stay Tuned For More Conversations.

00:43:32: Brain Health.

00:43:33: Thank you so much again friend!

00:43:35: It was a pleasure, thanks for having me.

00:43:43: You've been listening to the Brain Health Mission podcast where science meets action for healthier brain.

00:43:49: If you enjoyed today's episode don't forget follow us on Spotify or your favourite podcast app So that never miss an update For more tools tips and expert insights.

00:43:59: head to www.brainhalthmission.org That is www.BrainHealthMission.org.

00:44:03: Until next time take care of your brain.

00:44:06: It's the only one you've got.