Making a longer life worth living: Let’s try to eliminate unnecessary suffering, together Alejandro Jadad MD DPhil FRCPC FCAHS University Health Network and University of Toronto or Facebook, Twitter and Skype: ajadad LinkedIn: alexjadad Cell phone:

We are putting more years into our lives…

Death by success?

We are living long enough to accumulate diseases

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Wellbeing Individual Family Community Planet We must put more life into our years…

Wellbeing Individual Family Community Planet Wellness system (enabling an enjoyable life) Health care system (enabling a disease-free life) We need a wellness system along our health care system

Wellbeing Health care system Health promotion Disease prevention Early detection Diagnosis Treatment RehabilitationBereavement There is a lot of room to disrupt the health care system

This is not meeting expectations

Wellbeing Health care system Health promotion Disease prevention Early detection Diagnosis Treatment RehabilitationBereavement There is a lot of room to disrupt the health care system

Wellbeing Wellness system Active pursuit of joy Sharing Questioning Exploring Learning Creating Disrupting Making a difference There is a wide open field for the pursuit of joy

Wellbeing Wellness system Active pursuit of joy Sharing Questioning Exploring Learning Creating Disrupting Making a difference Elimination of unnecessary suffering Relaxing Forgiving Relieving Offloading Huge opportunities to eliminate unnecessary suffering

We cannot continue neglecting symptom control Journal of Palliative Care 21(2):80-7, 2005

Mental disorders: an invisible crowd! Depression is now the leading cause of disability in the world 30% of people worldwide affected by mental disorders Biggest contributors to morbidity in the world (at least 28% of global burden of disability) At least two thirds without treatment o 67% untreated in the United States o 74% in Europe o 90 to 99% in China

Caregivers: the largest invisible minority! 20% of the population Most are women, over 45 and employed They absorb one third of the overall health costs A few receive support from the system 50% acknowledge emotional distress and physical problems Who is liable? How could our innovations support them?

Wellbeing Wellness system Active pursuit of joy Sharing Questioning Exploring Learning Creating Disrupting Making a difference Elimination of unnecessary suffering Relaxing Forgiving Relieving Offloading Coping with unavoidable suffering Accepting Tolerating Compensating Transcending There is a wide open field for a wellness system

Drastic measures are emerging

“To cure sometimes, to alleviate often, to console always” Unknown origin [attributed to Hippocrates, Paré, Nightingale, Trudeau, and many others] The path to The Singularity must be fulfilling…

eHealth: lots of tools, but no viable business model

We lack good evaluation frameworks

The Maimonides Project Accelerating the transformation of the health and systems, together Ben Shahn ( ) in 1954

Radical ‘glocal’ innovation Plausible scenarios Living Laboratories Stakeholder input Feasible options Business models Risk mitigation plan

A global effort to reduce the impact of polypathology [

Radical ‘glocal’ innovation

Learning from living laboratories...

Radical ‘glocal’ innovation

Glocal encounters to align agendas and ideas

How could we support the US?

" The day will come when, after harnessing space, the winds, the tides, gravitation, we shall harness the energies of love. And, on that day, for the second time in the history of the world, man will have discovered fire. " Could we build a Noosphere? Pierre Teilhard de Chardin ( )

Will we be able to harness the power of our minds and tools to promote optimal levels of joy for all, together?