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The Initiative
Guest Editorial
The Bone and Joint Decade 2000-2010
June 1998
The successful work with declaring 1990-2000 as the decade of the brain world-wide has lead to a raised awareness of the impact of brain disorder and to significant scientific contributions. At a national level, the infrastructure and funding in various fields of brain research have greatly improved.
Musculo-skeletal conditions are the most common causes of severe long-term pain and physical disability, affecting hundreds of million of people across the world. The extent of the problem an its burden on patients and society can be understood from some examples:
- Joint diseases account for half of all chronic conditions in persons aged 65 and over.
- Back pain is the second leading cause of sick leave.
- Fractures related to osteoporosis have almost doubled in number in the last decade; it is estimated that 40% of all women over 50 years will suffer from an osteoporotic fracture.
- The severe injuries caused by traffic accidents and war produce a tremendous demand for preventive and restorative help. It it anticipated that 25% of health expenditure of developing countries will be spent on trauma related care by the year 2010.
- Crippling diseases and deformities continue to deprive children of their normal development.
The impact from bone and joint disorders on society, the healthcare system and on the individual, combined with the awareness that our resources need to be more efficiently used, led to an initiative beginning with an inaugural Consensus Meeting held in Sweden in April in 1998 and culminating in a proposal for the Decade of the Bone and Joint from 2000 to 2010.
The objective of the consensus meeting was to create a document describing the problem, current treatment options and to delineate future prospective regarding treatment of and research on musculo- skeletal disorders and injuries within mainly the following areas:
- joint diseases.
- spinal disorders.
- osteoporosis.
- trauma.
A consensus meeting is equivalent to a scientific hearing with the objective of clarifying the usefulness of current diagnostic and treatment methods with regards to effectiveness and safety in relation to social and economic effects for the individual and for society. furthermore, future developments should be addressed. Most of the information was conveyed by the experts in their written and oral presentations. However, in addition medical databases such as Medline and Cochrane were available.
The goals of the Decade, agreed upon at the meeting, are to improve the health-related quality of life for people with musculo-skeletal disorders throughout the world by
- raising awareness of the growing burden of musculo-skeletal disorders on society.
- empowering patients to participate in decisions on their care.
- promoting cost-effective prevention and treatment.
- advancing understanding of musculo-skeletal disorders through research to improve prevention and treatment.
The campaign will promote initiatives an all parts of the world, with particular support for activities in developing countries. There will be collaboration with patients and professional organizations, research bodies and scientific journals. It will be launched at an international forum in 1999, with co-ordinated announcements made globally.
A series of consensus documents were prepared by selected non-expert groups, based on papers by experts in each of four chosen topics. The agreed and edited versions are published as a supplement with the June issue of Acta Orthopaedica Scandinavica. The document was produced according to guidelines and may require further expansion and consideration. It provides useful outlines for the four clinical fields that had been selected, and an indication of the potential for advance in other musculo-skeletal conditions. The common features in all four reports were the need for research and advance, the conviction that this would probably be cost-effective in the future, and an awareness of the wide differences in standards and need throughout the world.
At the end of the two-day meeting, the cosensus document was agreed and an administrative structure set up for the next stages leading to the proposed launch. All the organisations joining the campaign will be represented on its Board, and a Steering Committee will direct the project, which will not be linked to any other specific organisation. Donations will be requested from member organizations and other non- commercial organizations to fund the initial campaign
Heinegård, Dick Dept. of Cell and Molecular Biology, Section for Connective Tissue Biology, Lund University LUND, Sweden
Johnell, Olof Dept. of Orthopaedics, University Hospital Malmö MALMÖ, Sweden
Lidgren, Lars Dept. of Orthopaedics, University Hospital Lund LUND, Sweden
Nilsson, Olle Dept. of Orthopaedics, Akademiska sjukhuset UPPSALA, Sweden
Rydevik, Björn Dept. of Orthopaedics, Sahlgrenska Hospital GÖTEBORG, Sweden
Wollheim, Frank Dept. of Rheumatology, University Hospital Lund LUND, Sweden
Åkesson, Kristina Dept. of Orthopaedics, University Hospital Malmö MALMÖ, Sweden
Executive SummaryThe goal for the Bone and Joint Decade is to improve the health- related quality of life for people with musculo-skeletal disorders throughout the world.
IntroductionMusculoskeletal disorders are the most common causes of severe long- term pain and physical disability, affecting hundreds of millions of people across the world. The extent of the problem and its burden on patients and society can be understood from some examples:
- Joint diseases account for half of all chronic conditions in persons aged 65 and over
- Back pain is the second leading cause of sick leave
- Fractures related to Osteoporosis have almost doubled in number in the last decade; it is estimated that 40% of all women over 50 years in age will suffer from an osteoporotic fracture
- The severe injuries caused by traffic accidents and war produce a tremendous demand for preventive and restorative help. It is anticipated that 25% of health expenditure of developing countries will be spent on trauma-related care by the year 2010.
- Crippling diseases and deformities continue to deprive many children of their normal development.
The impact from such bone and joint disorder on the individual, on the society, and healthcare and social systems led to an initiative beginning with an inaugural Consensus Meeting held in Lund, Sweden in April 1998 and culminating in a proposal for the Decade of the Bone and Joint from 2000-2010.
The Decade of the Bone and Joint will raise awareness of the suffering and cost to society associated with musculo-skeletal disorders such as joint diseases, osteoporosis, spinal disorders, severe trauma to the extremities and crippling diseases and deformities in children; of means to reduce this presently available and the need to advance this through research.
No one single organisation alone can accomplish the desired benefits for the patient. The Bone and Joint Decade is a multi-disciplinary initiative involving everyone concerned with care including communities, patients, healthcare providers and researchers.
Goals of the DecadeThe goals of the Decade will be achieved by:
- raising awareness of the growing burden of musculoskeletal disorders on society.
- empowering patients to participate in their own care.
- promoting cost-effective prevention and treatment.
- advancing understanding of musculoskeletal disorders through research to improve prevention and treatment.
The campaign will promote initiatives in all parts of the world, with particular support for activities in developing countries. This will be in partnership with appropriate patient, professional and scientific organisations; research bodies; scientific journals; healthcare providers; governments and non-governmental organisations
Action ProgramThis initiative began with the inaugural Consensus Meeting in Lund, Sweden in April 1998 and it will be launched at an international forum in 1999, with co-ordinated announcements made globally.
A series of consensus documents were prepared at this inaugural meeting by selected non-expert groups, based on papers by experts in each of four chosen topics - joint diseases, back pain, osteoporosis and severe trauma to the extremities. The agreed and edited versions are published (Acta Ortop Scand (Suppl 281 1998;69). They provide valuable outlines for the four clinic fields that had been selected, and an indication of the potential for advance in other musculoskeletal conditions. The common features in all four reports is what can be presently achieved, the need for research and advance, the conviction that this would probably be cost-effective in the future, and an awareness of the very wide differences in standards and needs throughout the world.
The aims and objectives of the Bone and Joint Decade were agreed at the end of the inaugural consensus meeting. Endorsement has been sought from a wide variety of stakeholders. An administrative structure has been established. There is a Steering Group which is representative of different geographical regions and disciplines. Its role is to direct and co-ordinate the endorsement, launch and activities of the Decade. One of the initial activities will be a health needs assessment for musculoskeletal disorders. There will be national co-ordinators and co- ordinating groups representing the various stakeholders at a national level who will be responsible for national activities. All the organisations joining the initiative will be represented on its Board.
Guiding Principles of the Decade
- The Decade will be a global campaign to establish priorities and provide information and support to national and international organisations representing patients with musculo-skeletal disorders and healthcare professionals. This will enable them to achieve the goal of the campaign at a national and regional level.
- The campaign will set a framework to promote co-operation within the decade 2000-2010 rather than establish a new organisation.
- The campaign will promote initiatives around all musculo-skeletal health.
- The campaign will include initiatives in any geographical location and will try to support activities in developing countries.
- The campaign programme will be developed in partnership with patient, professional and scientific organisations; research bodies; healthcare providers; governments and non-governmental organisations in consultation with all other stakeholders from all countries and regions.
- The campaign will identify the size of the burden of musculo- skeletal disorders now and in the future by undertaking a review and compilation of existing data.
- The campaign will support strategies that encourage the application of cost-effective prevention and treatment.
- Research needs will be identified and investment in research will be encouraged.
- The strength of the campaign will depend on a co-ordinated approach. Any activities undertaken in co-operation with the campaign should be identified by using the trademark campaign logo.
- All organisations joining the campaign will have a representative on its Board. A steering Group has been elected to direct the project.
- The campaign will act independently of sponsors and will not be linked to any one specific organisation.
- Philanthropic donations will be sought from member organisations of the Board and other non-commercial organisations to fund the campaign initially.
EndorsementThe Bone and Joint Decade has been endorsed by a wide variety of national and international professional, scientific and patient organisations, and scientific journals. Endorsement is being sought from the United Nations and from governments around the world.
FundingFunding will be sought to support the promotion and co-ordination of activities related to the Decade. This will include the costs of a small secretariat, Steering Group meetings, communication, health needs assessment, information clearing house and publicity. The estimate budget for the first year is US$ 350,000. Participating organisations will be invited to meet this cost. Organisations will be invited to donate at different levels depending upon the size of their membership. Foundation grants will be sought to supplement this.
SummaryThe Bone and Joint Decade 2000-2010 aims to improve the health- related quality of life for people with musculo-skeletal disorders by working in partnership with all stakeholders to raise awareness, identify needs, empower patients, promote cost-effective prevention and treatment and advance understanding through research to improve prevention and treatment.
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