A/HRC/18/37 18). There are many different types of accountability mechanisms, including national human rights institutions, health commissioners, democratically elected local health councils, public hearings, patients’ committees, impact assessments, judicial proceedings and others (see A/63/263, para. 11). And when mistakes have been made, accountability requires redress. 33. Any person or group victim of a violation of the right to health should have access to effective judicial or other appropriate remedies at both national and international levels. The Committee on Economic, Social and Cultural Rights reiterated the importance of redress by noting that all victims of such violations shouldbe entitled to adequate reparation, which may take the form of restitution, compensation, satisfaction or guarantees of nonrepetition (see E/CN.4/2003/58, para. 59). IV. Specific issues and concerns 34. In addition to the broad issues with respect to the right to health framework outlined in the previous section, there are a number of specific issues and concerns relevant to older persons that require a more detailed assessment. This section will consider some of those issues: primary health care and chronic illness; long-term care; palliative care; and informed consent as related to older persons, including guardianship issues. A. Primary health care and chronic illness 35. WHO defined primary health care in 1978 as “essential health care; based on practical, scientifically sound, and socially acceptable method and technology; universally accessible to all in the community through their full participation; at an affordable cost; and geared toward self-reliance and self-determination”.21 The defining features of primary care - continuity, coordination and comprehensiveness - are well suited to manage chronic illness, although more remains to be done to ensure that care of sufficient quality is provided. 22 WHO noted the importance of incorporating evidence-based, cost-effective primary and secondary prevention interventions into the health system, with emphasis on primary health care, 23 which is the most appropriate forum through which these can be integrated. 36. Chronic illnesses and disability increase in prevalence with advancing age. Around half of deaths due to non-communicable diseases occur in persons aged over 70.24 It is estimated that 35.6 million people lived with dementia worldwide in 2010, which will increase to 65.7 million by 2030 and to 115.4 million by 2050.25 In light of the increasing proportion of the population who are elderly, it becomes vital that these conditions are managed in an equitable and resource-effective manner. Health systems throughout the world are generally designed to deal with acute medical conditions. They have struggled to re-model and adapt to prevent or manage the increasing number of chronic illnesses. One 21 22 23 24 25 10 Alma Ata Declaration, 1978, part VI. Arlyss Anderson Rothman and Edward H. Wagner, “Chronic illness management: what is the role of primary care?”, Annals of Internal Medicine, vol. 138, No. 3 (February, 2003), p. 256. WHO, 2008-2013 Action plan for the global strategy for the prevention and control of noncommunicable diseases (Geneva, WHO, 2008), p. 16. WHO, 2008-2013 Action plan for the global strategy for the prevention and control of noncommunicable diseases (Geneva, WHO, 2008), p. 9. Alzheimer’s Disease International, “World Alzheimer Report 2010: The Global Economic Impact of Dementia”, p. 2