Published on: August 30, 2013
by George Vradenburg for Huffington Post:
The British government has just announced that it will host a G8 Summit in December dedicated to Alzheimer’s and Dementia. The announcement of the London event delivers on Prime Minister David Cameron’s pledge to use the UK’s Presidency of the G8 to launch a global initiative to address Alzheimer’s disease.
Mr. Cameron’s leadership is a notable victory not only for those who suffer from Alzheimer’s, but for families, communities and society at large. The prevalence of Alzheimer’s is exploding around the world as the global population ages, and Mr. Cameron is exactly right to assert that it will take a global response and global cooperation to fight and ultimately eradicate this disease. Alzheimer’s, quite justly, has been described as the health, social and fiscal nightmare of the 21st century, with one in eight over 65 and nearly one in two over 85 becoming its victim. With such stakes, Mr. Cameron’s G8 leadership is both desperately needed and richly deserving of gratitude.
To fulfill its potential, the London G8 Alzheimer’s Summit needs to lay out an agenda for a global response that includes innovative approaches to care, treatment, and prevention, as well as financing. With September nearing — thus marking the commencement of World Alzheimer’s Month — the G8 has an opportune moment to set the political commitments in place for this critical global priority.
Here are a few suggestions.
Innovate sources of funding: Currently, global funding levels for Alzheimer’s research are insufficient. At current levels and using today’s research and investment practices, Alzheimer’s research investments can neither expand nor accelerate the basic research needed to understand the complicated pathways of Alzheimer’s disease. At the same time, major progress has been made in understanding and treating other major non-communicable diseases like cancer and heart disease, where annual global funding levels are measured in multiple billion dollars. For Alzheimer’s, annual global research investments are, in our estimation, less than one billion dollars.
Given the estimated $604 billion that caring for Alzheimer’s victims consumes annually, current funding levels are shameful. Alzheimer’s should be one of the most generously funded diseases. But it isn’t. And the G8 can press the issue. It could use the U.S.’s and UK’s recent modest increases in investment to urge further funding. It can leverage new social impact investing and venture philanthropy models and additional public-private funding partnerships. And it can involve improved incentives for the private sector to drive increased investment from industry.
Acceleration of discovery and drug development: Given the rate at which people are being diagnosed with Alzheimer’s disease and other forms of dementia — one new case diagnosed every seven seconds worldwide — the snail’s-pace of discovery and drug development is maddening. Indeed, it reflects the same “murderously indifferent” attitude the world initially displayed toward HIV/AIDS. We’re in the dark-ages with our approaches to sharing discoveries and learning from failures, and there’s no sense of global urgency to accelerate our efforts.
This can be fixed by leveraging four tools: big data to find correlations that empirical science misses with its causal analysis; standing clinical trial networks to conduct coordinated drug testing with enhanced efficiency and quality; biomarkers and target validation consortia to provide early measures of drug effects and drug targets; and rapid-response crowd-sourcing discovery platforms to tap into the global network of talent working on the disease.
Care innovations: With 48 million people and 150 million caregivers expected to experience the impact of dementia by 2020, the current models of care will soon be financially unsustainable to public health authorities and breathtakingly burdensome to families. In China, the problem is especially pressing, as 23 million people will be over 80 by 2015 and an incredible 90 million by mid-century. We need new integrated and comprehensive care coordination infrastructures to support families through home- and-community-based care. Early experiments with smart assistive technologies – robotics, fall-detection devices, reminder signage, drug compliance monitoring, passive and active symptom and behavior monitoring — are promising. But the community and technical infrastructure to bring these practice and technology innovations to scale must be financed and built.
Research: Right now, the vast majority of Alzheimer’s research is insufficiently coordinated and inadequately linked to expertise outside the core Alzheimer’s community. One of the great lessons of HIV/AIDS is that collaborative and multi-disciplinary research is essential to maximize limited research resources, and it is time for Alzheimer’s to begin operating with that open science approach.
There are a few good first steps being taken. The NIH, working with the Alzheimer’s Association, has developed the International Alzheimer’s Disease Research Portfolio (IADRP) as a common lexicon and inventory of global research and the Alzheimer’s Association new GAAIN initiative points to new approaches for global research. The Global CEO Initiative on Alzheimer’s Disease (CEOi) is bringing together innovators from diverse sectors to develop a comprehensive global Alzheimer’s agenda that will align basic and translational academic and industrial research. In November, the CEOi and the New York Academy of Sciences are hosting an Alzheimer’s Disease Summit to frame and execute this agenda. This work will help inform an approach to follow through on the political commitments emerging from the G8 Summit.
Prime Minister Cameron should be applauded for his commitment to develop a global response to address Alzheimer’s disease. As the G8’s London Dementia Summit nears, let’s encourage Mr. Cameron and others in G8 to establish the path forward on a global agenda to prevent Alzheimer’s by 2025. The “miracle of longevity” that has been given to us by centuries of medical progress will turn out to be no miracle at all if we let Alzheimer’s continue unbound.
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