Alzheimer’s Epidemic Could Be Much Worse Than Reported
Editor’s Note: More than 50 million people around the world already have deadly Alzheimer’s disease. It’s the only major cause of death in the world that is on the rise. The epidemic is spreading fast and there are no answers in sight. Global leaders are mobilizing to tackle the issue. Unfortunately, hope is elusive, but some steps can be taken to stop spreading prion disease from infected people, wildlife and livestock. That’s right, mad cow disease and chronic wasting disease are related to Alzheimer’s disease. There is no such thing as a species barrier when it comes to prion disease. All forms of the disease spread through the bodily fluids of infected victims and very little is being done to stop this exposure.
The G8 took monumental strides in the fight against Alzheimer’s disease recently when it met in London to solidify a global movement against dementia. British Prime Minister David Cameron remarked that the event may become the day that “the global fight-back really started.” The G8 aligned to the U.S.’s goal of beating Alzheimer’s by 2025, and the world’s eight richest countries made commitments that were larger than anticipated.
After the G8 event, it seems that the world is finally getting serious about beating a disease that has been rightly identified as the 21st century’s “ticking-time bomb.” It is now well recognized that Alzheimer’s is no longer “the rich world’s problem,” and the G8 is spearheading a movement that is designed to become — and must become — truly global.
This is largely driven by demographics. At the moment, the G8 nations are some of the world’s “oldest.” Because Alzheimer’s correlates to age — affecting one-in-eight people over 65 and nearly one-in-two over 85 — the increase in human life spans in G8 nations is driving rates of Alzheimer’s.
But the developing world is not far behind. Over the past 50 years, life spans have doubled in dozens of nations around the world, and longevity that was once unique to the world’s most privileged nations is becoming the global norm. The most rapid increases in incidences of Alzheimer’s are occurring in low- and middle-income nations.
It is of tremendous consequence that the G8 has sounded the clarion, but its commitments to action must be enforced, practical and goal-oriented follow-through is needed. To this end, two key questions arise: What can be done to move the conversation from the G8 to the larger family of nations and peoples affected by Alzheimer’s? And what is the immediate and longer-term action-oriented agenda to execute against the G8 commitments?
To globalize the conversation, the OECD and the WHO are going to be absolutely essential. Each played a critical role at the G8 event, and each organization demonstrated how and why it can become an effective global leader.
The OECD is ideally suited to extend the conversation outside the G8 and to other key global powers like China and India. The OECD has already shown leadership in addressing questions of finances and innovations that are needed to beat the disease. Now, it can work alongside the G8 to cascade the global agenda through BRICS and deeper into the private sector.
The WHO is equally critical due to its unique reach and influence in lower income nations. In many places outside the G8 and OECD, Alzheimer’s is still seen as a natural, inevitable part of aging, and the stigma against the disease prohibits adequate assessment and treatment. The WHO has already taken notable steps to improve the situation, but there ismuch more to be done, as we are, according to WHO Director-General Margaret Chan, “empty handed” in “terms of a cure, or even a treatment.” Working with other advocacy and philanthropic organizations, the WHO can take immediate action by calling on all WHO member nations to adopt a National Dementia Plan — at the moment only 13 of 194 member nations have such a plan.
While the OECD and WHO can globalize the fight against Alzheimer’s, it is imperative to adhere to and drive towards specific priorities. To this end, during a convening by the Global CEO Initiative on Alzheimer’s disease (CEOi) of a diverse group of industry, academia, government and non-governmental organizations immediately following the G8 summit, six key action items emerged, including:
- Developing a global Alzheimer’s clinical trial platform that reduces the time, cost, and risk of drug testing, as well as advances the scientific understanding of disease pathogenesis and increases capacity and efficiency of clinical trials.
- Developing innovative financial models that increase private financial and philanthropic investment in Alzheimer’s disease discovery, drug development and infrastructure, as well as care delivery.
- Leveraging technological innovation in tools and Big Data techniques to advance Alzheimer’s disease research, patient engagement, and care delivery.
- Improving care practices globally to be more family centered and outcome oriented.
- Setting international norms on national efforts to plan and take action to address Alzheimer’s;
- Creating global standards for regulatory pathways of Alzheimer’s treatments.
Each of these goals requires a solution that inherently global. As nations, we have worked within our borders long enough, and the G8 is absolutely right to insist on the global nature of these goals.
While these are exactly the right goals for national governments, industry, science, and other stakeholders to be working towards, it could be argued that these goals overlook the present to focus on the future. This claim does have certain merit. We have both to act now on immediate issues of care but act now, as well, to drive with greater urgency toward a future cure.
Work can be done at the present on local and national levels to create better methods of care. The overly institutionalized model of care that presides today is both impersonal and inefficient. At the G8 event, the UK shared insights into a plan that it is developing, in which bus drivers, bank tellers, and other public-facing professionals will learn to better identify and assist persons with dementia, so that those with cognitive and functional impairments feel confident that they can participate in public life and not remain cabined at home. Such a program is low-cost, immediate-impact, and stigma-reducing — and it creates a model of front-line care that can be mimicked in countless other nations throughout the world.
For the cynic, it could be easy to chalk up the G8 event as just another wonky get-together in which high-flying rhetoric stood in for concrete action. This critique will be exactly right if we do not drive action-oriented follow-through from the event. But, as an optimist, I look forward to an international conference in 2025 when we refer back to “the spirit of London.”