What if a preeminent global health authority declared there's a public health "time bomb" among us? What if he were the person most responsible for leading the coalition that turned HIV/AIDS from a certain death sentence into a manageable illness? And what if this expert also warned that this crisis was a scourge that, due to the tragic and cruel torture it inflicts on its victims, also demanded, on ethical grounds, to be elevated to a human rights issue?
And what if −- as we already know −- this health crisis was poised to become the fiscal nightmare of the 21st century?
Last week in London, Dr. Peter Piot made each of these declarations at the Alzheimer's Disease International global meeting. Dr. Piot, of the London School of Hygiene and Tropical Medicine, has become the world's foremost public-health-official-cum-international-civil-servant. In his speech, he was genuine, forthright and inspirational. Yet, he was also practical, setting an agenda to shape global health priorities for decades to come. Let's just hope his message was heard at the European Medicines Agency in Canary Wharf, just a few train stops away. And, across the Atlantic, let's hope the folks at the FDA were taking notes.
Dr. Piot, who led the United Nation's UNAIDS organization with brilliance and imagination, delivered the impassioned call to action before some 1,500 scientists, patients, caregivers, advocates, and health officials. Before an audience gathered from every corner of the globe, Dr. Piot declared that we need a worldwide political movement to fund cures and preventions. With the global aging phenomenon extending lives by decades, Dr. Piot pointed out that we will see an unprecedented rise in the rates of Alzheimer's. In short, he suggested that we need to rally against Alzheimer's exactly as we did against HIV/AIDS in order to stem this oncoming tide. As I listened to his speech, I couldn't help but contrast this "campaign speech" to the trivial platitudes that we have come to expect on the official campaign trails from Peoria to Paris.
Dr. Piot's call to action builds on considerable momentum. In the last six years, nine countries have created national Alzheimer's plans. This is an unusual but welcome response against one disease. In France, England, Australia, Wales, Scotland, The Netherlands, South Korea, Norway and most recently the U.S., government-based national plans are in place to find preventions and cures. In India and other countries, plans are being developed by "civil society" that may shortly become government-endorsed. And, at a global level, the UN General Assembly recently held a high-level meeting "to shape the international agenda" on non-communicable diseases (NCDs), and they included an entire section on Alzheimer's alone.
As Dr. Piot's speech affirmed, we need to keep this momentum going. In May, at the annual World Health Assembly, we should expect similar attention when Health Ministers gather to pass the Japanese-sponsored resolution, "Strengthening NCD Policies to Promote Active Aging." Japan, home to the world's oldest population, has come to understand the inadequacy of today's tools to handle tomorrow's health crisis.
In the U.S., we need to press the issue. The government's heroic spending on basic research on other NCDs dwarf spending on Alzheimer's. Cancer, for example, gets 10 times the funding of Alzheimer's; cardiovascular gets five times; and diabetes double. As Alzheimer's experts and advocates agree, this is simply embarrassing, and it has led to an entirely predictable state of affairs. In the past decade, Alzheimer's-related deaths rose 66 percent, while deaths attributed other NCDs fell 20 percent.
From an economic standpoint, this underfunding forebodes disaster. Though Dr. Piot did not discuss the fiscal consequences of Alzheimer's, they are severe. Already, the disease consumes $604 billion annually, a full 1 percent of global GDP. As people live longer than ever before, the explosive trajectory of this spending is clear. Just consider that the risk for getting Alzheimer's is one in eight for people over 65 and one in 2.5 for those over 85. Indeed, as lives extend an additional two to three decades, the rates are poised to skyrocket. And what cruel twist it would be if, due to lack of basic research and prevention, the "miracle" of longevity became a curse.
As Dr. Piot argued, if we maintain the status quo, Alzheimer's is the "time bomb" among us. Dr. Piot has led a rescue team before, and now it is time to follow him again and defuse this bomb. So let's join Dr. Piot's campaign. Unlike many, this one is worth the fight.
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 Stanford Center on Longevity, United Nations, World Population Prospects, The 2008 Revision, Medium Variant Forecast.
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