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Michael Hodin

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WHO, Health and American Politics

Posted: 04/12/2012 2:00 pm

Now that Santorum has suspended his campaign, Romney and Obama are setting their sights on one another. For both candidates, the growing "senior" demographic is becoming an ever-more coveted prize. As they market themselves to the AARP and other voting blocs, Medicare is proving to be the decisive issue.

Obama claims that a Romney presidency will end Medicare as we know it. And Romney contends that the reforms within the "marvelous" Ryan budget are exactly what is needed to save Medicare. Whoever makes the better sell of his Medicare vision may prove victorious come November.

This debate is not limited to the U.S. In fact, if the Medicare debate has taken a brash rhetorical turn here in the States, then in Britain it's downright ugly. Last month, former British Health Minister Stephen Dorrell claimed that debates over the future of the NHS have "lost touch with reality," because they are built on "an increasing perception that care for the elderly does not work." And in Japan, where the politics are less sensational, the healthcare equation remains more daunting. With the "oldest" population in the world, Japan's "demographic tsunami" is "driving up the costs of universal healthcare... to unprecedented levels." A full seven years ago now, health scholars Colby and Ziolkowski noted that the world would "nervously watch Japan as it attempts to balance social needs with economic viability."

Thus, while Romney and Obama jockey for favor with the senior crowd, they're operating in a landscape where health is at the top of everyone's agenda, globally. And it's time they recognize as much and focus on how the U.S. can manage its world-leading health expenditures, as the more profound and far-reaching challenge is pushing the frontiers of health and medical innovation and how the U.S. can create paths for healthy and active aging without spending superfluously. In 2010, the U.S. spent almost 18% of its GDP on health, a proportion that is more than double that of Japan, the UK, and the OECD average. At first glance, this seems wasteful. But the question we need to be asking is this: does this expenditure provide incentives for research and development that will lead to prevention strategies and innovative cures for the 21st century's aging population? It is, after all, the fact that most innovation comes about incrementally, which needs a receptive marketplace to flourish. And in the context of global aging, innovation is essential for this exploding demographic to remain economically productive.

While the presidential candidates exchange jabs over Medicare reforms, we should press them to answer these questions. This is where the future success of the U.S. and other nations begin, especially in an era where we are living so much longer.

There is no disease that needs health innovations more than Alzheimer's. It is a disease that is directly correlated with aging, and it is already consuming 1% of global GDP. Not only is the Alzheimer's trajectory fiscally unsustainable, it is a tragic stain on human suffering as it spreads its poison throughout families and communities. And the future of Alzheimer's is crystal clear. Without innovations to treat, prevent and ultimately cure Alzheimer's, it is, according to Dr. Peter Piot, former head of UNAIDS, a global "time bomb."

No wonder the WHO has now officially set Alzheimer's as a priority with the launch of its historic Report "Dementia: A Global Health Priority." According to the report, jointly prepared with Alzheimer's Disease International, Alzheimer's is "overwhelming for the families of affected people and for their caregivers," and it requires support from "the health, social, financial, and legal systems." Indeed, without significant changes in our treatment paradigms, Alzheimer's will become both the human as well as fiscal nightmare of the 21st century.

So what's the first step forward? According to Alzheimer's Disease International, it's earlier detection and diagnosis. Due to social stigmas and ineffectual diagnosis processes, Alzheimer's advances without early medical intervention. And the loss here is twofold: one, medical researchers lose out on data they could use to work towards cures and two, the patients, families and caregivers aren't given the opportunity to ease into the new realities that come along with the disease.

Today, we focus on managing illness through care models. Looking ahead, this is less and less adequate -- as populations age globally and the risks of non-communicable disease steadily mounts. Twenty-first century demographic realities require a new approach to care. Now that the World Health Organization stepped up and declared both Alzheimer's and aging populations as defining challenges of our era, it is time for our presidential candidates to also get serious and honest about health policy fit for this century's demographics truths.