On World AIDS Day this Sunday, there are three compelling messages to share that go far beyond the AIDS disease and have far-reaching public health consequences.
First, we need to acknowledge the miracle of how a certain death sentence 20 short years ago has become a disease to be treated and managed. As the scholarly UK-based medical journal Lancet said almost three years ago, “Rapid scale-up of effective interventions to control AIDS has meant that this disease, once a death sentence, has become a chronic illness even in low-income and middle-income countries.”
Second, there’s still a great deal to be done on the innovation side and in delivering treatments to victims within poor countries. The progress in Africa, of course, has been stunning, as reported by UNAIDS: “The number of people in Africa receiving anti-retroviral treatment increased from less than 1 million in 2005 to 7.1 million in 2012, with nearly 1 million added in the last year alone. AIDS-related deaths are also continuing to fall – by 32 percent from 2005 to 2011, as are the numbers of new HIV infections, which have fallen by 33 percent from 2001 to 2011.” It is even more dramatic in the richer OECD countries; but there’s so much further to go.
Third, the successes of the AIDS crisis can ultimately be applied to Alzheimer’s and other dementias. It’s not inconsequential that the leader of the 20th century UNAIDS program, Dr. Peter Piot, recognized the Alzheimer’s crisis as a “ticking time bomb” for the 21st century, with its health and fiscal consequences, when he spoke at the 2012 Alzheimer’s Disease International (ADI) meeting in London.
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Dr. Piot, more than most, has seen the epidemic character of Alzheimer’s. The growing prevalence of the disease is linked to the otherwise wonderful miracle of longevity that modern science, improved sanitation and better public health has brought us. The reality of the fastest growing demographic on the planet is further exacerbated by the fiscal nightmare of caring for those with this tortuous disease, a cost that now exceeds $604 billion or 1 percent of global GDP.
As with AIDS in Africa, the social and fiscal disruptions are at least as consequential for Alzheimer’s, as reported in the Alzheimer’s Disease International 2013 report: Fifty percent of all care over the next decades will be sucked into this illness.
There are three interconnected solutions to the Alzheimer’s epidemic.
One, we must find the innovations – medicines and associated treatments – that we've come to expect for other non-communicable diseases. We are beginning to see this kind of dedication in new monies provided through the National Institute of Health, prompted by America’s joining with other nations for a national Alzheimer’s plan. Equally encouraging was the announcement this past spring by British Prime Minister Cameron about a new dedication of the G-8 to Alzheimer’s progress.
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The prime minister and the G-8 are making good on this promise: The G-8 summit in London the week after next will have an Alzheimer’s focus. But political inspiration will need to give way to pragmatic policy platforms – including profound changes in regulations and protocols to give medicines in the innovative pipeline a chance to work.
The second need with Alzheimer’s is a revolution in how we care for the afflicted. The tens of millions of us affected globally as the planet’s population ages cannot wait. The latest data is a true wake-up call, as reported at a series of roundtables held in D.C., London and Beijing: “Globally, the number of dependent older people will rise from 101 million in 2010 to 277 million in 2050, an almost threefold increase. Conservative estimates show that at least 36 million people currently live with Alzheimer’s disease and other dementias, and that number is expected to grow significantly in the coming years,” according to the report “Living with Alzheimer’s: A Journey of Caring.”
The third arena is to leverage the growing research findings on possible prevention models for Alzheimer’s. Scientists are beginning to observe some fascinating connections between healthier lifestyles and their impact on Alzheimer’s. As with AIDS, we may find a valuable tool in serious global collaboration on education and communication.
As we redouble our commitment to eradicate AIDS, perhaps the global health community will also step up to the Alzheimer’s crisis. We need health leaders to be joined by the private and public sectors – and the rest of us as well.
Michael W. Hodin, Ph.D., is executive director of the Global Coalition on Aging, managing partner at High Lantern Group, and a fellow at Oxford University's Harris Manchester College. He is a featured blogger for The Fiscal Times and The Huffington Post.
