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AIDS, Alzheimer's and Us

As we redouble our commitment to eradicate AIDS on the occasion of World Aids Day last week, perhaps the global health community will also step up to the Alzheimer's crisis.
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As G-8 government leaders meet in London later this week to launch a strategy for Alzheimer's disease, it is worth recalling how global leaders did it for HIV/AIDS not too long ago.

Twenty-five years ago, the first World AIDS Day was held. At the time, AIDS was scourging the world, and this first-ever global health day was launched to help alter the course of this lethal disease. A quarter of a century later, AIDS has become manageable and treatable.

The British medical journal Lancet has captured the evolution of AIDS most succinctly: "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."

The progress in Africa has perhaps been the most stunning. According to 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." As a result, AIDS-related deaths fell by 32 percent from 2005 to 2011 and new HIV infections dropped 33 percent from 2001 to 2011.

To be sure, there is still a great deal of innovation needed in order to better deliver treatments victims within less developed countries, but progress has been notable. It's not impossible to imagine a day when AIDS in Africa is at the same level as AIDS in richer nations.

Though the fight against AIDS must remain in full force, it is of profound significance that the leader of the 20th century UNAIDS program, Dr. Peter Piot, has recognized that Alzheimer's is the "ticking time bomb" of the 21st century. Already, Alzheimer's consumes $604 billion annually or 1 percent of global GDP. With individual longevity increasing around the world, rates of incidence (and the costs involved) are poised to skyrocket. Which is the driver for the G-8 meeting in London.

Indeed, according to new data from Alzheimer's Disease International, rates of Alzheimer's are "a staggering 17% [higher than] original estimates made in 2009." It is estimated that there are 44 million people currently living with dementia, and this number will escalate to 76 million by 2030 and 135 million by mid-century. G-8 leaders recognize a fiscal nightmare in the making and understand this requires extraordinary actions, including real funding for finding the cure and more effective care.

Given such incredible increase in incidence, this World AIDS Day we should learn from the global movement against AIDS to create a strategy for defeating the emerging global Alzheimer's epidemic.

First, we must find the innovations -- medicines and treatments alike -- akin to those developed for other non-communicable diseases. This will require funding, and early steps are being taken. The National Institute of Health, prompted by America's alliance with other nations for a national Alzheimer's plan, has pitched in, and British Prime Minister Cameron's dedication of the G-8 to global leadership with Alzheimer's may prove to be monumental.

So far, the prime minister and the G-8 are making good on the promise, as the December G-8 summit in London will focus on Alzheimer's. This political leadership, however, must lead to policy follow-through, including fundamental changes in regulations so that medicines in the innovative pipeline will have a chance to work.

Second, a revolution in how we care for those with Alzheimer's is badly needed. 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."

Third, the growing research findings on possible prevention models for Alzheimer's need to be leveraged. 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 on the occasion of World Aids Day last week, 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. The G-8 meeting in London can be such a milestone moment.

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