The Alzheimer's "Time Bomb" and the Supply-Side Solution

Alzheimer's Disease-related dementia is the next public health "time bomb." And it's not just a bomb of human suffering; in addition, AD dementia is also an already-exploding bomb of fiscal red ink.

"The figures speak for themselves. We are really going into the next global health time bomb"
--those are the words of the Belgian-born Dr. Peter Piot, now director of the London School of Hygiene and Tropical Medicine. Piot co-discovered the Ebola virus in Africa back in the 1970s, and, since then, he has been a leading voice on AIDS issues; he was president of the International AIDS Society, then took leadership roles at the World Health Organization and the United Nations. In other words, he has been a witness--both as a front-line worker and as a policy-maker--to epidemics in the past. And so when he espies a new "global health time bomb" on the horizon, he deserves a close hearing.

As Piot explains, the 36 million dementia sufferers in the world today--increasing a rate of one new case every seven seconds--will double in just eight years. And yet, he argues, it's a "myth" that dementia is an inevitable part of aging. That is, medical science could and should address the issue in a direct problem-solving manner. But unfortunately, the pipeline for AD drugs is drying up.

Here in the US, some six million Americans have Alzheimer's, costing annually, according to the Alzheimer's Association, $172 billion annually, reaching a cumulative cost of $20 trillion by 2050. Yet in American politics today, the focus of eldercare is on finance--Obamacare vs. Republican insurance alternatives.

In other words, AD is being seen as a "demand-side" problem; people are afflicted with AD, and then some financing mechanism kicks in, public or private. In other words, it's an accounting issue. The thought of dealing with AD on the "supply side," however--the cure side--is simply not being discussed in Washington DC or on the presidential campaign trail.

Yet if AD is handled the way we handle many other diseases--with an emphasis on paying for it, as opposed to curing it--then we face fiscal calamity, as well as medical calamity. In the past, healthcare was seen as a medical issue; doctors tried to cure the disease. Now increasingly, and perversely, healthcare is seen as a financial issue; that is, policy experts grapple with issues of coverage and cost-control. And so, not surprisingly, the idea of curing AD falls through the cracks of political and governmental indifference.

But the compassion factor aside, AD is not a finance issue.  It is a science issue.  Either we come up with an effective treatment for AD/dementia, or we face a future of enormous costs that will likely be uncompassionate in the extreme. That is, future leaders will either consign millions of elderly Americans to long-term 24/7 care, hiring millions more to care for them--and with brutally crushing taxes to pay for this bureaucracy of chronic suffering--or else concoct drastic measures to reduce those long-term costs.   And we do mean "drastic," in a way that could unhinge the idea of a safety net and a decent society.

Faced with the AIDS epidemic a quarter-century ago, America and the world resolved to focus on a cure, which in many cases today--not enough, but many--is the functional equivalent of a cure.  The medical-science approach to AIDS, as opposed to the finance approach, has been a bonanza for human compassion, for the advance of medical science, and for the economies of countries around the world.

Surely we should want the same sort of positive solution for this fast-approaching medical time bomb.

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