Bill Gates just put up $50 million of his own money to battle a looming economic and medical crisis: Alzheimer’s disease. Because people around the world are living longer, Gates says, many more people will inevitably fall victim to neurodegenerative diseases, and the time to act is now.
Alzheimer’s represents a huge threat because there’s no known effective treatment. It currently afflicts one in nine people over the age 65, and nearly 50% of those who live into their mid-eighties. Those who contract the disease are likely to face a steep mental and accompanying physical decline that can be costly: A person with Alzheimer’s spends about five times the annual out-of-pocket medical costs than someone without, Gates notes in a post on his personal blog GateNotes, which lays out his rationale for this decision. (In 2017, that number was projected to be a combined $259 billion among Americans.)
While 5.4 million Americans currently have Alzheimer’s, that number is expected to roughly triple by 2050. That uptick may hit Americans and the healthcare system hard, particularly as a huge generation of Baby Boomers get older, but it isn’t just a U.S. issue. The Gates Foundation has been spent decades working on health and poverty initiatives that increase the quality of life in developing countries, many of which are obviously also affected, especially as life expectancy improves.
Gates has invested in the Dementia Discovery Fund, which is working to come up with new treatments. “We need more approaches to stopping the disease,” he writes in his post. That’s one of five crucial areas where he sees room for serious advancement, all of which are pretty contingent on each other to make a substantial breakthrough.
“We need to better understand how Alzheimer’s unfolds,” he says, noting that it’s obviously difficult to observe the brains of live patients while autopsies are really a later-stage snap-shot: they don’t give the best clues to how the disease progressed and developed over time. He thinks current cognitive tests are too limited, and is pushing the medical community to explore a “more reliable, affordable, and accessible diagnostic” like a blood test, which might give clues about how well things like new drugs for treatment are working.
All of this could be expedited by a faster and easier approach to clinical trials (“If we could develop a process to pre-qualify participants and create efficient registries, we could start new trials more quickly,” he suggests), and if pharmaceutical companies and researchers alike were committed to sharing data. That would make it easier for researchers to look for patterns and identify new pathways for treatment.
In this case, the Dementia Discovery Fund won’t be using the money on the most promising treatments, but on other concepts to ensure additional angles of attack. “Most drug trials to date have targeted amyloid and tau, two proteins that cause plaques and tangles in the brain. I hope those approaches succeed, but we need to back scientists with different, less mainstream ideas in case they don’t. A more diverse drug pipeline increases our odds of discovering a breakthrough.”
For Gates, who notes some people in his family have been affected by the disease, it’s the sort of early-stage investment that might draw larger backing from an obvious place, if it all pans out. “I’m making this investment on my own, not through the foundation,” he adds. “The first Alzheimer’s treatments might not come to fruition for another decade or more, and they will be very expensive at first. Once that day comes, our foundation might look at how we can expand access in poor countries.”