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Alzheimer's disease: a progress report.

This year, we have seen real progress in the fight against Alzheimer's disease--both in terms of science and political mobilization. The Obama administration has fostered groundbreaking initiatives to increase funding and focus within the National Institutes of Health (NIH) on Alzheimer's research. Favorable changes in FDA evaluation standards have been proposed. Promising advances in proteomics research related to Alzheimer's have been made. Efforts on the research, regulatory, and political fronts are all critical to curbing the Alzheimer's health crisis. Certainly, it will take a concerted effort at every level of government, science, and industry to achieve the bold national goal of finding a means of prevention and effective treatment by 2025.

An estimated one in three seniors dies with Alzheimer's or another form of dementia: the disease is an emerging global killer on the scale of cancer and heart disease. The number of people dying of Alzheimer's is rising inexorably with the aging of the baby boomer generation, contrasting with the reduction in deaths from cancer, heart disease, and HIV/ AIDS, as a result of sustained commitment to research investments in those diseases. Alzheimer's disease is the fastest-growing threat to public health, and its medical costs already exceed those of cancer and heart disease. Simply put: without a disease-modifying treatment or cure, the health and fiscal stress on our nation and its families will become unmanageable. There are hopeful signs that the public is invested in the battle against Alzheimer's as never before, but there is much more to be done, both in terms of scientific research and the mustering of political will.

During the last 10 years, breakthroughs in neuroimaging and spinal fluid analysis have indicated that the disease may begin fifteen to twenty years before the first symptoms emerge. That insight has created a new emphasis on the strategy of prevention. Were a disease-modifying drug administered to slow the progression of the disease, symptoms might well be deferred for years.

Fortunately, the NIH has articulated the path forward in that strategy. Last May, the administration's update to the National Plan to Address Alzheimer's Disease included specific annual research milestones. Hitting those milestones, however, will require the additional funding recommended by the Advisory Council--namely, increasing annual NIH research funding for Alzheimer's from $0.5 billion to a minimum of $2 billion, a level still below that of cancer ($6 billion) or HIV/AIDS ($3 billion). Parallel investments from the private sector are also needed to accelerate the research-to-patient timelines for treatment.

Unfortunately, sequestration is standing in our way. Congress's inability to approve a budget in 2012 and the resulting automatic federal spending cuts not only blocked planned increases in Alzheimer's research but resulted in drastic, across-the-board budget cuts to NIH, slowing the progress toward a cure. At the same time, however, there is growing bipartisan support for biomedical research and for prioritizing research funding for Alzheimer's. As Sen. Barbara Mikulski (D-MD), Chairman of the Senate Committee on Appropriations, recently commented, "We need to make public investments in research ... If we find a cure ... we could reduce the Medicaid budget by 50%." Sen. Susan Collins (R-ME) is also working to rally support by urging a doubling of annual investments in NIH funding for Alzheimer's research in the Fiscal Year 2015 budget, as a down payment on the ramping up of annual funding to the $2 billion target set out by the Advisory Council.

Research funding increases are only part of the puzzle. Innovative changes in the setting of research priorities and in the business processes of moving basic discoveries through the tab-to-patient pipeline are essential to increase the volume and velocity of possible treatments for those at risk of Alzheimer's.

From polio to cancer to heart disease to HIV/AIDS, history has shown that a commitment to research investment on high-cost diseases is a proven deficit reduction strategy. Beyond this, we've also seen the benefits of highly ambitious endeavors such as the Human Genome Project, which generated $141 in economic activity for every $1 we invested and paved the way for major advances in medical treatments.

Increased research funding can serve as a rallying point for advocates, researchers, industry, and our nation in the fight against Alzheimer's. If we are serious about stopping this disease for future generations, the legislative and executive branches, industry, and scientists must continue to work together to provide the innovations and the resources needed to meet that goal.

George Vradenburg is the Chairman and Cofounder of the USAgainst Alzheimer's Network, an education and advocacy network and campaign committed to mobilizing Americans in the battle against Alzheimer's disease.
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Title Annotation:Washington report
Author:Vradenburg, George
Publication:Medical Laboratory Observer
Date:Nov 1, 2013
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