Every four seconds, somewhere in the world, there is a new case of dementia. Alzheimer’s disease, which was considered rare 50 years ago, has today reached pandemic proportions, affecting some 45 million people globally. The cost of caring for Alzheimer’s has skyrocketed to more than $600 billion (about 1% of global GDP) and – if a breakthrough doesn’t come soon – those costs are projected to exceed $1 trillion by 2025.
Source: Dementia: A Public Health Priority by the World Health Organization and Alzheimer's Disease International
Doctors have made significant progress towards understanding the causes of Alzheimer’s. For the first time, brain scans are revealing changes in the brains of living Alzheimer’s patients, allowing scientists to see how the disease develops. A disease in a dish model of Alzheimer’s is helping researchers efficiently and rapidly screen hundreds of drugs. New cognitive assessment tools and blood tests for early detection are in development. Experimental medicines targeting abnormal brain proteins are in clinical trials, and the first stem-cell trial for Alzheimer’s is about to begin in the United States. Meanwhile, a team of leading researchers recently published a roadmap for accelerating the testing phase of novel regenerative therapies. One of the most interesting areas is optogenetics, which uses light to activate brain cells, and has been shown to restore memories in amnesiac mice.
Despite these advances, there are still a lot of things we don’t know about dementia, and still room for research. We need better tools for detecting Alzheimer’s before it becomes full-blown, as well as new interventions that can delay the onset of disease in those at high risk, plus new treatments that can target tiny regions of the brain and boost memory. At a basic scientific level, we still need to gain clearer insight into what causes Alzheimer’s and the role played by proteins (such as amyloid and tau), as well as the immune system. It’s time for that to change, and a scientific competition with a lucrative prize could be just the thing to bring it about.
The right time to act
If there’s one thing stalling progress on Alzheimer’s, it’s a lack of resources. Our current investment levels remain modest: we spend 400 times less on research than the sum of the economic toll of the disease. More than 100 “promising” experimental medicines for Alzheimer’s have failed in clinical trials and no new treatments have come to market in the past decade. This failure rate also highlights the need to move from conventional thinking to new paradigms when it comes to dementia research.
The good news, however, is that today we are living in an extraordinary time, when technology is allowing small teams of individuals to accomplish what was once the province of only governments and the largest corporations. Empowered by machine learning, artificial intelligence, ubiquitous networks, cloud computing, robotics and digital manufacturing, small teams are building platforms and enterprises that are touching the lives of billions. If these creative and interdisciplinary teams begin to tackle Alzheimer’s, we may have a way forward. The challenge is to motivate them to do so.
Tapping into competition
Throughout history, our indomitable spirit of competition has brought about breakthroughs and solutions that once seemed unimaginable and impossible. In 1714, the British government’s Longitude rewards inspired a solution to the great scientific challenge of pinpointing a ship’s location at sea. The Apollo Project, to land a man on the moon, was spurred by intense competition between the US and USSR.
More recently, in 2004, a $10 million competition dubbed the Ansari XPRIZE challenged private entrepreneurs to build a spacecraft. The award spurred the advent of the private space industry and ushered in a new era of scientific prizes. Unlike awards given decades after a discovery, and often to an individual or small academic group (such as the Nobel or Lasker award) competition-based XPRIZEs offer a fast payout (two to seven years depending on the challenge) and revolve around narrowly defined, preset goals. Since the Ansari challenge began, XPRIZEs have led to the development of new oil-spill clean-up methods and a portable, real-life Star Trek Tricoder to diagnose disease. Prior XPRIZES have ranged from $2 million to $30 million.
Ken Dychtwald of Age Wave, a leading think tank on ageing, has co-conceived an Alzheimer’s XPRIZE. By offering a large monetary award, he hopes to inspire brilliant innovators who wouldn’t otherwise study Alzheimer’s to delve into the challenge. Whether they come from academia, industry or the general public, the hope is that new teams will look at dementia with fresh eyes and be able to see things that have been missed. A sponsor is now being sought to create the prize.
P. Murali Doraiswamy, MBBS FRCP, is Professor of Psychiatry and Medicine at Duke University and a leading researcher at the Duke Institute for Brain Sciences. He chairs the World Economic Forum’s Global Agenda Council for Brain Research and is a co-author of The Alzheimer’s Action Plan. He will be speaking at the Addressing Alzheimer's Issue Briefing at Davos.
Peter H. Diamandis, MD, is the Chairman and Founder of the Xprize Foundation, which designs and launches large incentive prizes to drive radical breakthroughs for the benefit of humanity. He is Co-founder and Chairman of the Singularity University, which counsels the world’s top enterprises on how to utilize exponential technologies. He is the coauthor of BOLD: How to Go Big, Create Wealth and Impact the World.