Brain diseases are estimated to cost the US $1.4 trillion annually. The global burden approaches $3 trillion, and with the growth and the aging of populations across the globe, it is estimated that, by 2030, these costs will double. With one in three people disabled by dementia after age 80 and one in 10 disabled by mental illness, usually starting before age 25, brain disorders are becoming the public health challenge of the 21st century. But this is more than a public health challenge. In the words of Jim Yong Kim, president of the World Bank: “Despite hundreds of millions of people around the world living with mental disorders, mental health has remained in the shadows … [Brain health] is not just a public health issue – it’s a development issue. We need to act now because the lost productivity is something the global economy simply cannot afford.”
We are surely not the only ones in shock when we read that, despite these staggering costs on society, only 3% of global healthcare resources are targeting brain health. And in low-income countries that figure barely reaches 1%. By contrast, in the private sector, especially in the pharmaceutical and neurotechnology industries, there has been no dearth of effort to develop solutions – treatment, drugs and/or devices – for patients suffering from psychiatric, neurodegenerative and other brain diseases. The last decade has been a golden age of discovery in neuroscience; finally, the technological breakthroughs from fundamental science have begun to translate into new scalable diagnostic and therapeutic solutions for people with brain disorders.
Recently, the World Economic Forum’s Health and Healthcare community convened a meeting in New York where the focus was on new innovations and science driving improved healthcare outcomes. Given several of the recent developments in neurotechnologies and brain sciences, the air was filled with cautious optimism that the world might just be on the brink of finally tackling the scourge of mental illness and transforming brain health. In the words of Klaus Schwab, the founder and executive chairman of the World Economic Forum, the Fourth Industrial Revolution is offering a “range of new technologies that are fusing the physical, digital and biological worlds, impacting all disciplines, economies and industries, and even challenging ideas about what it means to be human” – and if we may add, what it means to heal and improve the lives of humans, physically as well as mentally.
Progress in science (and health) usually requires new technologies, new concepts and new practices – generally in that order. Innovation in neurotechnologies and brain sciences is being driven by a new breed of neuro-entrepreneurs who are together driving a wave of startups in biotech (e.g. Denali Therapeutics, BlackThorn Therapeutics), invasive (e.g. Neuralink, Kernel) and non-invasive brain health solutions (e.g. EMOTIV, Mindstrong), and in research platforms that enable deep science (e.g. Inscopix). For the first time, there is now the possibility to scale and dramatically reduce the cost of early detection of brain-related issues. Portable electro-encephalographic (EEG) devices that cost less than a gaming console and that can be ordered on the internet allow the recording of brain waves virtually everywhere with signal quality as good as clinical equipment 50 times more expensive. Innovative systems and mobile phone apps that decode facial emotions (e.g. Affectiva) and detect anxiety and stress from the way people interact with the screen will play a major role in suicide prevention, for example.
These new technologies are yielding an era of deep neuroscience that will no doubt lead to a much better understanding of brain function and dysfunction. Older ideas of a “chemical imbalance” can be replaced by data on the specific pathways involved in depression or schizophrenia. We can now address mental disorders as circuit disorders, with the potential for precise biomarkers and precision neurotherapies. The new leaders in the neurotech space, and many others, in conjunction with not-for-profit private sector institutions, such as the Allen Institute of Brain Science and the Howard Hughes Medical Institute, are driving the development of potentially game-changing brain-health measurement and diagnostics, and the development of drugs and devices that will transform treatment and brain healthcare.
The private sector is newly reinvigorated and bustling with activity. It is time the public and private sectors joined forces, across borders, to harness synergies and to march together in the quest to conquer brain disease and to transform brain health. We can start by having the leaders of the world’s most developed economies recognize the looming public health challenge that mental illness and brain disorders pose to their countries and to the world. We have no doubt that such recognition, coupled with public funding commitments, will spur the creation of new public-private sector partnerships. There are precedents for these partnerships, and we can learn from past public-private efforts to battle pandemics and innovate on vaccines. Transforming brain health will probably also require new business models that, for example, enable and incentivize companies to commercialize and scale promising innovations coming out of taxpayer-funded projects
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We must not lose this opportunity. We must capitalize on the momentum building in the private sector to bring all stakeholders together, and help foster an environment to stimulate partnerships across stakeholders and across borders. Let’s continue to invest in ongoing efforts to better diagnose and treat brain disease, and let’s commit to an era of deep science. A brain health revolution is on the horizon. And as with any revolution, we must also discuss and debate the unintended consequences of technological leaps and new knowledge.
With the Global Future Council on Neurotechnologies and Brain Sciences just having convened in Dubai, we need the public sector to step up to address a critical global need in brain health, and to embrace an increasingly vibrant private sector that is key to both enabling the deep neuroscience and the neurotechnologies needed to translate the resulting knowledge into the therapies of the future. As Nitin Nohria, the dean of Harvard Business School once remarked, "There is no problem facing society and humanity today that can be solved unless business plays a vital role." Brain health is no exception.
The authors are members of the World Economic Forum’s Global Future Council on Neurotechnologies and Brain Sciences