A Global Response to the Global Challenge of Dementia Yves - - PowerPoint PPT Presentation

A Global Response to the Global Challenge of Dementia

Yves Joanette, PhD, FCAHS

Chair, World Dementia Council

World Dementia Council

Leading the Global Action Against Dementia

Populations are getting older

Populations are getting older

% of Growth of Population 2005-2030

Source: United Na0ons Department of Economic and Social Affairs, Popula0on Division, World Popula0on Prospects, 2005

Prevalence of Dementia

• Approx. 6-8 %
• Approx. 30-35 %

Source Alzheimer Society Canada, 2016

• World population

is aging

• Even more for the
• ldest
• Main risk factor for

dementia: age

• Incidence

increases with age

The Longevity/Dementia Vicious Circle

World Dementia Council

Leading the Global Action Against Dementia

I can think of no other condition that has such a profound effect on loss of function, loss of independence, and the need for care. I can think of no other condition that places such a heavy burden on society, families, communities, and economies. I can think of no other condition where innovation, including breakthrough discoveries, is so badly needed. G8 Dementia Summit, London, 2013

• In Dec 2013, UK hosted a G8

Dementia Summit

• Goal was to bring together

experts across the world to start a global conversation about solutions for dementia

• The Summit resulted in a

declaration that set out an international response to dementia with the aim of identifying a cure or a disease modifying therapy by 2025

• France’s President Sarkozy had

put Alzheimer as a national priority in 2008 and lead a European rally around collaborative research at the

• rigin of JPND

The Political Push

World Dementia Council

Leading the Global Action Against Dementia

• In February 2014, the UK Prime Minister appointed Dr

Dennis Gillings as the World Dementia Envoy & established the World Dementia Council (WDC)

• WDC Members are from a wide range of experts from

research, academia, industry, the NGO sector, people living with dementia & governments

The Initial World Dementia Council

World Dementia Council

Leading the Global Action Against Dementia

World Demen0a Council Full Members, February 2016

• Following the WHO First Ministerial conference in

March 2015 a broad consensus was reached amongst key global stakeholders & the WDC, on a global model to pursue with the challenge of dementia

• A complementary approach:

Ø WHO working with Member States towards

Ø Establishment of a Global Dementia Observatory Ø Preparation of a Global Action Plan on Dementia

Ø WDC working with leaders from all sectors as well as PLWD, focused on 5 priorities and independent of governments Ø No formal governance between WDC and WHO, nor any other stakeholders, but a collaborative approach to optimize global impact

G7 to Global – The Continuity Model

World Dementia Council

Leading the Global Action Against Dementia

• Since February 2016, WDC membership has

been expanded globally

– New members drawn from a range of sectors &

• rganisations across the wider global dementia

community (24 Members) – Chair/Vice-Chair – Yves Joanette/Raj Long

The Current World Dementia Council

World Dementia Council

Leading the Global Action Against Dementia

Sperling et al., Alzheimer’s & Demen0a, 2011 Adapted from Jack et al., Lancet Neurol., 2010

Neurodegenerative Diseases Causing Dementia: A Life Course Challenge

Prevent Cure/Delay Care

• 1. Favor integrated drug development
• 2. Advocate for innovative and global finance

models

• 3. Encourage open science collaborative global

research including big data

• 4. Stimulate adequate care for people living with

dementia and their carers in high, middle and low-income countries

• 5. Facilitate the identification and the

dissemination of risk reduction strategies

Integrating cross-cutting themes

§ Women and dementia § Awareness § Stigma § Inequalities

Current Priorities of the Council

World Dementia Council

Leading the Global Action Against Dementia

• Design and promote a funding dashboard using exis0ng

data to show current funding across the spectrum of demen0a-related ac0vi0es and to highlight dispari0es and cri0cal gaps

• Iden0fy exis0ng/innova0ve alterna0ve funding models

and approaches that could be applied to demen0a, e.g. Cancer, HIV etc.

• Use the dashboard and data on funding models in order

to reduce/eliminate funding dispari0es by influencing funder decisions

World Dementia Council

Leading the Global Action Against Dementia

Finance Models

Global Lead Chris Llewellynn Partner, McKinsey & Company, London

Global costs of dementia will reach US$ 2 trillion by 2030 more than the costs of cancer and diabetes combined

Global costs of disease

Direct and indirect costs1, US $, billions

604 500 863 290 2,000 745 1,040 458

+49% +231%

Cancer Demen0a Cardiovascular disease Diabetes

16

The global cost of demen:a by 2030 will exceed:

• Current GDP of

all but the 7 wealthiest countries in the world2

• Two thirds of

the current healthcare expenditure in the US

Global costs, 2030 Global costs, 2010

% increase 2010-2030 +21% +58% World Dementia Council

Leading the Global Action Against Dementia

But far less is spent on public sector demen:a research than on other major diseases

% total research spend

1.4% 2.6% 3.6% 6.8%

Demen0a Diabetes CVD1 Cancer Research spend per prevalent case Diabetes 0.5% 3.7% CVD1 0.1% N/A Cancer2 Demen0a Research spend for $ spent on health and social care

0.4% 0.9% 0.7% 4.1%

Demen0a CVD1 Cancer Diabetes Research spend

• n disease per

prevalent case Research spend per disease as a % of total research spend Research spend

• n disease per

$ spent on care

Less is spent on demen:a research than

• n other major

diseases

World Dementia Council

Leading the Global Action Against Dementia

And only 2% of drugs in phase I-III development are focused on dementia

Percentage of drugs in phase I-III development by therapeu:c area

%, Extracted November 2014 and February 2015

2% 3% 5% 28%

Diabetes Demen0a Cancer Cardiovascular

World Dementia Council

Leading the Global Action Against Dementia

• In March 2015, the WDC helped to shape the UK

Govt-led work to establish the Dementia Discovery Fund – a ground breaking public/ private venture capital fund which aims to finance pre-clinical research to find new drugs to treat

• dementia. The initial fund level is just over $100m

& it aims to raise a further $100m during 2016

19

Progress – Finance Models

World Dementia Council

Leading the Global Action Against Dementia

• Iden0fy and engage key payer groups for medicines/

health technologies in Europe and globally, e.g. Na0onal Ins0tute for Health Clinical Excellence (NICE) in the UK

• Develop a robust strategy for engaging payer groups,

taking into account different models that exist (e.g. varying guidelines, expecta0ons etc.)

• Iden0fy strategic drivers to enable the development of

a global plan for access to demen0a treatments and to support adop0on of the plan

World Dementia Council

Leading the Global Action Against Dementia

Integrated Drug Development

Global Lead Raj Long

Deputy Director, Bill & Melinda Gates Foundation

Currently focusing on areas of added values

• Raj Long involved in IMI Roadmap Inititaive
• WDC Associate Member States to facilitate

connection with Health Technology Assesment

• George Vradenburgh involved for US/

Canada

World Dementia Council

Leading the Global Action Against Dementia

Integrated Drug Development

• Facilitate the global expansion of funding programmes such

as the EU Joint Programme in Neurodegenera0ve Diseases

• Develop a global statement promo0ng open science
• Promote the use of big databases to public and private

payers

• Convene stakeholders to advocate for increased

collabora0on in demen0a research and to address barriers

• Influence Governments to invest in public interven0on trials

to demonstrate the benefits of risk reduc0on

World Dementia Council

Leading the Global Action Against Dementia

Research, Open Science and Big Data

Global Lead Philippe Amouyel

Directeur général, Fondation Plan Alzheimer Scientific Director, JPND

• Facilitate the global expansion of funding programmes

such as the EU Joint Programme in Neurodegenera0ve Diseases (Montreal, October 2016)

World Dementia Council

Leading the Global Action Against Dementia

Research, Open Science and Big Data

• Facilitate the global expansion of funding programmes

such as the EU Joint Programme in Neurodegenera0ve Diseases (Montreal, October 2016)

• Develop a global statement promo0ng open science
• Promote the use of big databases to public and private

payers

• Convene stakeholders to advocate for increased

collabora0on in demen0a research and to address barriers

• Influence Governments to invest in public interven0on

trials to demonstrate the benefits of risk reduc0on

World Dementia Council

Leading the Global Action Against Dementia

Research, Open Science and Big Data

• Identify clinical practice and health system-based interventions that

would promote a timely and accurate diagnosis of dementia in primary health-care practices

• Establish longitudinal cognitive surveillance of healthy individuals

to detect earliest changes that distinguish premanifest neuro degenerative diseases causing dementia from normal ageing, and which may be used as endpoints in primary prevention clinical trials

• Develop and validate biomarkers—including biological, genetic,

behavioural, and cognitive markers—for neurodegenerative brain diseases causing dementia, to identify similarities and differences between diseases and dementia subtypes, and assess progression from premanifest (presymptomatic) to late-stage diseases

• Diversify therapeutic approaches (eg, pharmacological and non-

pharmacological interventions) for discovery and development in clinical trials for neurodegenerative and other brain diseases that cause dementia

World Dementia Council

Leading the Global Action Against Dementia

Some of the Priorities

• Promote collaborations to explore more efficient trials, adaptive

trials, and combination therapy for dementia Identify, validate, and apply better outcome measures for clinical trials of cognition, function, and other biomarkers for neurodegenerative diseases causing dementia

• Understand the contributions of vascular conditions to

neurodegenerative diseases causing dementia

• Identify underlying mechanisms of resilience to

neurodegenerative diseases causing dementia at all stages (such as cognitive reserve, protective genotypes, and neuroprotection)

• Understand the role of inflammation and of the immune system in

the initiation/onset and progression of neurodegenerative diseases that lead to dementia

• Investigate biological processes of neurodegenerative diseases to

understand their contributions to dementia to optimise individualised therapeutic strategies

World Dementia Council

Leading the Global Action Against Dementia

Some of the Priorities

• Explore single and multi-domain approaches for primary and

secondary prevention of dementias based on evidence on risk/protective factors and the relationship with other chronic diseases

• Understand the influence and interactions of non-modifiable

(eg, gender, genetics, age) and modifiable (eg, physical activity, diet, and cognitive stimulation) risk and protective factors for dementia in population-based samples

• Determine the feasibility, optimal mode of administration, and

effectiveness of interventions to address risk factors for dementia (including physical activity, cognitive activity, education, nutritional factors, and others)

World Dementia Council

Leading the Global Action Against Dementia

Some of the Priorities

• Introduce and disseminate a bold Word

Demen0a Council statement around the importance of, and principles for, op0mal demen0a care and support

• Iden0fy gaps in current knowledge around

demen0a care, including the areas with greatest poten0al for genera0ng the most impact and benefits for people with living with demen0a and their caregivers

World Dementia Council

Leading the Global Action Against Dementia

Care

Global Lead Harry Johns

President & CEO, Alzheimer’s Association

WDC linking with Global Brain Health Institute

• Influence global programmes focused on healthy

ageing/brain health (e.g. Global Brain Health Ins0tute – GBHI, Global Council on Brain Health, etc.), to ensure the inclusion of the perspec0ves and needs of Low and Middle Income Countries (LMICs)

• Support LMICs to engage in Risk Reduc0on ac0vi0es –

e.g. by facilita0ng a risk reduc0on pilot project in Indonesia with support from the GBHI Fellows or Scholars Programmes.

• Engage into pilot programs in LMIC

World Dementia Council

Leading the Global Action Against Dementia

Risk Reduction

Global Lead Ron Petersen

Director, AD Research Center, Mayo Clinic

WDC linking with Global Council on Brain Health

World Dementia Council

Leading the Global Action Against Dementia

• WFSJ provides a support environment for

9000 journalists around the world

• Toolboxes can be preppared and

disseminated to general journalists on specific topics

• WDC is in disucssion with WFSJ to prepare a

Dementia Toolbox that would help journalists from all continents

• Goal is to support journalists to enhance

awareness of dementia and contribute to coverage of the May 2017 WHO vote on Global Action Plan WDC working with WFSJ on to Global Awareness

Funders NGOs Industry Academia

World Dementia Council

World Dementia Council

Leading the Global Action Against Dementia

Member States

PLWD

WHO ADI JPND IADRFC WW-ADNI GBHI CEOi GCBH

World Dementia Council

World Dementia Council

Leading the Global Action Against Dementia

PLWD

WHO ADI JPND IADRFC WW-ADNI GBHI CEOi GCBH

World Dementia Council

World Dementia Council

Leading the Global Action Against Dementia

PLWD

WHO ADI JPND IADRFC WW-ADNI GBHI CEOi GCBH

A Global Response to the Global Challenge of Dementia

yves.joanette@umontreal.ca

Chair, World Dementia Council

World Dementia Council

Leading the Global Action Against Dementia