by Karen Rubin/News & Photo Features

With five million Americans suffering from Alzheimer’s today, and nearly 15 million expected to be affected by 2050, Hillary Clinton is pledging a new, groundbreaking $2 billion annual commitment to prevent, effectively treat and make a cure possible for Alzheimer’s disease by 2025, if she is elected President.

Alzheimer’s is the 6th leading cause of death in the United States and is the only cause in the Top 10 that we cannot currently prevent, cure, or even slow.

But scientists say that therapies that would prevent, cure or slow the progress are in reach, provided there is adequate, predictable funding for research. There is a “budget constraint, not a knowledge constraint” that is the main obstacle to success, scientists say.

While the incidence of major diseases is falling, the incidence of Alzheimer’s is rising. “Rates of incidence will only go up in future, as the population ages. But cure is at hand, just lacks funding. Impact of disease combined with the nearness of solution is what is causing Hillary Clinton to want to increase funding.”

The $2 billion a year that Secretary Clinton pledges to devote to research – almost quadrupling the $586 million that has been allocated to the National Institutes of Health (NIH) – is a figure that comes out of the Congressional Task Force on Alzheimer’s disease which she co-chaired while in the US Senate, and from other professional panels. And the cost is miniscule compared to how much is spent now: Alzheimer’s is one of the costliest diseases in America – exceeding $200 billion in annual costs to the economy from the disease and related dementia. Recent reports suggest that by 2050 the total cost may exceed $1 trillion per year.

Women and communities of color are disproportionately affected by for this terrible disease. Two out of every three Alzheimer’s patients are women, older African Americans are twice as likely than older white individuals to be afflicted and older Latinos are 1.5 times as likely.

In developing this plan, Hillary Clinton has consulted with leading physician-scientists to understand what it would take to rapidly accelerate progress currently being made in the field.

“We owe it to the millions of families who stay up at night worrying about their loved ones afflicted by this terrible disease and facing the hard reality of the long goodbye to make research investments that will prevent, effectively treat and make a cure possible by 2025,” Clinton said. “The best scientific minds tell us we have a real chance to make groundbreaking progress on curing this disease and relieving the pain so many families feel every day. My plan will set us on that course.”

Clinton’s plan will:

• Dedicate a historic, decade-long investment of $2 billion per year to Alzheimer’s research and related disorders – a fourfold increase over last year’s $586 million. Leading researchers including the research advisory council to the congressionally-authorized National Plan to Address Alzheimer’s Disease, have set out this goal of $2 billion a year to prevent and effectively treat Alzheimer’s and make a cure possible by 2025.
• Ensure a reliable stream of funding for fighting Alzheimer’s between now and 2025. This plan ensures predictability of funding between now and 2025, so that researchers can work consistently towards developing effective treatments and a cure. This gives researchers greater freedom to pursue the big, creative bets – including cross-collaboration with researchers in related fields – that can result in dramatic pay-offs.
• Appoint a top-flight team to oversee this initiative and consult regularly with top researchers to ensure progress towards achieving the treatment target. At each stage, this plan will embrace a range of approaches to drive new knowledge into effective treatments.

Clinton’s new research investment in preventing and effectively treating Alzheimer’s will yield results not just in the fight against this disease, but for a range of neurodegenerative illnesses, from Parkinson’s disease to Lewy body dementia to frontotemporal dementia. The plan will also help medical professionals understand the intersection of Alzheimer’s with other conditions, including the high rate of individuals with Down syndrome who experience early-onset Alzheimer’s.

This commitment to Alzheimer’s research is only part of Clinton’s overall commitment to a substantial increase in investment at the National Institutes of Health to prevent, treat, and secure cures for the broad array of diseases that afflict Americans.

In addition to investing in research, Clinton announced today new parts of her agenda to support caregivers, like those who give critical care and support to the millions of families struggling with Alzheimer’s. Her plan will fight for Medicare to cover a comprehensive, care-planning session with a clinician following every new diagnosis of Alzheimer’s or related diseases, work with Congress to reauthorize the Missing Alzheimer’s Disease Patient Alert Program and direct the Social Security Administration to raise awareness of the Medicare-covered annual wellness visits and their associated preventive and screening benefits, including the cognitive screening – which is especially critical for patients suffering from Alzheimer’s and other related dementia, by presenting this information alongside Social Security payments that beneficiaries will open and read.

“An Alzheimer’s Epidemic – and No Survivors”

The United States is facing an Alzheimer’s epidemic. And there are no survivors. and while the incidence of other diseases have gone down, the incidence of Alzheimer’s is rising.

But scientists are confident that therapies can be found – “we don’t have a knowledge problem. We have a budget problem.”

“The proposed boost in funding could not have come at a better time – last couple of years, revelations, discoveries in this field that have been unprecedented,” said Dr. Rudolph Tanzi, the Joseph P. and Rose F. Kennedy Professor of Neurology, Harvard Medical School. Dr. Tanzi is Director of the Genetics and Aging Research unit at Massachusetts General, the Chair of the Cure Alzheimer’s Fund Research Consortium and was named one of Time Magazines’ 2015 “100 Most Influential People in the World.”

“From a scientific side, it is reasonable, rational that if we can throw enough money into it, we have a chance to dramatically reduce incidence, stave off disease for folks at highest risk,” he said during a conference call hosted by the Hillary for America campaign.

This disease was described 1906 by Dr. Alzheimer after studying the pathology in the brain of a 56-year old patient and found a mutation in the brain, the same mutation as Alice  portrayed in the movie, “Still Alice”.

He said that research into early onset Alzheimer’s has shown common conditions, but most importantly, that people can have the conditions for Alzheimer’s for 10, 15, and 20 years before the first symptoms emerge, but by then, it is too late to do anything about it.

Early research was done on mice brains and yielded incorrect results. The breakthrough came when researchers “grew” Alzheimer’s in a “minibrain” in a dish – a gel-like environment – “and lo and behold, after the amyloid formed, it created the tangles that kill nerve cells. This was the first proof of concept, that if we do the right experiment and use human nerve cells, not mice, the amyloid causes the tangles.”

He added, “We also learned that the third pillar of pathology of Alzheimer’s is inflammation, which is probably the most significant target in a patient who already has the disease, because the inflammation kills many of the nerve cells. Through the Alzheimer’s Genome Project we now know genes control inflammation – so the first drug target is to quell the inflammation in the brain.”

He pointed to research on “resilient brains where we see a person who dies in their 80s or 90s with no cognitive issues, but when we look at their brain, we see the tangles, but they don’t have the inflammation. So if can quell  inflammation, we can better help patients.”

This could be a path to at least slowing the progress of the disease and the severity.

“If we can stave off the conversion of simply having plaques in the brain of a 50-60 years old – a picture like in a colonscopy so the brain would be assessed – for amyloid load, how much plaques – we would know if 10, 15, 20 years away the patient is at high risk of dementia (cognitive problems),” said Dr. Tanzi. “The goal would be that could be given a drug, together with lifestyle, that patient never gets to the point of dementia. You might have  the precursors, but not the three -plaques, tangles, inflammation. If we can stave it off for 5 years, the savings to Medicare, Medicaid treatment, nursing home savings would be in the many, many billions of dollars. Once we have one or two of these drugs to slow down these pathologies.”

“I’m optimistic. The main bottleneck in the field is funding. We discovered the genes in the 1980s, 1990s. We discovered two dozen Alzheimer’s genes, but there has been very little work, including on genes that control the inflammation because there is no budget – the research is considered high risk because so far there has been little success. If we had more money, many more shots on goal, many more genes being studied – because most of what we know comes from studying genes,” he said, he is confident of success.

“We have budget constraint, not knowledge constraint. Hopefully with $2 billion a year, we finally can do the work we can do to stop the disease by 2025.”

The $2 billion a year that Clinton would allocate, compared to the $586 million that came from NIH last year, amounts to $20 billion commitment over 10 years.

“Our experts would validate that the predictability of funding is almost as important as the money itself,” said Robert Egge, the Executive Director of the Alzheimer’s Impact Movement. Mr. Egge previously served as Executive Director of the Alzheimer’s Study Group – a blue ribbon task force of national leaders co-chaired by former House Speaker Newt Gingrich and former Nebraska Senator Bob Kerrey. “$2 billion is the amount we know will make a difference and is what was recommended … to help get us over the finish line. We know that, but we haven’t seen the will in Congress to match the recommendation.”

The $2 billion annual commitment is part of larger plan that Senator Clinton is unveiling today at an event in Fairfield, Iowa. Other elements would bolster Medicare so a physician could follow every diagnosis of Alzheimers, working with Congress on a patient alert program (which has lapsed) and a  tax credit proposal that would allow caregivers to take 20% up to $6000 in care-related costs a year.

The focus on Alzheimer’s is the first piece of a larger commitment to increase the research investment that Hillary Clinton would  seek. In addition to investment in manufacturing and infrastructure, she is proposing a plan to dedicate funds for research to help innovate and lead the world in next-generation cures of diseases that are ravaging Americans. This commitment for Alzheimer’s is just the first piece of that.

The campaign also noted that plan announced today “build on Hillary Clinton’s long and strong record of advocating for patients and families who bear the burden of Alzheimer’s disease. In the U.S. Senate, she consistently pushed for greater funding for Alzheimer’s research, including federally-funded stem cell research, and she co-chaired the Congressional Task Force on Alzheimer’s disease. She also introduced legislation to restore funding for the Alzheimer’s Association 24/7 Contact Center and for Alzheimer’s disease demonstration grants. And she forged links across the aisle on the issue, appearing with former House Speaker Newt Gingrich to promote a new study group on Alzheimer’s research. This record reflects her long-time understanding that this disease not only represents a physical, psychological, and financial burden to millions of Americans, but an overwhelming economic and budgetary threat to our country that we must address.”

A full fact sheet on the new plan is available here.

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