Pole position in the race to be humanity’s greatest enemy is highly competitive, with catastrophic climate change, an epidemic of depression, monster asteroids, an epidemic of obesity, AIDS and cancer all revving up at the starting line. Now British Prime Minister David Cameron has added dementia to the line-up.
Speaking to a summit of health and finance leaders in London last week, he said, “The truth is that dementia now stands alongside cancer as one of the greatest enemies of humanity.”
And many people do fear dementia more than cancer. In a society in which the Enlightenment values of rationality and autonomy are treasured as the only qualities which make life meaningful, the prospect of losing them is terrifying for many people. Baby-boomers have lived for decades with the Nike slogan “just do it”; for many of them befuddlement and dependence might be worse than a painful terminal illness.
According to the World Health Organization, 35.6 million people suffer from dementia, with 7.7 million new cases appearing every year. Alzheimer’s disease is the most common form but there are others. The total will almost double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050.
Part of Mr Cameron’s solution is to pour government money into dementia research. He has just launched the world’s biggest dementia study, a US$27 million public-private partnership to analyse data from 2 million people. “We have to fight to cure it,” Mr Cameron says. “I know some people will say that it’s not possible, but we have seen with cancer what medicine can achieve.”
Why is government money needed? Because the pharmaceutical industry is sceptical about the possibility of finding effective treatments any time soon. World Health Organization head Margaret Chan even told a G8 summit last year: “In terms of a cure, or even a treatment that can modify the disease, we are empty-handed. “
That hasn’t stopped the United States, the G8, and the United Kingdom from setting a deadline for the cure: the year 2025, just 10 years away. Experts say that this is unrealistic. Alzheimer’s disease appears to have a 15 to 20-year incubation period. “This means that if we had, today, already in hand, the funding, recruitment and the perfect drug, the trial would still take 15 to 20 years,” one US Alzheimer’s researcher has pointed out.
So it appears that the deadline has already been missed — before the ink was dry on Mr Cameron’s press release.
In fact, his analogy with the War on Cancer is a telltale sign of political grandstanding to soothe the anxieties of worried voters. President Richard Nixon declared war on cancer in 1971. More than US$100 billion has been spent on cancer research in the US over the past 40 years, but people are still dying of cancer. The enemy is elusive and sneaky and the war is far from won.
So if the war on dementia takes as long as the war on cancer, the real crisis is a crisis of care. Do we have the generosity and determination to care for the victims of a lingering disease which makes them unproductive and unresponsive? It is these silent human qualities which Mr Cameron should be fostering, just as much as new medication.
Apart from financing dementia care, there are at least two strands to the care crisis which he could address.
First, family breakdown. Many people are entering their twilight years with few or no children and a history of broken relationships. They will lack strong family support at the time they need it most. In the UK, figures from a couple of years ago showed that nearly 2.5 million people between the ages of 45 and 64 had no spouse, partner or children living with them. Who will take care of them if they fall ill with dementia? They will end up in the care of an institution – which is both expensive and soulless. What will the government do to strengthen families?
Second, our track record on caring for the vulnerable is abyssmal. At the other end of life, the weight of public opinion is that “unproductive” people should not be born. Some studies indicate that more than 90 percent of Down syndrome children are aborted because their mothers fear that they will be too great a burden. This is far from true, as experience shows that Down syndrome kids make valuable contributions to the lives of their families. But the prejudice against unborn Down syndrome children shows no sign of abating.
Some research is being done on promising treatments for Down syndrome. But with most of these children being aborted, there is little incentive to fund it. Cystic fibrosis affects one-tenth the number of children affected by Down syndrome, but gets three times as much money. “The geneticists expect Down syndrome to disappear,” Alberto Costa, an American neuroscientist told the New York Times, “so why fund treatments?”
Something similar could happen with the field of dementia research if euthanasia is ever legalised. With movies like Amour, the 2012 French film about a pianist who suffocates his demented wife, winning Oscars, it is not dementia but people with dementia who will be viewed as enemies of humanity. Why waste money on research if the victims can be euthanased?
Framing dementia as a kind of medical Armageddon is an irresponsible way to prepare the public for the coming challenge. What Mr Cameron and other politicians should be saying is that the way we treat victims of dementia is the ultimate test of whether we are truly a compassionate, democratic society. This could be our finest hour.
Michael Cook is editor of MercatorNet.