G8 pledges to beat dementia scourge


Tom Coppins speaks of the frustration and fear he has regarding his dementia

Leading nations have committed to developing a cure or treatment for dementia by 2025 at the G8 dementia summit.

Health ministers meeting in London said it was a “big ambition” and that they would significantly increase funding for research to meet that goal.

The UK has already said it aims to double its annual research funding to £132m by 2025.

The global number of dementia sufferers is expected to treble to 135m by 2050.

The G8 said it would “develop a co-ordinated international research action plan” to target the gaps in research and ways to address them.

Dementia across the globe

  • 44 million
    globally have dementia
  • 135 million
    will have the disease in 2050
  • By then
    71%
    will be poor and middle income
  • $600bn
    global cost of dementia
  • In the UK, cancer research gets
    8x
    as much funding as dementia

It also called on the World Health Organization to identify dementia as “an increasing threat to global health” and to help countries adapt to the dementia timebomb.

In a statement it said “We recognise the need to strengthen efforts to stimulate and harness innovation and to catalyse investment at the global level.”

Dementia is incurable and ultimately leaves people needing full-time care as brain function wastes away.

There is growing concern that some countries will simply not cope with the growing burden of dementia.

It costs the world billions of dollars each year: £370bn ($604bn) in 2010, according to the World Health Organization.

Health ministers from the G8 nations are meeting – under the presidency of the UK – to find the best ways to advance research.

Analysis

James Gallagher Health and science reporter, BBC News

Dementia is heading towards being the biggest health and care problem of a generation so you’d think it would have the funding to match. Yet it really is the poor relation of other diseases.

In the UK, about £590m is spent on cancer research with £267m coming from government. At the moment £52m of government money goes to dementia research.

It’s a pattern reflected around the world.

Part of the problem is that until recently dementia was considered a “normal part of ageing” whereas cancer has been documented as far back as ancient Egypt.

It means dementia research is starting from a low base.

The UK is aiming to double its spend, but this will still leave dementia significantly behind.

The Alzheimer’s Society says it expects more.

David Cameron called on governments, industry and charities all to commit more funding. He said the G8 should make this the day “the global fight-back really started”.

He said the UK Government would boost annual research funding from £66m, the 2015 pledge, to £132m, which will be adjusted for inflation, by 2025.

Mr Cameron told the summit: “This disease steals lives, wrecks families and breaks hearts.”

“If we are to beat dementia, we must also work globally, with nations, business and scientists from all over the world working together as we did with cancer, and with HIV and Aids.

“This is going to be a bigger and bigger issue, the key is to keep pushing.”

The health secretary Jeremy Hunt said: “The amount [of money] going into research is too little.

“We would like a cure to be available by 2025. It’s a big, big ambition to have. If we don’t aim for the stars we won’t land on the moon.”

However, so far only the UK has made a definite funding announcement with the other nations committing to “a significant increase in overall dementia research”.

Mr Hunt said a Dementia Envoy would be appointed that would also help industry and charities boost funding.

‘Global leadership’

The chief executive of the Alzheimer’s Society, Jeremy Hughes, said: “Today the UK has demonstrated global leadership on tackling dementia.

“Dementia has come out of the shadows and is centre stage – but we must ensure G8 has a lasting legacy.

“The governments’ have all committed to updating progress on research biannually, but every month counts for the millions of people living with dementia worldwide.”

Hilary Evans, from the charity Alzheimer’s Research UK, said: “This action plan is the best possible news for people living with dementia, it tells them that the world will fight for them, and that the best and most collaborative science is our greatest weapon.

“With the right investment, we can be more optimistic than ever that we will meet if not exceed the G8’s 2025 target.”

Bran scans

A dementia brain scan will also be introduced for some NHS patients with complicated symptoms.

It could help rule out Alzheimer’s disease, the most common form of dementia, by hunting for damaged proteins in the brain.

A radioactive marker which binds to amyloid, a hallmark of Alzheimer’s disease, will be injected. If there is amyloid in the brain then the tracer will show up on brain scans.

The test will initially be offered at Imperial College Healthcare NHS Trust in London and will be rolled out to other specialist centres.

What is dementia?

  • It is an umbrella term that describes about 100 diseases in which brain cells die on a huge scale
  • All damage memory, language, mental agility, understanding and judgement
  • Alzheimer’s disease is the most common form, affecting 62% of those living with dementia
  • It gets worse with time and eventually people are left completely dependent on carers
  • It is incurable

Dr Richard Perry, a consultant neurologist at Imperial, told the BBC: “For a patient who can’t get an answer using the usual tests this will make a big difference as it’ll provide clarity.

“Knowing the cause is the first step to getting treatment.”

Around 100 patients a year are expected to get access to the scan.

David Cameron: “”If we are to beat dementia, we must also work globally”

There have been a flurry of other funding announcements tied to the talks including:

  • The Medical Research Council (MRC) will commit £50m to improve treatments and delay the progression of the disease
  • The Alzheimer’s Society has promised to spend at least £100m on research in the next decade
  • A new £3m “Dementia Consortium” will unite the charity Alzheimer’s Research UK, two pharmaceutical companies and MRC Technology in the hunt for new drugs
  • The Engineering and Physical Sciences Research Council has put up £5m improve ways of diagnosing and measure disease progression.

Meanwhile, the Care Quality Commission (CQC) plans unannounced inspections of the care of dementia patients at 150 institutions across England.

The CQC said it would look at what needed improving, how to cut hospital admissions from care homes and ways to help people with dementia maintain their physical and mental well-being.

David Behan, chief executive of the health regulator, said: “We know that these people are often vulnerable because of their condition and can rely on a number of services across health and social care to support their physical, mental and social well-being.

“Our findings will draw conclusions on a national scale about what works well and where improvements are required.”

Polio is re-emerging in areas previously considered polio free.


Concern is mounting that the global drive to eradicate polio is being undermined by security problems and access constraints that have led to a resurgence of poliovirus in a number of countries previously declared to be free of polio.

On 30 September South Sudan’s new health minister, Riek Gai Kok, declared a “national health emergency” after confirming three cases of wild poliovirus type 1 infection. The country had been officially polio free since June 2009, but the health ministry had been on high alert for its reintroduction since an outbreak was confirmed in Somalia last May, which rapidly spread to Ethiopia and Kenya.

There have now been 174 confirmed cases in Somalia, 14 in Kenya, and three in Ethiopia. Major emergency vaccination campaigns have been started in these and neighbouring countries, but vaccinations have been unable to take place in certain no-go areas in Somalia, Sudan, and Yemen.

The Sudanese Doctors’ Union warned that the disease could rapidly spread across the border because of a “large immunity gap” caused by the denial of aid access in the Nuba Mountains and Blue Nile areas bordering South Sudan, where the lack of vaccination had left “almost all children susceptible to polio and other vaccine preventable diseases.”1 2

On 1 October the union wrote to the UK prime minister, David Cameron, calling on him to denounce the Sudanese government’s denial of access to healthcare, after doctors were prevented from treating hundreds of people injured in recent demonstrations.

The union’s UK spokesman, Abdelmalik Hashim, told the BMJ that Sudan had just experienced the worst outbreak of yellow fever in recent years after the expulsion of aid groups from Darfur, and now “the refusal of the government of Sudan to cooperate with the international community is jeopardising all the gains achieved by the global polio eradication programme since 1988.”

Source:BMJ

DNA mapping for cancer patients.


dna

Up to 100,000 patients with cancer and rare diseases in England are to have their entire genetic code sequenced.

The Prime Minister will announce £100m has been set aside for the project over the next three to five years.

The aim is to give doctors a better understanding of patients’ genetic make-up, condition and treatment needs, and help develop new cancer treatments.

One human genome contains three billion base pairs – the building blocks of DNA.

Sequencing the code produces a huge amount of data. Although the price is falling fast, it currently costs £5,000 to £10,000 – which explains why no country in the world has embarked on mass DNA mapping on this scale.

When it will start – who will do the genome sequencing and analysis – has not been worked out – nor which patients will be eligible for the voluntary testing.

But the hope is by comparing genetic profiles of huge numbers of patients, it will allow scientists to understand why some do far better than others – and help in the quest for new treatments.

Privacy campaigners are concern such a move could allow personal data to be passed on to private companies, such as insurance companies.

 

Dr Kat Arney from Cancer Research UK: ”There could be very big benefits for cancer patients in the future”

But ministers insist the project is for medical research alone.

For existing patients, DNA mapping may lead to better targeting of medicines.

The power of this type of genetic analysis was demonstrated earlier this year when a study of 2,000 breast cancers showed the cancer should be thought of as 10 completely separate diseases.

Personalised therapies

There are already a handful of targeted treatments – for breast, lung, bowel and blood cancers – where tests for a single gene can reveal whether a patient is likely to respond.

For example, breast cancer patients are tested to see if their tumour is positive for ‘Her2’, a protein that can accelerate the growth of malignant cells. If so they can benefit from Herceptin, a drug which works on patients with high levels of the Her2 protein.

Whole genome mapping may yield more of these personalised therapies.

Speaking ahead of the announcement David Cameron said: “By unlocking the power of DNA data, the NHS will lead the global race for better tests, better drugs and above all better care.”

The chief medical officer for England, Prof Dame Sally Davies, said: “Single gene testing is already available across the NHS ranging from diagnosing cancers to assessing patients’ risk of suffering side effects from treatment.

“At the moment, these tests focus on diseases caused by changes in a single gene. This funding opens up the possibility of being able to look at the three billion DNA pieces in each of us so we can get a greater understanding of the complex relationship between our genes and lifestyle.”

Stratified medicine

  • Cancer Research UK launched it ‘stratified medicine’ project last year. It aims to group, or ‘stratify’ patients into those who will respond best to particular treatments. DNA samples of 9,000 patients with breast, bowel, prostate, lung and ovarian cancer, and melanoma are being collected at seven centres across the UK. The genetic make-up of the cancer will be analysed and the key mutations noted. The information will be stored as a guide to help future research.

There are a number of existing projects seeking to improve understanding of the genetics of cancer, such as Cancer Research UK’s ‘stratified medicine’ programme.

The UK is part of the International Cancer Genome Consortium which is planning to sequence 50 different cancers and catalogue their different mutations.

There are more than 200 types of cancer – it is a complex and highly resistant disease – the talk among specialists is less of cures and more of improved long-term outcomes.

So most of the benefits from these ambitious projects are likely to be among the next generation of cancer patients.

Source: BBC