The February 1, 2019 edition of Fortune magazine for Asia Pacific includes a fascinating story on Alzheimer’s, and how an ethnobotanist is reshaping research into the disease. See the story on Fortune.com, at Could This Radical New Approach to Alzheimer’s Lead to a Breakthrough?
The story is a tale of failed science, expensive bets that haven’t paid off (to the tune of hundreds of billions of dollars, AND countless lives not saved from Alzheimer’s), and a very different approach that’s bringing new hope to a heart-breaking disease. What interests me the most throughout the story is the emphasis on collaboration. We always say that collaboration isn’t about the technology you use – it’s the mindset and approach to getting work done. And in the case of Alzheimer’s disease, Paul Cox’s new collaboration-based approach is creating a roadmap for health transformation that has been missing in action.
Here are some of the themes in the story that stood out to me:
- The power of the outsider. Most research on Alzheimer’s has followed a single idea. Paul Cox, an ethnobotanist, saw the problem differently, approached the question differently, and has helped pioneer a different narrative that points to a very different set of outcomes.
- The need for a different approach to funding science. “The problem is the way science is done and funded,” said Zaven Khachaturian, editor-in-chief of trade journal Alzheimer’s & Dementia who formerly directed Alzheimer’s research across the National Institutes of Health, during one of several long phone calls. “It’s populated by people who follow the orthodoxy. To get continuous support, scientists must follow existing orthodoxies. Everybody says they value the individual or the maverick, but nobody will fund them because they say it’s a fishing expedition.” Research has shown that evaluators on panels that award government funding to scientists at research universities regularly give higher scores to conservative proposals than to those trying to break new ground.
- The power of cross-fertilisation between disciplines and sub-disciplines, and the use of a structured process to achieve it. Cox is the consortium’s ringleader, emcee, flack, and switchboard operator. He says he’s on email or phone calls with a handful or two of the scientists every week, learning about new research, suggesting new avenues to pursue, and connecting them to others in the group. The consortium gathers once a year, often in Jackson but sometimes in places like Johannesburg or Stockholm. “We’re all in different fields,” marine biologist Larry Brand told me. “We all present our results and try to connect the dots on everything from causes of algae blooms to medical problems to possible prevention and treatment.” Brand’s work has evolved as a result of these collaborations. A decade ago, when he first joined the consortium, Brand was trying to understand what causes the huge algae blooms that Florida sees so often. Now he’s trying to figure out how much BMAA is getting into the food chain via crabs, shrimp, and other marine life that can be found in those blooms. “Paul’s something of a Renaissance man,” Brand told me. “He’s very knowledgeable in a lot of different fields, and he’s very good at connecting the dots.”
- The cost of not changing how health research is done. In the absence of a cure, the pool of Alzheimer’s patients will soar: while 47 million people worldwide live with Alzheimer’s today, 141 million may have the disease in 2050, according to the Alzheimer’s Association. In the U.S. alone, the financial cost of caring for today’s 5.7 million patients is a staggering annual $277 billion. By mid-century, Americans may spend $1.1 trillion annually on Alzheimer’s, a crippling blow to a reeling health care system. The ultimate cost, of course, is that we are no closer to curing Alzheimer’s than we were 20 years ago.
Collaboration is about people bringing their expertise, experiences, research and brilliance to bear on problems, challenges and opportunities that can’t be solved alone—a reality that’s beautifully shown in the above story. Technology can indeed help to connect the dots and enable something great to happen within a new collaborative approach, or can merely be used to replicate the existing (broken) processes and structures that haven’t resulted in any progress.
It’s certain that the well-funded Pharma companies that have experienced such dismal failures in Alzheimer’s research have had access to the best-in-world technology to enable the delivery of good science. But without the corresponding change in approach, it’s all ultimately been for nothing.
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