Prioritising the global brain health crisis

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Graphic showing brain depicted as world map

The numbers associated with the human brain are staggering. Each of us has around 86 billion neurons, fed by blood vessels that would stretch four times around the Earth if laid out end to end. Those neurons are networked by around 100 trillion connections.

But just as staggering are the numbers related to brain disorders. These disorders are associated with more than 18 per cent of all health loss around the world. The number of people with dementia increased by 161 per cent between 1990 and 2021. Over the same period, Parkinson’s disease cases increased by 273 per cent. Stroke – a condition caused by the brain being starved of blood – is the second biggest cause of death globally. Even if it doesn’t result in death, it can be a major cause of life-changing disability.

And the problem is only getting worse. Between 1990 and 2021, the total number of strokes globally increased by 86 per cent. “Stroke is now the number one medical emergency in our accident and emergency departments,” says Temitope Farombi, Consultant Geriatric Neurologist at University College Hospital at Ibadan in Nigeria.

All of these issues are set to worsen as the global population ages and the statistics suggest that the world is heading for a huge problem with brain health crisis requiring multiple approaches. “The big challenge with brain health is that it’s so many different diseases and every country has a completely different healthcare system,” says Michael Oberreiter, Head of Global Access at one of the world’s largest biotechnology companies, Roche. The challenge is so large that no single organisation or government can tackle it alone.

That’s the problem that Roche, a founding member of the Brain Health Initiative (BHI), aims to solve. Started in collaboration with the Institute of Health Metrics and Evaluation (IHME), an international public health agency based at the University of Washington in Seattle, the BHI aims to qualify and quantify – with reputable data – the global burden of brain disorders, as well as to improve understanding of the challenge ahead and of the resources needed to drive policy change. Ultimately the goal is to gather and communicate the evidence to inform and shape health policy, to ensure that people with brain disorders get the treatment and care they need. “If you believe that our future lies in having a resilient health system that addresses the needs of all patients, there is no way that we can ignore brain health,” Oberreiter says.

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Brain disorders are not just a threat to the health of individuals; they also threaten societies. “Brain capital” – an individual’s social, emotional and cognitive resources – means that a healthy brain is vital to a thriving population, not only powering our markets and economies, but also defining who we are as people. “Brain health is not just a health system problem: it touches all aspects of society and will continue to do so until we can create meaningful change,” Oberreiter says.

The BHI is particularly focused on driving global policy changes because they can bring in lasting and meaningful improvements to those living with brain disorders. One key is to provide policymakers  with relevant, actionable information. The current lack of such data is what led to the creation of the Brain Health Atlas, a free online mapping and data tool on brain-disorders, offering a wealth of insights into countries, decades, brain disorders and the social and economic burdens they are causing.

The base-level information comes from a global database of scientific evidence, mostly derived from the Global Burden of Disease study. This collects data on 369 diseases in more than 200 countries via a consortium of more than 11,000 researchers, who publish the study in The Lancet.

Data from the Global Burden of Disease study on brain health is sifted out of this by IHME’s network of health and policy experts. This network provides the foundation for the BHI’s other key offering: collaboration. Whether within a region or across continents, everyone involved knows the importance of sharing the task of challenging the growth of brain disorders. “National research is very important, but we also need to have cross-country research,” Oberreiter says.

That’s because every country has a different healthcare system. Only with international collaboration and data-sharing can researchers compare the efficacy of different approaches, and identify the interventions that really make a difference in people’s lives.

Such insights, gathered and shared in the right way, are key to persuading decision-makers to act: it gives them everything they need to make the case for policy change. That includes economic information – always a powerful persuader. Preliminary estimates on the Brain Health Atlas show, for instance, that care for people who live with brain disorders cost the global economy over $1 trillion in 2019 and an additional $1.66 trillion was lost in income by those living with brain disorders. If policymakers want a thriving, healthy, productive population, they must pay attention to brain health.

But the issue is getting worse. In Japan, the total number of deaths due to Alzheimer’s disease and other dementias has increased by 368 per cent since 1990; Alzheimer’s disease now ranks as the country’s top cause of death. Nigeria, meanwhile, can expect eight times as many lost years of healthy life in 2050, in a population that will have little more than doubled.

Farombi is not surprised. “We are seeing people coming down with stroke in their thirties or their early forties – it’s getting towards a pandemic level of stroke in young adults,” she says. “That is going to cause a lot of disability in life here.”

All of this will be addressable if projects like the Brain Health Initiative get traction and take-up. So far, things are looking good, Farombi believes. “I’m optimistic because the World Health Organization and major health organisations are now talking about it,” she says. “They can use their platform to talk to governments of different nations so that we can all come together and take action.”

Oberreiter is also hopeful. He recently attended an event run by the European Brain Council where brain health issues were very much in the spotlight. “It brought the smartest brains from around the world together to discuss the advances we need to make,” he says. People are beginning to appreciate that there is a huge potential return on investment to society from interventions in brain health. It’s time to move past discussion and take tangible next steps in solidifying global efforts to tackle the growing brain health crisis.

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