January 19, 2012

NAPA: New Plan to Fight Alzheimer's, but... Where's the Money?

On Monday and Tuesday, representatives from Health and Human Services met with medical experts to discuss the National Alzheimer's Project Act (NAPA), which was passed by both houses of Congress and signed into law by president Obama on January 4, 2011. NAPA – when finalized -- is intended to treat and prevent Alzheimer’s disease by 2025, and will resemble the wars on cancer and heart disease.

A Great Plan for 2025 But Alzheimer's Research Needs Money Now
An estimated five million Americans suffer from Alzheimer's disease, a number expected to triple by 2050. Our obesity epidemic will undoubtedly inflate those numbers, too, since diabetics are more prone to AD. People with Parkinson's also face increased risk of AD . . . one reason for my personal interest in NAPA.

The National Institutes of Health (NIH) conducts most groundbreaking disease research. Its budget for Alzheimer's research has remained under $500 million. By contrast, the cancer research budget is $6 billion; HIV/AIDS, $3 billion. No question -- as a prostate cancer survivor, and as someone who has lost many close friends to AIDS, I support those efforts. It's important to recognize success, and death rates from cancer and HIV/AIDS are dramatically down in recent years. Spend the money on research; see results.

For a full list of NIH's research budget by disease, click here.

Alzheimer's differs from cancer and HIV/AIDS since it more often requires extended caregiving. That care is costly in an institutional setting. Even when care is provided at home by family members, it costs society -- as providers often must abandon other productive work.

Yesterday morning, I listened to the Diane Rehm Show on NPR. During a discussion about NAPA, one speaker estimated that AD costs our economy $183 billion a year.

What's the Likelihood of More Research $$ on this Costly "Silver Tsunami"?
Zilch. Last July, Congress voted to cut NIH's budget by $321 million, only the second time in its 40-year history that NIH received a budget less than that of the previous year. Alzheimer's research has been "lucky" -- its estimated budget for fiscal 2012 is $458 million, up from $450 million last year. Terrific! An $8 million increase in the face of the enormity of the problem.

It gets worse. Last August, as part of a deal to raise the debt ceiling, it was agreed that if this session of Congress fails to come up with an agreement on cutting the deficit by $7.1 trillion over 10 years, automatic spending cuts of $1.2 trillion will kick in for 2013 -- half of that total from defense spending and the other half from domestic spending. Given the track record of this Congress, what odds would you give that it will be able to overcome the enormous political obstacles and reach an agreement on a combination of tax increases and spending cuts totaling $7.1 trillion? 100 to one? 1,000 to one? Higher?

If this doesn't happen and the alternative scenario of $1.2 trillion in spending cuts kicks in for 2013, NIH's disease research budget will surely take a big hit.

Political pundits generally agree that there's little chance Congress will be able to enact any major legislation in the politically charged atmosphere from now to the November election. But some speculate that there's a chance Congress might come up with the super deal on tax increases and spending cuts in the brief window between the elections and year's end.

The rationale is that if this doesn't happen, the Democrats will be faced with the automatic cuts in domestic spending on programs they favor, and Republicans will be faced with the unpleasant prospect of cuts in defense spending to come up with the total of $1.2 trillion in spending cuts. AND they also will see the Bush tax cuts favoring the wealthy expire at the end of 2012.

But even this slim chance of avoiding the scheduled automatic spending cuts doesn't offer any real hope for the needed dramatic increase in funds for Alzheimer's research. On the contrary, if Congress by some miracle agreed on a "Super Deal," it also would have spending cuts as part of the deal.

So far, I've mostly addressed Alzheimer's huge potential hit on the federal budget. But the real tragedy is Alzheimer's impact on the emotional and financial health of millions of Americans today . . . and on a dramatically increasing number in the future.

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