Some 80 million Africans are projected to have dementia by 2050 – a fourfold increase from 2015 – and governments need to invest in brain health as an “economic imperative” to mitigate this.

This call was made by the Davos Alzheimer’s Collaborative (DAC) at a meeting in Johannesburg on Tuesday, on the eve of the G20 Health Ministers meeting in South Africa.

DAC founder and board chair George Vradenburg told the meeting that it is precisely because the African population “skews young, not old” that the continent has the opportunity to prevent cognitive decline.

“Preventing Alzheimer’s, in significant part, can be achieved by taking care of the brain during the course of your life,” Vradenburg told the meeting, which was co-hosted by the Science for Africa (SFA) Foundation.

Key interventions from experts during the course of the day-long meeting highlighted the importance of nutrition – particularly during the first 1,000 days of a baby’s life – in enhancing brain health.

“The science is clear. Brain development begins in the womb, and the first 1,000 days of life shape the architecture of the brain,” said Mireille Wenger, Provincial Minister of Health and Wellness in the Western Cape province.

“Nutrition, stimulation, safety, love and support in those early months and years determine learning potential, mental resilience, social participation and economic opportunity later in life.”

Wellcome Leap’s Dr Holly Baines added that “adolescence is another critical period in terms of brain development” and emerging research actually indicates that Alzheimer’s disease might actually be a condition starting in midlife in relation to women’s health”.

“The brain undergoes these distinct critical periods, and so it’s really important for us to think about when the brain is particularly sensitive, but also malleable, to different environmental factors and interventions,” said Baines.

However, she added that scientists still don’t understand “the critical intervention windows”. 

The meeting launched Africa’s first-ever Brain Health Plan for Africa, a five-year roadmap to investing in African “brain capital” developed by 25 academics and 28 institutions.

It sets clear goals across six strategic areas, covering advocacy, the “brain economy”, harnessing data,digital and AI solutions, repurposing resources, breaking down silos and funding.

Economic dividends

Around 60% of the continent’s population is under the age of 25, and by 2030, half of all new workers in the world will come from sub-Saharan Africa, said Vradenburg. 

“To harness the potential economic and innovative potential of those workers, we must invest in their brain health – the ‘brain capital’ of Africa is dependent on the skills of creativity, problem-solving ability, and imagination so badly needed in the 21st-century job market. African competitiveness and workforce productivity are dependent on the brains of its people,” he noted.

Scaling up known interventions to address brain health conditions could add $6.2 trillion, around 3% to the global GDP, each year by 2050 – mostly by improving productivity and labour force participation, according to Kana Enomoto, director of brain health at the McKinsey Health Institute.

In contrast, a modelling study by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, found that in 2019, Africans had spent about $10 billion on direct health services related to 24 brain disorders, said IHME’s Dr Angela Apeagyei.

“Millions are being spent on the development of AI, yet very little is being invested in brain health,” said Vradenburg. “The argument that we are making to the G20 governments is: invest in human intelligence with the same sense of urgency and pace that you’re investing in artificial intelligence.”

Shifting demographics

While Africa has a young population, this is shifting, warned Prof Mohamed Salama from the American University in Cairo’s Institute of Global Health and Human Ecology.

“The demographic pyramid is not going to be a pyramid by 2050, as the number of older adults is going to triple. Rather than having around 47 to 50 million older adults, we would reach 150 million,” said Salama.

“This stark increase will pose different challenges to the healthcare system, economy, politics, everything, and we need to be prepared.”

Wenger agreed, saying that the demographics in South Africa were already changing, and her province was ageing the fastest: “Planning for healthy ageing cannot begin at retirement age. It must begin much earlier with prevention, early development, nutrition; with early diagnoses, social connection and systems designed to support people throughout their lifespan.”

Harnessing digital solutions

While governments are investing an outsized amount in AI, several digital and AI tools do have the potential to help Africa.

Speakers told the meeting that chatbots speaking in various African languages could assist with the care of people with dementia. This had been piloted in Tunisia, which has only one Alzheimer’s treatment centre for the entire country, and it had both assisted people and reduced their need to travel to the centre.

AI and digital tools can also expand the early detection of cognitive problems.

Tom Kariuki, CEO of the SFA Foundation, described brain health as “an economic and social investment that will determine how well Africa competes, innovates, and thrives”.

“Investing in brain health is investing in innovation, productivity, and resilience, the very foundations of our continent’s long-term growth,” said Kariuki.

Professor Claudio Bassetti, vice-president of the European Brain Council, said he was not aware of any country in the world that is investing significantly in the prevention of dementia and other brain disorders.

“My country [Switzerland] is investing 2% of the entire health budget in prevention, although, for example, 80% of the cost for dementia goes into nursing homes,” said Bassetti, who chairs the Lancet Commission on Brain Health.

Vradenburg said that next year, DAC aims to “get practical” about what needs to change, moving from “brain health into brain capital, the brain economy”.

DAC is trying to figure out how to address both demographics, with older populations that are going to be sicker and incur “unsustainable health costs around the world” and “artificial intelligence, which basically threatens to eliminate 90% of our jobs, which will destroy humanity”.

“We have got to figure out how to take this moment and turn it into a human brain positive economy, not just an artificial brain economy.”

Image Credits: DAC.