DAVOS – In this snow-covered Alpine town where the world’s rich, powerful and elite met in January for the World Economic Forum, a quiet but consequential shift in thinking about dementia research crystallized – one with the potential to shape political engagements and research investments for the coming decade. 

Long treated as a disease primarily studied, diagnosed and managed with treatments developed in wealthy countries, Alzheimer’s and related disorders are now a global equity challenge— one where the best new solutions may, paradoxically, emerge from the low- and middle-income regions also facing the biggest future burden. 

The simple but powerful approach is central to a strategy being rolled out by the Davos Alzheimer’s Collaborative in 2026 – which aims to make diversity an underpinning of dementia research. 

New initiatives across Africa, India and beyond

The strategy, articulated at the dome-shaped “Brain House” here in Davos, underpins a series of new DAC initiatives being rolled out in Africa, India and elsewhere in the Global South to test new diagnostics; better harness the potential of AI; and build big data platforms that can link research communities and their findings. 

In an interview with Health Policy Watch, Drew Holzapfel, DAC Chief Operating Officer (COO), outlined a strategy for a fundamentally different model of dementia research— rooted in global collaboration. Key elements include:

• • Expanding diverse data collection
    “We’re going into Kenya, Chile, Egypt… so that we get some better understanding of the heterogeneity of the disease.”
  • Breaking down data silos and building large-scale, harmonized datasets
    “Creating platforms that allow researchers to “share, access and analyze brain health and dementia-related data… in giant data sets… so that you can draw some through lines.
  • Developing AI-driven discovery platforms
    Integrating multimodal data to map “causal mechanisms to biomarkers, targets, and personalized prevention.”
  • Driving personalized treatments – Al that integrates data from genomics, clinical, prevention and trials – mapping causal mechanisms to biomarkers, targets, and personalized prevention and therapeutic strategies.

Harnessing the power of big data sets

The new DAC collaboration with the Gates-funded Alzheimer’s Disease Data Initiative (ADDI)  and the African Population Cohorts Consortium (APCC) is a leading example of how the power of big data can be harnessed.  

The initiative aims to create an intraoperative data-sharing platform enabling African researchers to share, access and analyze brain health and dementia-related data. 

“Giant integrated data sets ideally are harmonized  across different populations, so that you can draw some through lines. The fact that we’ll be getting diverse data means we can better understand the heterogeneity of the disease, Holzapfel said.

The numbers of people whose health and lives are at stake are equally big. 

As George Vradenburg, DAC founder and chairman put it: “The Global South will have 80% of cases of dementia in the next 20 years.” That reality is forcing researchers, policymakers and investors to confront a new truth: innovation that ignores the global majority is not just inequitable—it is incomplete.

Neurological conditions of some kind affect more than 40% of the world’s population somehow, causing over 11 million deaths each year – with the largest gaps in care in low and middle income countries, pointed out WHO’s Dr Tedros Adhanom Ghebreyesus, speaking at a Brain House session. 

“Demographic and environmental pressures are intensifying these challenges: ageing populations, hypertension and diabetes, pollution, injuries and climate change are driving a sharp rise,” he said. 

The ‘Global Majority’ as an innovation catalyst

But investing in brain health research and development in the Global South is not only about equity – it is about efficiency.  As such, it’s a win-win for both rich and poor countries alike.

For decades, biomedical research into dementia has been shaped by data drawn largely from populations of primarily European ancestry.  And that lends a very incomplete picture of the disease and related conditions, observed Holzapfel: “90% of the data in GWAS [genome-wide association studies] is built upon  European ancestry… but only 10% of the world is of that ancestry.”

That imbalance is not just a scientific gap—it is a barrier to discovery.

Diverse populations bring diverse genetic profiles, environmental exposures and disease pathways, explained Michael Cook, Chief Science Officer of the UK-based research entity Our Future Health .  As he put it, “diversity will help… make sure that we create medications and interventions that fit for all populations.”

Added Vradenburg, the Global South is “a potential area of innovation on how to lower cost and increase the access to the products that we would like to have.” 

Lawrence Jones, author of the “Influential Minds” podcast series, reframed the conversation with a simple linguistic shift: “Instead of the Global South, we should be referring to that part of the world now as the Global Majority.” 

The biology of diversity

Beyond pure cost-efficiencies, the Global South offers richer understanding of the disease itself.

Dementia is not a single condition. As Sam Barrell, CEO of the UK-based non-profit medical research organization LifeArc, explained: “It’s a bit like saying there’s just one type of cancer.” In reality, it is a constellation of subtypes, each with distinct biological drivers.

Research in diverse populations is essential to untangling that complexity. 

Environmental exposures—heat, pollutants, agricultural chemicals—vary dramatically across regions and may shape disease pathways in ways not yet understood, said Vradenburg. Noting that even basic factors like water quality and brain health remain understudied, he pointed to  the need for more “exposome research across a wide variety of different exposures.” 

There are also gender disparities. “Two thirds more likely to happen in women than men,” Barrell noted, emphasizing how much remains unknown.

Without inclusive data, the patterns remain hidden. With it, entirely new avenues for prevention and treatment may emerge.

Rethinking access: from clinics to communities

In this new R&D  paradigm: health system constraints— including limited infrastructure, fewer specialists, tighter budgets—are not just obstacles. They are catalysts for entirely new models of care.

And while bringing solutions to the proverbial “last mile” is an especially acute challenge in low- and middle-income countries, where specialist care is scarce and even basic electricity infrastructure spotty, the same bottlenecks exist in wealthy nations too. 

“Wait times now, over a year in the United States,” Vradenburg said, noting that some patients effectively “time out” before they can access treatment.

At the same time, barriers exist to bringing new and potentially transformational research findings to market. 

Vradenburg described the challenge starkly: “you can have the most brilliant new discovery… but if, in fact, it doesn’t get through a regulatory system… a clinical trial system…then it is dead in the water.  

“The government can fund research,” he added. “But the investors have to take that research into the marketplace through the translational so-called ‘valley of death’. You have to get that [innovation] picked up and bought by an exit strategy with large pharma, and you have to get that through a regulatory system that is hopefully willing to take a degree of risk.

“So you need innovation, a friendly regulatory system, and then you need somebody to pay for this.”

Global cohorts initiative

Moving beyond Africa, the DAC Global Cohorts initiative aims to reduce research costs and amplify results by linking up like-minded initiatives worldwide in North-South collaboration nodes. The programme involves seven research cohorts extending from Kenya to Malaysia and the Caribbean, supported by funders ranging from DAC to the pharma industry and the National Institutes of Health. 

Researchers in the cohorts are testing new diagnostics tools as varied as digital voice imprints and olfactory glands – with the aim of bringing successful models to scale.

“Just think of what Kenya community health workers can do,” Vradenburg said, as a simple measure of feasibility. “They’re not going to take a venous blood drop. They’re not going to do a half-hour long, paper and pencil test.” 

Disruptive diagnostics 

The race to develop more low-cost diagnostics that can predict the risks of developing dementia years before symptoms occur is one recurring theme that illustrates both the challenge and the potential of more linked-up R&D engagements.

Today’s gold-standard diagnostics—such as PET scans and spinal fluid tests—are costly, invasive and inaccessible to most of the world. “Most people do not have access to that,” noted Barrell, the  driving force behind LifeArc.

The UK-based self-funded non-profit, is co-sponsoring a multi-country research project on lower cost alternatives, due to yield results due in 2028. The research  is comparing the current “gold standard” diagnostics with finger prick tests for blood-based biomarkers and digital tests for other biomarkers, including cognitive tests delivered via smartphones.

Already, blood-based tests based on venous draws can detect certain pathological changes in the brain associated with Alzheimer’s long before symptoms appear: “potentially up to 15 to 20 years before you actually have clinical signs,” Barrell said.

So if the same proteins can be picked up accurately from a fingerprick test, the shift to earlier  detection—could redefine the entire trajectory of the disease.

“Early predictive diagnostic tests… can be transformative, particularly if they are scalable, low- cost alternatives to the expensive scans we’ve got now,” Barrell said, noting that preliminary data from the study appears promising.

“If you can intervene earlier on those lifestyle factors that make you more likely to develop dementia and you could fast-track people into the right trials with the right treatments that would make a big difference in the longer term,” she added, noting that there are pioneering treatments in R&D due to come to market in the near term.

And because these tools are being designed with low-resourced settings in mind, they would ultimately benefit everyone. A finger-prick test that works in rural Africa will also be cheaper in Europe or the United States.

“So in the utopia of the future,” Barrell said, “You and I would get a little card in the post; we would just prick ourselves; and put our blood on it… and then… using a digital app, hopefully get a result of our risk of dementia with a high degree of accuracy.”

AI: promise and pitfalls

Artificial intelligence is another force reshaping the research landscape—but its role is complex.

On one hand, AI offers unprecedented reach. As Susan Armiger, CEO of Catalight, explained, “AI can offer a ‘direct to consumer approach’… somebody could come to a website… and they would talk about whatever they’re experiencing without having the barrier of a medical professional.”

In contexts where doctors are scarce, that could be cost-efficient as well as revolutionary. “Sometimes we find that they are the barrier to someone getting into a screening or a diagnostic evaluation,” added Arminger, who heads America’s leading network of healthcare providers for autism and developmental disabilities.

But prevailing AI models also reinforce existing inequities.

Or as Peter Lee, President of Microsoft Research warned, “AI model training today is oriented towards the Global North… the lack of cultural alignment… continues to be a problem.” Language, imagery and cultural context all shape how AI systems interpret symptoms—and misalignment can lead to misdiagnosis or exclusion.

He also highlighted a deeper structural challenge faced by rich and poorer health systems alike: “Cognitive health intervention involves a mix of different audiences – professional healthcare deliverers, community workers and informal/ family caregivers.  And that mix of different communities and people amplifies the trust issues and creates practical problems …that you need [to overcome] in order to collaborate.” 

Innovation ‘in all directions’ can benefit us all

Along with the new African data initiative, DAC is also establishing an India branch in collaboration with the Indian government. 

This will include a workplace-based study on cognitive health in collaboration with the Indian Institute of Technology as well expanded  research into new AI-based diagnostics assessing voice imprints and eye movements.

“There’s a belief that you can detect a cognitive impairment through voice, and so we’re trying  to validate that in India, which has incredible throughput and volume,” observed Holzapfel. “So we’re set up in a giant office park, and we are taking voice samples at a pace you would never believe. 

“If you fast forward, the real opportunity here is to have the ambient voice collection when you’re in the doctor’s office that’s listening and determining if you have cognitive impairment.”

And it is planning for a series of high-level events this year to build political will and commitment – from the United Nations General Assembly in New York  to technical meetings in Africa that lay the framework for the Global Mental Health Summit in Rwanda in early 2027.

As Vradenburg put it in a moment of stark clarity: we are investing hundreds of billions in artificial intelligence, while the health of the human brain—“eight pounds powered by less than a light bulb”—remains underfunded.

Politicians need to understand that “only when innovation flows not just from North to South, but in all directions. Only when equity is not an afterthought, but a driver of discovery – then the solutions built for the most constrained settings may ultimately benefit us all.”

Image Credits: Flickr: Florey Institute of Neuroscience & Mental Health, DAC , DAC , Martin et al., 2019, Health Policy Watch, Witkoppen Clinic, DAC , Health Policy Watch .