 Good morning, good afternoon, and good evening. Thank you for joining us today to discuss the Davos Alzheimer's Collaborative, a new global mechanism being launched today by the World Economic Forum and the Global CEO Initiative on Alzheimer's. The Davos Alzheimer's Collaborative, or affectionately DAC, is addressing the worldwide Alzheimer's pandemic. I'd like to thank the World Economic Forum for inviting me to moderate this session and for the partnership of the forum, led in this regard by my dear colleague and friend Arnaud Bernard, Head of Health and Healthcare at WEF. I'd also like to thank our panelists for joining me this morning, this afternoon, this evening. Professor Margaret Chan, Founding Dean of the Vanky School of Public Health and Vanky Chair, Professor at Tsinghua University in Beijing, China, and of course, Emeritus Director General of the World Health Organization. Dr. Haruo Naito, Representative Corporate Officer and Chief Executive Officer of ASI Company Limited Headquartered in Japan. Dr. Andrea Pfeiffer, Chief Executive Officer AC Immune Headquartered in Lausanne, Switzerland. A quick note on housekeeping. This session is being live streamed through the World Economic Forum's web platform. Some of you have access to the chat function and I hope you'll use it. This 30-minute panel will be followed by a more detailed 30-minute discussion limited to forum members and partners. Just stay, those forum members and partners just stay on the line at the end of the first 30 minutes. I call Alzheimer's a pandemic because it will affect 150 million families, probably half a billion people by mid-century and between now and 2030, 13 trillion in global costs. Almost 70% of those cases are in low and middle-income countries. With that extent of suffering, what else can one call Alzheimer's but a global pandemic? Disappointingly under-recognized as such in my view but certainly understood as such by the hundreds of millions of people suffering its emotional, physical and financial impact. Alzheimer's can be beaten. There's new hope on the horizon and it's time for the world and it's time for the world to seize the opportunity to tackle this disease at the scope and scale at which it is attacking us. It will be a surprise to many, not steeped in the science that Alzheimer's is not the inevitable result of aging but a disease. And strikingly, it's not a disease that starts in old age. We know that the disease of Alzheimer's begins 20 or more years before its symptoms appear. Alzheimer's disease as opposed to Alzheimer's symptoms starts in those in midlife, once 40s and 50s. This insight, this discovery gives us a 20-year window to intercept Alzheimer's disease with either disease modifying medicines or risk reduction steps which can slow or stop disease progression and thereby delay or prevent symptoms. Not unlike the strategy pursued with HIV AIDS where today an HIV positive individual can with medicine and positive individual care with medicine can live a full life without the fatal symptoms of AIDS. What can a global mechanism add to existing efforts? COVID-19 taught us how global stakeholder collaboration can lead to greater resource development and distribution of new therapies in much more rapid fashion than it was thought possible. Same with Alzheimer's. So what would the Davos Alzheimer's Collaborative do? We do not intend to replace or replicate existing national individual, academic, company or national efforts, but rather to link scale and build coordinating tools and mechanisms to tackle this disease at the scale and geographic scope with which it is attacking us. First, to fund innovation and national health systems so that we can detect and diagnose those with Alzheimer's before symptoms occur. Second, to speed innovations and disease modifying interventions which will intercept disease progression through a more efficient global clinical trial support platform. And third, to enhance and link and enrich existing discovery science infrastructure in low and middle and high income countries to unlock new comparative insights and therapeutic targets. Right now I'd like to turn to our esteemed panelists and colleagues joining me today and hear from them. Professor Chan, I'm gonna start with you. In 2012 as Director General of the WHO, you identified Alzheimer's as a global health priority. What led you to that view? And then how did you approach the challenge of Alzheimer's disease as WHO Director General? Well, George, let me first and foremost thank you for the invitation to join this Davos meeting to tackling Alzheimer's. Yes, indeed. When I was Director General of WHO, my team, of course, led by many scientists and good mental health experts. Reminded me, dementia is a big problem and Alzheimer's accounts for 70 to 80% of it. I mean, when I look at the data, it is heartbreaking. Plus all the data that you have shared with us at the beginning of this session, I fully agree with you. Alzheimer's was 9.9 million new cases per year globally. We can use the term pandemic to describe it. Clearly it requires global action of a matching scale and to match the size of the problem to find solutions. I think we should be hopeful. I mean, dementia and Alzheimer's is one such disease where prevention is possible. I thank my team in WHO for the leadership and issuing a global plan on the public health response in 2017, May, during my last year as Director General. But I'm sure it's just the beginning of a call to action of all stakeholders in the world. And today is actually a sign of hope led by WEF and of course all the people who are in this public-private partnership. Let me ask you, Dr. Chan, do you believe that is important for the private sector to ally with WHO and other international forces? Is it important to have multiple sectors involved? Well, I still remember the time when I was Director General. I said, we need the private partnership and we do need the industry to find public health solutions. And this is one such example. Alzheimer's, without the involvement of the industry, I don't think we can get there. Of course, before the industry comes in, well, actually they should come in right from the start together, working with the scientists, supporting the clinical trial, supporting the scientists to find biomarkers to come up with a cure. Now, sort of that, at least at this point in time, what kind of preventive measures can we introduce based on their study, based on their research and gradually working towards a cure for Alzheimer's disease? Thank you, Dr. Professor Chan. I'll be back to you in a second. But next I'd like to turn to Dr. Pfeiffer. I was struck by a remark you made during our chat last week that recent developments in Alzheimer's research makes you hopeful in the fight against Alzheimer's, notwithstanding the numerous failures in clinical trials over the last nearly two decades. I'm curious, Dr. Pfeiffer, what gives you hope that there's a solution to Alzheimer's? Yeah, well, I mean, I have to start that my first sign of hope is actually that we're having this panel today organized by the web because it means that there is increasing awareness that Alzheimer is a problem to the world. And I'm personally extremely happy that this Alzheimer collaborative is, in fact, initiated and inaugurated because it will be the ideal platform to provide the leadership which we need in this slow pandemic. Now, let me come back to the hope. I think we have seen progress in drug development where in last year we were 121 clinical trials ongoing, 80% with disease-modifying drugs. There might be in 2021 the first approval of an anti-A-beta antibody aducanoma by biogen, and I was extremely encouraged by the data a few weeks ago by another antibody from Lilly showing in a relatively small phase two study that positive results can be reported. And this is all going back to the many advances which we have made for many of the clinical trials which unfortunately have failed, where we actually learned that the careful selection of biomark of patients by, in fact, using established biomarkers is key leading to what I think is critical, instrumental is precision medicine. And I'm coming back to that. Today we have biomarkers which allow us to select patients 10 to 20 years before their symptoms occur, actually allowing us to think about prevention studies. So moving from treating a disease when already a lot of the brain has been damaged to actually preventing a disease which of course would be the very best aspect of dealing with a disease. And here in this aspect, I have great hopes into the genetics where we are now running in genetic populations prevention trials which eventually will show validate a better as a target but at the same time demonstrate potentially that Alzheimer can be prevented. This would be a great breakthrough. I think what we need to really look into it, how we bring this message of hope to the public and how we can actually educate people in particular vulnerable populations such as women to take measures which will help to prevent this terrible disease. You know, I know you've had a background at NIH in cancer and thus have had a good deal of experience with this concept of precision medicine where we actually can identify those a genetic risk or other biotypic risk and target medicines for that particular subset of the overall cancer population. How would that work in Alzheimer's? Is not Alzheimer's just one disease? Well, it's definitely not one disease. And as you know in cancer, really the breakthrough was achieved now 35 years ago when we looked when we did biopsy tumors, we identify mutations and we allocated this mutation to specific cancers and actually more broadly to a group of cancer and actually really went from cytotoxic treatment to a very targeted mutation specific treatment not just of one cancer, but of multiple cancers. Now we know today that Alzheimer is in fact not a monotarget disease but there are multiple proteinopathies involved in the disease and we stiffer from patient to patient. So I think it is extremely important that we understand in fact what targets are involved in the disease use precision medicine to really select the right target population, define the right treatment, define the right biomarkers and end points and actually define the right drug or combinations were off to really treat the underlying pathology. In fact, in my view, we will move like in cancer from looking at Alzheimer at a monotarget disease to look at Alzheimer at a multiple target disease and actually potentially move from treating Alzheimer or Parkinson's to actually treating the underlying proteinopathy. So like in cancer, this will be a complete change in paradigm of treatment and as you know it made us extremely successful in cancer but that requires that we cooperate between industries between all the stakeholders to generate the right biomarkers to in fact identify these pathologies and actually establish the right treatments potentially combinations of treatments to really tackle this disease. I think we are just at a gross road of the breakthrough which we had in cancer 35 years ago. Thank you, Dr. Pfeiffer. You've been at the forefront of this. I know in testing medicines and down patients and we for genetic types and so it's an exciting moment as you would suggest, exciting moment in the history of the attack against this disease. Dr. Naito, you and I met last year at the Forum's 2020 annual meeting. Oh, how long ago that now seems. Yes. And it was during a private multilateral meeting that the idea for this global collaborative to accelerate Alzheimer's research and innovation was conceived. You yourself were a strong supporter of the development of what we're launching today. You've served on the Davos Alzheimer's Collaborative Leadership Group. You have several members of your organization supporting our efforts in a wide variety of ways. I'd like to ask you, Dr. Naito, why did ASI choose to participate in this collaborative and how do you believe industry can participate and contribute to this global public-private partnership to address the challenges we face in Alzheimer's research and innovation? Yeah, one point to which I'd like to emphasize this time. Thank you very much for this opportunity. Is now fighting to this disease, we need the patient's participation or even the people's participation. Regular normal people's participation is inevitable to fighting against this disease. So as Andrea said, the preventive area is quite promising these days, but to attain these preventive actions, we need to gather daily living information of the people such as how they sleep, how they eat and how they exercise. And sometimes we like to have a very, preliminary brain checking, like a brain performance checking by easy 10 minutes or so IOTs. So those information would be requisite to find out a good way to advise them how to be better in daily living, not being disease worsening. And this kind of personal health records has a tremendous, tremendous advantage to prevent the disease. So that's one. The other one is again, digital technologies. Nowadays, for example, even our clinical studies, we can use remote diagnosis or home infusion sometimes. So remote digital online technologies advancement is great. So we can fully utilize those technologies in terms of covering emerging areas or developing countries as well as well. And also the pharmaceutical industry, including ourselves has tremendous data and sometimes human samples gathered through latest clinical trials. That will again attract many people's, collaborate with us. Certainly the top priority is diagnosis. So now blood diagnosis is quite rapidly proven and progressing. So people may measure their Alzheimer's conditions like a cholesterol checking. It's gonna be coming relatively soon, I believe. That will be tremendously change the scope of Alzheimer's disease. So those connections again, the industry can facilitate that kind of connection through digital, genome sciences or data sciences, et cetera. So it's gonna be huge, huge kind of ecosystem involvement of the participation of the people and the patients. Dr. Naito, it has been your personal as well as your company's emphasis in all of our work that we really think through completely differently how we detect and diagnose this disease and intervene with a lifestyle or medicines based upon using new digital technologies. So we are building into this effort, particularly in low and middle income countries which do not have access to very, very large imaging equipment. Blood and digital markers with an emphasis on digital markers because those are much more accessible and less expensive around the world. So thank you for doing that. Let me ask you a question because I am curious as to other than the pharmaceutical companies in Japan, are there other industries and indicating an interest in this field from a business opportunity point of view or a collaborative way of thinking about supporting those with Alzheimer's or treating those with Alzheimer's? Yeah, it's amazing that we have been approached by financial service industry people quite a lot. Insurance companies, they like to create a good Alzheimer's insurance to the public so that they like to collaborate with us because they like to confirm the cognitive status of the people who like to purchase those insurance policies firstly, obviously. So this is one connection or banking business people, investment banking business people because when you are diagnosed as Alzheimer's disease in many cases, the financial asset of those people are frozen. It's no more activating, no more useful for the society. So banking people like to know beforehand so that they can have some preventive action towards us, you know, secure those financial assets beforehand. So they like to collaborate with us or retailing business people. They are constantly suffered from, you know, work loads is less and they like to try to recruit more elderly people to their details business such as, you know, caching or inventory checking. And they like to know if those elderly people about 70 is qualified or not by, you know, using the system of cognitive function, you know, checking. Of course, fitness club people because many of their customers like to, you know, have the good exercise program for maintaining their cognitive function well. So many industry, other industry usually not to come into medical, you know, practices they like to join us. That shows how this disease is social, sociable. Yep. Dr. Professor Chan, let me come back to you in a second. I have mentioned the inclusion of low and middle income countries. How important do you think it is to include low and middle income countries in the strategy and the execution of the fight against Alzheimer's? Gosh, you know, I was going to make this very important point. Now, first and foremost, Davos Alzheimer's Collaborative is a catalyst, a very important catalyst for global action. And of course we need to include all the stakeholders. When I look at the presentation on this subject, there are three important pillars. You have the cohort pillar, you have the clinical trial and the health system preparedness. And I think the low and middle income countries would contribute a lot to the understanding of this disease. Unfortunately, at this point in time, most of the work is done in Europe, in North America. And I hope this Davos Alzheimer's Collaborative can promote and initiate more countries from the developing world and particularly from the low and middle income countries in Africa as well as in Asia to join as partners for this very important initiative. Thank you. I totally agree with you. Andrea, in your comments, you mentioned the impact on women. And I know your personal involvement in this work in Switzerland, tell me about the impact of Alzheimer's particularly on women and what you think is important to do in that regard. Yeah, I mean, what is actually still unknown, surprisingly unknown is the big impact of Alzheimer's and women in fact too out of the Alzheimer's incidence in women is twice as high as with men. And actually the majority of the caregivers are also women. So actually women are disproportionately affected by Alzheimer in double ways. So I think it is really important that women have a voice in this that they have the education that something can be done in terms of lifestyle changes. In fact, that they can do something about their brain health. For example, as Dr. Naito very nicely said, change your nutrition to exercise, train your brain, establish social activities. So all of that can contribute to prevention of Alzheimer. In fact, there is the finger study by Mia Nivipalko which clearly shows that if you use these parameters, you can actually prevent the onset of dementia by several years. So this requires, however, that we educate and in fact, we trust the brain trust, the global brain trust, which we have inaugurated last week is really focusing on women and bringing their thought leadership into it to help other women to educate them about the possibilities. Now, the finger study is not just addressing women, it's actually goes beyond, it affects everybody. And I think to communicate, and here again, I consider this panelist very important from an awareness and communication point of view is equally important when to generate results which obviously are coming along. Thank you. We need to get women involved at a wide variety in different ways. So thank you for that and for your leadership there, Dr. Pfeiffer. Last question for this panelist, Dr. Naito. Excuse me. Why are governments more involved? Or how can we get governments more involved? This is clearly going to be a cost to governments around the world, the health systems around the world, to supporting older populations with long disease cycles like Alzheimer's. Why aren't they more involved? How can we get them collaborating themselves on how to solve this problem as a collaborative fashion? Yeah, that's one of the reasons why we are expecting World Economic Forum double conference may function, try to encourage the governments do one step more for Alzheimer's disease because as Margaret said, it's like the same as pandemic, the same degree of the impact to human health like COVID-19. We like to, at least the government's leaders, policy makers try to legislate legislational efforts of a basic dementia act which covers prevention, R&D and diagnosis and the treatment options, including disease awareness such as diagnosis may be supported by public funding of the local governments or federal governments. Those needs of legislation make it by law. So it's very similar to cancer. I have a mirror image to cancer. Cancer has been, have tremendous advantage in terms of curing cancer by this kind of government's efforts to make a registration. So I hope that World Economic Forum can have some help to that. Simultaneously, I think for developing countries, World Economic Forum has the great, great success such as GAVI and CEPI activities, Margaret knows this very well. I hope for developing countries, we have not exactly the same like vaccines but similar PPP may be needed to cover the various necessity of Alzheimer's disease and that's something I'm very much expecting that World Economic Forum can function such ways. Thank you panelists. We're nearing the ending of our time for this half hour this morning. I'd like to close by thanking the forum again for their partnership to change the Alzheimer's landscape for the better and for allowing us to bring such a permanent and pertinent topic to the global stage. I'd like to thank our global audience for tuning in, our panelists for supporting the launch of the Davos Alzheimer's Collaborative. I invite you to follow our work and to reach out to us at www.davosalzheimerscollaborative.org Click on the contact us page and we will be in touch with you and engage you hopefully in our work and engage your ideas in our work.