We won the war on Covid, now beat Dementia!

A short digression on Covid, Dementia and Sir Alexander Fleming.

Blain’s Late Morning Porridge – June 8 2021 – We won the war on Covid, now beat Dementia!

“You may set out to find one thing, and end up discovering something entirely different.”

This morning – A short digression on Covid, Dementia and Sir Alexander Fleming.

It’s a short and very late Porridge this morning as I’ve been on a deal conference-call since early doors.. As always, after the reading the papers I wonder if I’ve been caught in some parallel universe these past few months?

The global economy has been ravaged by COVID 19. Despite the dismissals, it’s proved a serious disease. Whatever its origins – which could still blow-up economic activity if suspicions of an accidental Chinese leak continue to grow – it is a low mortality-rate flu-like virus, where the vast majority of people recover. Fearful of the virus swamping our health services, we’ve spent literally trillions on combatting it. We’ve prioritised its treatment over all other illnesses, closing economies, enforcing lockdown, closing schools, while trampling social freedoms and creating all kinds of fear and angst that may take decades to readjust.

Yet, we have also seen human ingenuity and decency at their best – from the invention and innovation of new vaccines in record time, to the tireless and courageous work of front-line staff in the health services. The new therapies designed to treat it are incredible.

Despite all these efforts our global society have been profoundly impacted to protect health services from being swamped by a disease that preys predominantly on the elderly and infirm. The media might have whipped up the story, but there have been moments of crisis – in India, Brazil, the panicked scenes in European Hospitals, overflowing morgues in New York and protests against the draconian lockdown measures… Long Covid, the after effects of the illness do seem be affecting a large number of people.

Covid has been a massive economic challenge. The response from government was to spend, spend and spend some more. It’s sort of worked. We’ve proved resilient and inventive.

In contrast, Dementia and Alzheimer’s kills over 65,000 UK residents every year. Even at the height of the pandemic in March 2021, it remained the leading cause of UK deaths, ahead of heart disease and Covid which came third. I don’t need to explain the awfulness of the disease’s progression – but its frightful, distressing and arguably a far greater economic cost to society in terms of long-term costs and care than Covid.

The fact is we all die. It’s how we will die that matters. When the UK government instigated a successful heart-health campaign, the result was a significant reduction in fatal heart-attacks, but an almost equal rise in dementia.

All of which leads to the news Biogen’s “Aducanumab” has been approved by the US Food and Drug Administration. The drug works by removing “amyloid” plaques in the brain. It’s not perfect – and there have been objections following mixed evidence from clinical trials… but the way in which Biogen’s stock spiked yesterday highlights the value the market puts on a dementia cure.

But wait… a cure that is estimated to be only 20% effective will cost $56,000 per year under the brand name Aduhelm. That’s why the stock spiked. The wealthy are price indifferent, but $56k is way beyond the reach of most elderly sufferers in nations that are without cradle to grave health care. Even in the UK, its entirely possible the drug won’t be approved – the UK’s NICE determining it’s not cost effective when its only therapeutic advantage being the reduction in amyloid in the brain – which is – as yet – an unproven approach.

It’s taken a wartime economic approach to beat Covid which kills a fraction of the people who die by Dementia. There are many who will argue firms that pioneer new therapies and drugs deserve every reward and the riches Biogen will reap. But… I wonder. Why is it Charities are responsible for so much of health research? Why is it health is a matter of wealth.

The greatest advance in medical science and treatment over the last 100 years has been the discovery of the antibiotic Penicillin. It was discovered by a Scottish microbiologist Alexander Fleming. He served in the First World War and was shocked by the effects of sepsis on wounds, but recognised that the antiseptics used to kill bacteria were also destroying the body’s defences against bacteria in deep wounds. He spotted that something else in human tissues and secretions was killing bacteria.

After the war he led a team that experiment with all kinds of secretions to test as bacteria killers. The legend is he discovered Penicillin by accident, but it the work the team has done that led to the serendipitous accident of a staphylococci culture being left for a few weeks in the corner of the lab, and a mould destroying them. The mould was Penicillin. It then took Fleming years to convince the medical community and it was largely the Second World War that accelerated its adoption. Thousands of troops survived serious wounds, and the course of human history was turned around (till now, when our over prescribing of antibiotics has led to super-resistant bacteria.)

Fleming received a knighthood for his work.

He was furious to discover the American factories who patented the production of the drug had made their owners millionaires: “I found pencillin and have given it free for the benefit of humanity. Why should it become a profit-making monopoly of manufacturers in another country.”

Health and dignity should be a right – not a privilage of wealth.

Here endeth today’s lesson….

Bill Blain

Shard Capital