For Bill Gates, donating toward Alzheimer’s research and detection is both personal and practical. His father suffered from Alzheimer’s disease. And his philanthropic investment team determined that better diagnostics could help advance treatment.
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Four years ago, Bill Gates led an effort in which he and a few other billionaires, including Jeff Bezos and MacKenzie Scott, pledged $30 million to create a new engine inside an Alzheimer’s foundation to speed up development of tests that could diagnose the disease. That funding later grew to $50 million.
Now the Alzheimer’s Drug Discovery Foundation has announced a new $50 million funding commitment from previous donors including Gates, Bezos, former Estee Lauder chair Leonard Lauder and the family of the late Ray Dolby as well as some new donors–money that will support the next phase of its efforts to improve detection of Alzheimer’s disease. (Lauder founded the foundation with his brother Ronald Lauder.) The donations to the Alzheimer’s Drug Discovery Foundation are “venture philanthropy.” Any financial returns that the investments receive will go back into the foundation, rather than into the pockets of any donors.
Gates, Bezos and Lauder are now each donating $11.25 million toward the foundation’s diagnostics effort, while Dolby Family Ventures is contributing $5 million. The four new donors joining them to support diagnostics research are the drug companies Biogen (donating $5 million) and Eli Lilly & Co. (donating $1 million), the NFL Players Association and the Shanahan Family Charitable Foundation, which is donating $5 million and is tied to former Capital Group executive R. Michael Shanahan, who, per his obituary, died in 2020 after a long battle with Alzheimer’s disease.
The donation by Bill Gates is personal as well. In January 2018, he revealed on the Today show that his then 92-year-old father, Bill Gates Sr., suffered from Alzheimer’s disease. Bill Gates Sr. died in 2020 at age 94.
Alzheimer’s has been difficult to diagnose. As Gates spelled out in a blog post in 2018, neither of the two most common methods–a spinal tap or a PET scan–are ideal. A spinal tap is invasive and can be uncomfortable, and a PET scan requires patients to sit very still for as long as 40 minutes, which isn’t easy to do.
The goal for the Alzheimer’s Drug Discovery Foundation’s diagnostics effort is to have widely available non-invasive tests – like an eye scan or blood tests– that could perform an early diagnosis of the disease. Some are already in development–and a new blood test for research purposes was announced by a foundation-backed company called Quanterix on Wednesday.
“The role of our philanthropy is to take risks,” says Dr. Howard Fillit, cofounder and Chief Science Officer of the Alzheimer’s Drug Discovery Foundation. “The seed capital we provide is critically important.” Fillit describes the work that the foundation does as funding “the valley of death”—helping shepherd promising academic research into pre-clinical trials—research that is often seen as too risky by many venture capitalists and by big pharma.
Niranjan Bose, managing director for health and life sciences at Bill Gates’ investment firm Gates Ventures, explains that with the foundation’s first $50 million diagnostics fund in 2018, “we started seeding the [diagnostics] field with investments.” Now some of those investments have advanced to the point where they need more funding, and in some cases, bigger checks of $2 million to $3 million. So Gates and others are re-upping their donations now, says Bose, “to get those sprouts to continue growing.”
Fillit, who has also been treating patients with Alzheimer’s disease for 40 years, brims with enthusiasm about the progress that has been made so far. When he first started working as a doctor, the only way to diagnose Alzheimer’s was with a brain biopsy (after the patient had died). “Right now I can send a patient for a brain scan called Amyvid” that is FDA-approved, he say. That scan, he adds, can tell him with 90% certainty whether a patient has the disease. The Alzheimer’s Drug Discovery Foundation seed funded Amyvid, which was initially developed by Avid Radiopharmaceuticals and researchers at the University of Pennsylvania; now it is owned by Eli Lily & Co.
It’s an exciting time for Alzheimer’s researchers. There are more than 120 drugs in clinical trials around the world; 30 of those have received funding from the Alzheimer’s Drug Discovery Foundation. Over the past four years, the foundation’s diagnostics accelerator has invested about $50 million in more than 40 global research projects that include blood tests, eye scans and early digital technology.
A company called RetiSpec, backed in part by the foundation, is developing a retinal test that detects neurodegenerative changes. “The eye is the window to the brain,” explains Fillit, who envisions a scenario where you may go for your eye checkup once a year and have extra imaging performed that could detect Alzheimer’s disease less invasively than current tests do.
Bose of Gates Ventures is also keen on the possibility of an ocular test to diagnose Alzheimer’s–because it could detect the disease earlier. “Before you start seeing amyloid [proteins tied to Alzheimer’s] in the blood, you start seeing it in the back of the retina,” says Bose, who estimates that it could be another year or two before the retinal test would be ready. Other companies are pursuing optical diagnostic tests as well.
For anyone interested in how to stave off Alzheimer’s given the current lack of easy diagnosis and the lack of drugs that halt the disease, Fillit says much has been learned about prevention. “The basic premise is what’s good for your heart is good for your brain,” he explains, pointing to regular exercise; a Mediterranean diet; avoiding smoking, alcohol and stress; and getting enough sleep. The foundation website has information about prevention as well as reviews foods and supplements and articles on brain health.
There is still much to learn about Alzheimer’s disease and related dementias. Fillit says research on the disease is maybe 50 years behind where our understanding of cancer is. One challenge: It’s difficult and expensive to enroll patients in Phase 3 clinical trials for new Alzheimer’s treatments. But having better diagnostics could make that process more efficient and far less costly, says Fillit. And better diagnostics could enable enrolling patients into trials at an earlier stage of the disease.