In a society where the value of mental health and wellbeing is becoming increasingly recognised, it is critical to bring attention to conditions that affect millions of people but are rarely spoken about. In this regard, we must pay special attention to and learn about Alzheimer’s disease, a relentless neurodegenerative disorder. Professor Akin Abayomi, the Honourable Commissioner of the Lagos State Ministry of Health, was kind enough to have an illuminating talk with us as we mark World Alzheimer’s Day on September 21, 2023. His observations shed light on the difficulties caused by Alzheimer’s disease and serve as a ray of hope for those who suffer from it. In this illuminating interview, brought to you by the courtesy of the Gabi Williams Alzheimer’s Foundation (GWAF), we discuss the urgent need for education about Alzheimer’s in Nigeria, the challenges of learning about the disease, and the novel strategies being developed to battle it. Help us get to the bottom of Alzheimer’s awareness with Professor Abayomi, and together we can build a better, more understanding society for everyone.
Why is it important for Lagosians/Nigerians to know about Alzheimer’s disease?
Alzheimer’s disease is a progressive neurodegenerative disease that causes the death of nerve cells in the brain. It is the most common form of dementia that typically affects people over the age of 65, but it can also occur in younger people. There are an estimated 2.5 million people in Nigeria living with Alzheimer’s disease and other dementias, a number that is expected to rise to 5 million by 2050. This makes it important for all Nigerians to be aware of the disease, its symptoms, and its impact on individuals and families. It’s imperative for Lagosians and Nigerians to be well-informed about Alzheimer’s disease because this knowledge empowers individuals and communities to recognise its early signs and symptoms. Early detection allows for timely medical intervention, which can significantly improve the management of the disease and enhance the overall quality of life for affected individuals. Additionally, raising awareness about Alzheimer’s disease can help reduce the stigma associated with it, fostering a more supportive and inclusive society for those living with the condition and their caregivers.
Key Points: - Awareness leads to early detection and better care. - This improves the quality of life for patients and reduces the burden on families and healthcare systems.
What do you think are the drivers for the low awareness of Alzheimer’s disease in Nigeria?
The low awareness of Alzheimer’s disease in Nigeria can be attributed to several factors. First and foremost is the limited availability of comprehensive information about the disease within the country. Public education and awareness campaigns specifically targeting Alzheimer’s are not as common as they should be. Moreover, the cultural stigma surrounding mental health issues in many Nigerian communities can lead to silence and secrecy surrounding Alzheimer’s cases. This lack of openness makes it challenging for individuals and families to seek help or share their experiences. Additionally, there is a shortage of healthcare infrastructure and resources dedicated to Alzheimer’s awareness and support in Nigeria, further contributing to the low level of awareness.
In addition to these general drivers, there are also some specific factors that contribute to the low awareness of Alzheimer’s disease in Nigeria. For example, the country has a relatively young population, with a median age of just 18 years old. This means that Alzheimer’s disease is not yet seen as a major public health challenge.
Despite these challenges, there is a growing movement to raise awareness of Alzheimer’s disease in Nigeria. For example, organizations like GWAF are working to educate the public about the disease and provide support to people with Alzheimer’s disease and their families. This is a step in the right direction.
Key Points: Low awareness of Alzheimer's in Nigeria may be due to: - Limited education and information dissemination - Limited public health campaigns. - Cultural stigmas around mental health issues
What are the best public health approaches to combating the stigma associated with Alzheimer’s disease?
Effective public health approaches to combating the stigma associated with Alzheimer’s disease are multifaceted. Firstly, educational campaigns should be designed and implemented to inform the public about the disease, its symptoms, and the available support services. These campaigns should focus on dispelling myths and misconceptions surrounding Alzheimer’s. Secondly, community-based programmes and support groups can create safe spaces for individuals and families affected by Alzheimer’s to share their experiences and seek emotional support. Thirdly, involving healthcare professionals and encouraging open dialogue in healthcare settings can help reduce stigma and ensure that individuals receive appropriate care and support without discrimination.
Key Points: The best public health approaches to combating Alzheimer's stigma involve: - Education - Community support - Reducing misconceptions through awareness campaigns, support groups, and involving healthcare professionals.
What resources is the Lagos State government currently committing to addressing the rising rates of Alzheimer’s disease?
The resources committed by the Lagos State government to address the rising rates of Alzheimer’s disease vary, but the State’s approach incorporates investment in research, healthcare infrastructure, and awareness campaigns. This includes identifying funding opportunities for research studies on Alzheimer’s prevalence and risk factors in the local population. As part of our expanding health strategies is the development of specialized Alzheimer’s care facilities and clinics.
The government also plans to support Non-Profits and NGOs to initiate and sustain public awareness campaigns to educate Lagosians about Alzheimer’s, its early signs, and the importance of seeking medical assistance.
Key Points:
- Identify and allocate resources to Alzheimer's research, including prevalence and risk factors in local population.
- Drive awareness campaigns.
- Create specialized care facilities to address rising rates.
A new Alzheimer’s disease drug called Lecanemab was approved by the US Food and Drug Administration on July 6, 2023 following a research study showing significant clinical benefits among people with early phase Alzheimer’s disease. However, the drug is very expensive ($26k for a full course of drug treatment per patient, per year). It is inaccessible to most patients in the US without health insurance. Are there steps the government can take to help make this drug available in Lagos?
Lecanemab is a monoclonal antibody that targets amyloid beta, a protein that is thought to play a role in the development of Alzheimer’s disease. The National Agency for Food and Drug Administration and Control (NAFDAC), Nigeria’s regulatory body for drugs and medical devices, has not yet approved the drug despite the US FDA’s approval of it. The first step towards getting the drug available in Lagos is to go through NAFDAC. There are a number of steps that need to be taken before a new drug can be approved for use in Nigeria. These steps include:
- The drug manufacturer must submit an application to NAFDAC.
- NAFDAC will then review the application to assess the safety and efficacy of the drug.
- If NAFDAC is satisfied with the application, it will approve the drug for use in Nigeria.
The approval process can take several months. It is therefore unclear when Lecanemab will become available in Lagos, Nigeria.
We must also consider that accessing expensive Alzheimer’s drugs like Lecanemab can be a significant challenge. To make such drugs available in Lagos, the government can explore various strategies. This may include negotiations with pharmaceutical companies to lower the cost of these drugs, which can be particularly effective when done in collaboration with other regions or countries to leverage bulk purchasing power. Additionally, the government can consider establishing subsidies or financial assistance programmes for patients who cannot afford the full cost of treatment. Integrating such treatments into public healthcare coverage or insurance plans can also help bridge the affordability gap and ensure that these drugs are accessible to those who need them most. Finally, promoting local research and development in healthcare can potentially lead to more affordable treatment options for Alzheimer’s disease in the long term.
Making Lecanemab available in Nigeria would be a significant step forward in the fight against Alzheimer’s disease. The drug has been shown to slow the progression of the disease, which can improve the quality of life for patients and their families. Therefore, it is a path worth exploring.
Key Points: To make drugs like Lecanemab accessible in Lagos, the government could explore: - Partnerships with pharmaceutical companies for price negotiations leverage bulk purchasing power. - Establish subsidies for underprivileged patients. - Strengthen healthcare coverage to include these costly treatments in insurance plans.
