A Perfect Storm, A Perfect Opportunity

September 28, 2011


Dr. Bruce Sigsbee

The barriers to those neurologists entering a career in research always have been substantial. In this environment of federal budgetary deficits and cuts to programs, those barriers are even higher. The American Academy of Neurology Foundation will celebrate its 20th anniversary next year. The Foundation has filled the gap for those who need a track record to attract funding.

To date, more than 120 fellowships have been offered, and 100 percent of these recipients have received further funding after their Foundation grants. However, many excellent candidates each year do not receive funding. Dr. John Mazziotta just assumed the chair of the Foundation and held the first meeting of the Board this August. His vision is to attract substantial philanthropic dollars to support the Foundation's mission. He agreed to provide a summary of his perspective for the readers of AANnews®.

Bruce Sigsbee, MD, FAAN
President, AAN

In 2012, the American Academy of Neurology Foundation celebrates its 20th anniversary. Best known for its phenomenal successes in supporting the clinical research training fellowships, it has also produced many meaningful and sustained activities during its history. In addition to raising philanthropic dollars, the Foundation has developed strong partnerships with disease-specific organizations and advocacy groups, attracted public figures through its public leadership award (Janet Reno, Julie Andrews, Michael J. Fox, and others), advanced public education about brain health and neurologic diseases (Brain Health Fair) and achieved government recognition when the mayor of Toronto and the governor of Hawaii both proclaimed the AAN's Annual Meeting week as "Brain Awareness Week."

The time is right and the organization is poised to greatly amplify its influence, impact, and recognition. Why would this be so?

First, the general public is aware of and concerned about neurologic diseases. These disorders are in the news every day and it is nearly impossible to find an individual who has not had a family member or friend affected by one of the many disorders that attack the nervous system.

Second, the general public is concerned that they, or their family members, will be stricken by a neurologic disease directly. References to Alzheimer's disease have permeated the daily lexicon of individuals in all walks of life. Most people are aware that neurodegenerative diseases represent an epidemic in the modernized world as the population ages. It is also becoming clear to the public and public officials that Alzheimer's disease alone has the capacity to bankrupt most industrialized countries by 2050, when its annual cost in the United States alone will exceed one trillion dollars and its aggregate cost between now and then will exceed 20 trillion dollars.

Third, basic science research is poised to deliver to clinical investigators a vast amount of new opportunities for treatments in all neurologic diseases. For 40 years, an army of 30,000 basic scientists has studied the normal nervous system and disorders that affect it. To return to the example of Alzheimer's disease, a treatment that would delay its onset by only five years would drop the prevalence of the disorder to 50 percent. A 10-year delay would reduce the prevalence by 75 percent.

Fourth, NIH funding has been flat and the budget line continues to decrease for clinical and basic science research in normal brain function and diseases that affect the nervous system. The current expenditures on neurologic disorders are a tiny fraction of the costs required to provide care for individuals with these problems.

Fifth, clinical reimbursement dollars will fall in the coming years. This reduces the margin of academic medical centers, the private sector medical care industry, and other entities to support research and novel new treatments. Sixth, the American Academy of Neurology members recognize the Foundation as a fundraising opportunity and have been loyal and supportive of it. As a group, the membership represents the network to help the Foundation achieve its goals and contact individuals in their local communities who have both the means and the motivation to provide philanthropic support.

Thus, this is a perfect storm: Vast research potential for finding new treatments but little funding to support it. It is also the perfect opportunity: A knowledgeable public and an AAN membership that recognizes the consequences of inactivity and the opportunities of success. The junction between the storm and the opportunity is philanthropy, and the American Academy of Neurology Foundation is positioned to be the vehicle that makes the link.

To realize this potential the Foundation will need to evolve, grow, and partner with new groups, engage the public, and become the engine of success to train new clinician-scientists and to drive basic science and clinical research to the urgently needed products of better and safer treatments and, ultimately, cures for neurologic disorders. This won't be easy and it won't happen spontaneously, but with the right plan and the commitment to succeed, it can and will happen.

John C. Mazziottta, MD, FAAN
Chair, AAN Foundation