Global Brain Health Act of 2019

The brain is the center of the human nervous system, exerting centralized control over all other organs of the body.

Abnormalities in sections of the brain—namely the corpus callosum (which facilitates communication between the two hemispheres of the brain), the amygdala (which affects emotion and social behavior), and the cerebellum (which is involved with motor activity, balance, and coordination)—usually occur during prenatal development.

Three main brain disorders are autism, hydrocephalus and Alzheimer’s and other forms of dementia. They impact people in both the developed and developing world, but weigh more heavily on sufferers in developing countries due to lack of effective health care, lack of access to health care, or cultural influences that inhibit treatment of sufferers of one of these conditions.

Autism is a complex neurological disorder that affects an individual in the areas of social interaction and communication. Because it is a spectrum disorder, it affects each individual differently and to varying degrees of severity. People with autism process and respond to information in unique ways. In some cases, coexisting medical issues and aggressive or self-injurious behavior may be present.

The occurrence of autism spectrum disorders (ASD) has increased during the past decade from an estimated one in 150 in 2000 to an estimated one in 68 in 2012, according to data released by the Centers for Disease Control and Prevention (CDC) in December 2016. CDC classified as suffering from ASD children whose behaviors were consistent with the DSM–IV–TR criteria for Autistic Disorder, Asperger Disorder, and Pervasive Developmental Disorder—Not Otherwise Specified (PDD–NOS).

The increased number of children diagnosed with autism is a growing and urgent concern for families, healthcare professionals, and educators, as the health and education systems struggle to respond to the needs of this population in a comprehensive manner.

The prevalence of autism in developing countries is also growing rapidly, and health and education systems in these countries are particularly ill-equipped to deal with these issues. According to the World Health Organization, tens of millions of individuals in Africa are affected by autism.

Children with autism who receive intensive and appropriate educational services before age 5 often make significant functional improvements. In the United States, significant efforts are being pursued to expand early diagnosis and the provision of these services. In a report on the identification, evaluation, and management of children with autism, the American Academy of Pediatrics recommended in November 2007 that all children should be screened for developmental delays and disabilities, presumably including autism, twice by the age of 2, even if they have no symptoms. Early screening and services for autism are sorely lacking in most of the developing world. An opportunity exists to use United States expertise to significantly aid children and families in developing countries, for relatively small costs.

Hydrocephalus, also known as “water on the brain”, is a medical condition in which an abnormal accumulation of cerebrospinal fluid in the ventricles or cavities of the brain causes increased intracranial pressure inside the skull and progressive enlargement of the head. If left untreated, hydrocephalus leads to physical and mental disabilities and eventually death.

Hydrocephalus is an extremely painful condition that most commonly occurs in infants and young children as a result of a congenital abnormality (anatomic abnormality, aqueductal stenosis, spina bifida or encephalocele), or post-infectious hydrocephalus (PIH) caused by infections acquired after birth, such as meningitis, that attack the brain.

In developed countries, up to one of every 1,000 newborns develop hydrocephalus, while up to five of every 1,000 newborns in developing countries develop the condition. It is conservatively estimated that more than 300,000 children are born with or acquire hydrocephalus in the developing world each year. Experts posit that hydrocephalus is more common in developing countries because of higher birth rates, as well as high rates of nutritional deficiencies, low infant birth weight, and perinatal and neonatal infections.

Children with hydrocephalus who are not effectively treated or who are not treated in the early stages of the condition suffer from cognitive deficiencies or physical disabilities or both.

Families of children who have hydrocephalus in developing countries rarely know that it is a treatable condition, where to go for treatment, or how to care for a child suffering from the condition. In addition, access to care is limited in many developing countries due to low numbers of practicing neurosurgeons. In 2007, for example, Africa had 565 neurosurgeons, roughly 86 percent of whom were practicing in South Africa and Northern Africa.

Many children with hydrocephalus in developing countries are abandoned, ostracized, or abused due to their appearance, physical and mental disabilities, and inadequate options for care.

Hydrocephalus can be treated, and advances in innovative medical procedures such as ETV/CPC have the potential to save thousands of lives annually and prevent or mitigate physical and mental disabilities in thousands of children in developing countries.

A number of international studies show that between 3.5 to 15 percent of all patients diagnosed with Alzheimer’s or another form of dementia actually have Normal Pressure Hydrocephalus, a condition in which there is too much cerebrospinal fluid, used to cushion and protect the brain and spinal cord, in cavities in the brain called ventricles. Such significant incidents of misdiagnosis illustrate the need for greater awareness among members of the medical profession and the general public of adult hydrocephalus, as well as the need for adopting a holistic approach towards brain health instead of a siloed one.

Dementia is a degenerative condition caused by disease of the brain—usually of a chronic or progressive nature in which there is disturbance of multiple higher cortical functions, including memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgment. Between 5 to 7 percent of the world’s population age 60 and above are estimated to have dementia.

Dementia can be caused by various factors, including traumatic or localized brain injury, a temporary interruption of the brain’s supply of blood or oxygen, infection, stroke, brain hemorrhage, prolonged seizures, or even excessive alcohol use.

According to Alzheimer’s Disease International, more than 47,000,000 people worldwide were suffering from Alzheimer’s or dementia in 2015, a figure that will expand to more than 75,000,000 people by 2030 and more than 131,000,000 people by 2050 if the current trajectory of the disease remains unchanged. Globally, a new person develops dementia every four seconds. Almost 60 percent of people with dementia globally live in low-to-middle income countries, and by 2050 this percentage will exceed 70 percent.

Alzheimer’s disease and related dementias impose a devastating, unsustainable, and rapidly growing toll on the health and fiscal well-being of the United States and all countries. In 2015, dementia care cost an estimated $818,000,000,000, worldwide, more than 1 percent of the world’s Gross Domestic Product (GDP). The cost of dementia care is projected to reach $2,000,000,000,000 by 2030.