NAPA 2.0: The next giant leap

In this issue of the Alzheimer’s & Dementia, a meeting report is published [1] by the attendees of a meeting entitled “State of the science conference on the advancement of Alzheimer’s disease diagnosis, treatment, and care” [2] convened by the Marian S. Ware Alzheimer Program at the University of Pennsylvania on June 21-22, 2012. The meeting sought to assess the current state of Alzheimer’s disease (AD) care and research. Building on many similar past efforts, the Ware conference also sought to address the scientific, ethical, and policy challenges that must be met to improve the diagnosis, treatment, and care of AD patients. This publication is quite timely given that a new round of planning for the US National Plan to Address Alzheimer’s Disease (USNPAAD, or the “National Plan”) is underway [2]. The National Institutes of Health Alzheimer’s Research Summit report [3], the Alzheimer’s Association’s Workgroup on the National Alzheimer’s Project Act (NAPA) Scientific Agenda for a National Initiative on Alzheimer’s Disease [4], as well as the Leon Thal Symposia [5-8] each has contributed to a now-comprehensive catalog of fully vetted short-, medium-, and long-range project ideas to advance public health efforts to control AD. Although the ultimate objective for these efforts is to advocate for increased government research funding and support for services, another important goal is to identify achievable public policy opportunities to modify existing programs and regulations without significant impact to departmental budgets. This is particularly important in the United States given the present realties of the Budget Control Act and the importance of “deficit reduction” policies. Since 1978, National Institute on Aging (NIA) established an extensive national network of AD research facilities at academic institutions. Despite the capacity of this network and their many critical contributions, today these programs are inadequate. The efficiency and effectiveness of each program can be substantially improved via consolidation and integration. For example, the ADRC program or the current Centers (P30s and P50s) can be modified so that some of the centers can be converted into Comprehensive Alzheimer’s Disease Centers (ADCs) (P60s). A small number (5-10) of such regional centers could support not only research, demonstration projects on care/ treatment, clinical trials, and education but also allow for the integra-