Treatment is under the spotlight in this, our fourth episode.
We’ll be talking about the solutions that exist and the value of bringing them to the people. We’ll also discuss the importance of taking a holistic approach and hearing about the importance of innovation.
Plus we’ll have messages from the some of the companies who are who are delivering innovative solutions and hear from a person living with Young Onset Parkinson's Disease
Treatment is under the spotlight in this, our fourth episode.
We’ll be talking about the solutions that exist and the value of bringing them to the people. We’ll also discuss the importance of taking a holistic approach and hearing about the importance of innovation.
Plus we’ll have messages from the some of the companies who are who are delivering innovative solutions and hear from a person living with Young Onset Parkinson's Disease
Welcome to the One Voice for Neurology podcast, a series of seven podcasts exploring why it's time to make a neurology, a priority, how that can be achieved with a global and a uniform response and what that could mean for the future of neurology and those living with a neurological disorder. I'm Sam Pauly, and you're listening to episode four, entitled zooming in on treatment. Thank you for joining us on this special series of podcasts in which we're exploring the new one neurology initiative across seven daily episodes. In our previous episode, we focused on people living with neurological disorders and heard more about the challenges they face and where they find hope. In today's episode, we'll be discussing treatment and finding out about solutions that exist and the value of bringing them to the people, living with neurological conditions, as well as hearing about innovative new solutions. We'll also hear from Richelle Flanagan, who was living with young onset Parkinson's disease, and we hope you'll join in the conversation too. You can find us on Twitter at@OneNeurology_ with the hashtag#OneNeurology. In this episode, I'll be talking with three guests individually, and then at the end of the episode, we'll all join together for a further discussion. Coming up, we'll be meeting Dr. Maria Teresa Ferretti for the Women's Brain Project and Dr. Simone Hiltl from Novartis. But first I'm delighted to welcome Frédéric Destrebecq, Executive director of the European Brain Council. Fred, thank you so much for joining us.
Frédéric Destrebecq:Good morning.
Sam Pauly:So Fred EBC has worked on the cost of brain disorders study and value of treatment study. What were the findings of both?
Frédéric Destrebecq:So EBC works and released, 10 years ago, so in 2011, the study on the cost and burden of brain disorders in Europe, where we came to the conclusion that managing brain conditions at the European scale every year was costing European society, nearly 800 billion euros. So it means bailing out the Greek debt seven times every year. In front of this massive amount, we really wanted to find out what it actually meant. And that's how we decided to conduct a new study on the impact of not treating disorders. Because this 800 billion euros, however big we think this is, this is a necessary investment into the quality of life or the management of those conditions. It would be actually worst off if we were not investing that money. With the value of treatment study, we demonstrated that in spite of the investment, it was basically cost saving or cost efficient to put those in place.
Sam Pauly:Because just to clarify. So if you don't treat, the cost of non treatment, you said is higher. Where are those costs then of non treatment?
Frédéric Destrebecq:If you imagine people living with MS, not being able to go for their treatments, people living with migraine or headache disorders. So all, all of that creates basically a snowball effect. If you delay the intervention, you delay the progression of the disease, you delay these phases where patients get worse off, but the longer you, you kind of plateau this progression, the better, the better you can improve the quality of life of people.
Sam Pauly:And we talk about value of innovation. What do we mean by that?
Frédéric Destrebecq:What we meant by that was to take the same kind of value based approach to innovation in the same way that we did to treatments. When we talk about value base is how do we define values. Is it only an economic value, or are there other ways to define value? And that's where the need to center this definition of value around the patients was paramount. And that's what we did in the value of treatment study. And that's what we wanted to replicate in our value of innovation approach, which is now called the brain innovation policy roadmap, because, basically we wanted to demonstrate how innovation was improving outcomes for patients, so bringing very concrete benefits, rather than to talk about something that is really like techy, cutting edge, that we can read in newspapers, but hardly gets at our pharmacists counter or you know, hospitals. And there is a lot to be said, maybe around the capacity of our healthcare system to absorb this innovation. When we talk about the value based approach to innovation, where does that value translate? Where does that value actually provided to those who actually are in need to have this value being generated?
Sam Pauly:You talked about providing evidence of concrete benefits. Have you got any examples of that?
Frédéric Destrebecq:Well, as I said, in our value of treatment study, we have this demonstration. So for the first round of case studies, we had nine disorders. The most various you can think of all came to the same conclusion, which was that the earlier we detect the earlier you can intervene and let's say the better it gets for the patients, for society, for the economy in terms of how costly the general intervention is getting,
Sam Pauly:What solutions does the EBC propose in order to optimize treatment?
Frédéric Destrebecq:Actually, EBC is working on a policy roadmap that is going to be released during the brain awareness week. So this roadmap actually is giving us a way ahead in terms of how to create innovation in the brain space and make it available to patients, but also identify those challenges that needs to be addressed on that road. Challenges, which can be of basically any nature- we know the intrinsic complexity of understanding the brain and generating new cures, but we also have challenges of a cultural or regulatory nature. We need to redefine maybe the way HTA processes work, the way we run clinical trials. Because of the complexity of the brain, we fail to be able to have an objective measurement of the benefit of new therapeutic options. But also what we fail to do is to properly embed what the patient perspective in terms of what they actually want from a therapy. You know, clinicians talk to us about the length of a pace of the pace of a Parkinson patient, and just say, okay, because they can make a pace that is actually wider than than previously, it improves their conditions of life. And the Parkinson patients can come to us and say, you know what I experienced and what I miss the most is to be able to take my grandchildren on my lap and not shake when I cuddle them. So we need to really, to change a little bit, our mindset and to integrate that a little bit better.
Sam Pauly:Wonderful many, thanks Fred for that. And we'll be hearing from you a little later in the episode now, throughout the series of podcasts, we're hearing personal accounts from people living with different neurological disorders. Today, we hear from Richelle Flanagan who is living with young onset Parkinson's disease.
Richelle Flanagan:Hi, my name is Richelle Flanagan. I'm based in Dublin, Ireland. I was diagnosed with young onset Parkinson's disease when I was 47 and pregnant with my daughter. I was three months pregnant at the time, and I actually picked up on the diagnosis myself through my work as a dietician. Um, when I was writing, I noticed my handwriting had gotten a lot smaller over the years. And what was really strange was I couldn't make the handwriting bigger. And this triggered me to ask for a referral to a neurologist who was fairly confident I didn't have Parkinson's because my symptoms were so minimal. And so I had to get a DatSCAN. I had to wait for that DatSCAN until I was finished breastfeeding my daughter. And unfortunately it showed that I did have Parkinson's. And the biggest difference for me in terms of symptoms is basically I have a sort of slowness or rigidity on my dominant side, my right side, which has really affected my typing and writing and texting, which has impacted my work. Also my communication with friends, it's very tiring and I have started to use voice recognition software, which I really didn't want to have to do, didn't want to have to give in, but, you know, at the end of the day, it is a disability and I need to use the tools that are out there available to me. I suppose, the other thing is fatigue, it's really strong. And the thing about Parkinson's is that many of the symptoms are sort of hidden and people probably don't understand until they could walk in my shoes, what it feels like. And when you have a four year old, just full of energy and a 14 year old, you need to have your energy. And that's pretty hard when you've a c ondition that slows you down. A nd I s uppose what's really frustrating is that the treatment is pretty limited to one type of drug. And w hilst there are different iterations of this, there has been really no huge progress in managing the symptoms from a drug point of view or slowing progression, whatever by the cure. And that's hard to face when y ou're only young with Parkinson's. I s uppose the o ther thing that has been quite hard to deal with as a woman, I n otice every month that prior to my periods, my symptoms get much worse. And I know a lot of my colleagues, u m, young women with Parkinson's mentioned the same thing, and I believe it's quite similar in MS. And also that it can affect cognition and dementia in terms of younger women also. So this campaign would be brilliant to kind of bring a bit of focus on not only younger people with neurological conditions, their needs, but also young women and women in general, with regard to the hormonal effect, u m, neurological conditions. So I know in terms of Parkinson's that, apparently some research has shown if you take HRT during p eri-m enopause, that it may help symptoms, and in fact, slow progression. That is huge for someone who is living with Parkinson's and has a young family. So I'd really l ike to see that this campaign helps to focus our mind, to share the common themes across the different conditions, to find ways to manage symptoms better, so progression and ultimately find a cure for us all. Thank you!
Sam Pauly:Richelle Flanagan there with her powerful account of living with young onset Parkinson's disease. Well, as we continue to focus on treatment, I'm delighted to be joined by Maria Teresa Ferretti, co-founder of the Women's Brain Project. M aria, thank you so much for joining us. Before Richelle, we were hearing from Fred Destrebecq. Did you have anything that you wanted to pick up on, on what he said, and we w ill be a ble t o talking later on?
Dr Maria Teresa Ferretti:Yes, absolutely. Actually I was struck when Fred mentioned that there are different needs in the neurological space. So on one hand, we need to invest money research and resources. On the other hand right now, there are maybe other needs of patients that we should address, let's say more physiotherapy. And at the moment there is this tension between these two. It somehow reminded me the discussion w e a re having now that we s ent Perseverance to Mars, you know. And there is this discussion, say why should we go to Mars if we have issues here on earth? And I think that there is, there are similarities there. And I think, and I agree with Fred in thinking that actually we should find ways to do both because research is our future but there are very pressing needs that we have to address.
Sam Pauly:Let me ask you a little bit more about treatment, now. I'd like to know what approach of treatment you advocate?
Dr Maria Teresa Ferretti:Absolutely. At the Women's Brain Project, we think that treatment should be looked at from a holistic point of view. So we put the patient and the individual at the center, pretty much following what Fred was talking about. But we try to look at this person from a 360 degrees. So what do I mean by that? You put the patient at the center. So of course i t will have to listen to the specific needs of this person. This needs are, some of them are biological. They come simply from, you know, the disease, the biomarkers, but that's only part of the story. And a person is not just biology. It's very important to consider also s ocio-e conomic dimension. So you have s ocial e conomic determinants of health. To give you an example, poverty and low education are risk factors for diseases like dementia and very important lifestyle changes. Brain health is not just treatment. It can also be driven by lifestyle changes in nutrition, i n fitness. If you empower the p atient, and if you give them any information, they can become a gents of their own change and their own brain health. And a final aspect, a p erson is never isolated. When you have a person sick, you actually have a family that is sick and you have to support the entire family. So again, in this holistic view of brain health, we should try, and treat, and support the pa tient, but always thinking of the people that surround this person. We really promote this holistic point of view, where we should look at brain health from multiple aspects and support patients from all these points of view.
Sam Pauly:What we mean by the term precision medicine. Is that something that you, you advocate as part of that holistic approach?
Dr Maria Teresa Ferretti:Absolutely. So it was going back to the listening to the specific needs and characteristics of patients. Uh, so precision medicine advocates for giving the right treatment at the right patient at the right time. And this is something that is very well established in other fields like oncology. And this is a field where I had a personal experience. So I can really talk to that. You know, in oncology, you basically in breast cancer, which was my case, you never consider that there are two breast cancers that are equal, even though you might have a lump that looks very similar between two women. Those two women are completely different. So in oncology, we had this amazing progress because we started to understand that patients are not equal. You have groups of patients with very specific pathologies that needed tailored treatment. And this has allowed an incredible, you know, improvement in the variety of treatments that we have available in quality of life of patients. At the Women's Brain project, we think that a similar progress should be also made in neurology where we should actually start really understanding whether the subgroups of patients exist and how to support specifically the subgroups with implementing biomarkers, of course, understanding the neuropathological changes and hopefully finding drugs that can address exactly those changes.
Sam Pauly:Maria Teresa, you're co-founder of the women's brain project. Why is it the women's brain project?
Dr Maria Teresa Ferretti:It's actually a very nice story and started from a couple of friends studying Alzheimer's disease. And we started to realize how you had the sex and gender differences in Alzheimer's. You have two thirds of patients that are women. And then we started to look around and realize that it was not just Alzheimer's. You had a lot of other disorders. You have multiple sclerosis, where it's overwhelmingly women. Migraine is 80% of patients are women. So we started to think that there might be something interesting from the sex and gender differences in terms of vulnerability to disorders-biological, as well as socioeconomic. By studying the sex and gender differences, we think that we can actually promote change in innovation in brain health, which can support both men and women. Because again, going back to precision medicine, understanding the specific characteristic of patients will actually promote a better treatment for everybody.
Sam Pauly:Just finally, can precision medicine be used in the diagnosis and what benefit could that have for the treatment?
Dr Maria Teresa Ferretti:Yes, we are big, big supporters of this idea. And I'm just going to give you one example from the Alzheimer's field, which is where I come from, what I'm studying. We have known for a long time that neuropsychological tests- so these tests that we do to measure memory let's say- we have known for a long time that in some tests, women outperform men and in some other tests men, outperform women. This doesn't make a huge difference in normal life, but it's becoming clearer and clearer, that actually, when you use this test in people that are starting to have cognitive impairments- wo we are talking about very early stages of Alzheimer's- actually these sex differences might have an impact. And what some studies are showing is that because women outperformed men, they actually miss the diagnosis early on because they just ace this test, even though they have as much pathology in their brains as men. And so you miss this chance for early diagnosis, which we know is absolutely crucial in fundamentals. This is an example of how understanding specific needs and characteristic of patients, and then design a sex-adjusted or sex-specific test, might actually be a way a key to find something that allows us to promote early diagnosis.
Sam Pauly:And therefore earlier treatment?
Dr Maria Teresa Ferretti:Yes, because the sooner you can diagnose the sooner you can of course start treatment.
Sam Pauly:Fantastic. Well, thank you, Maria Teresa. Again, we'll be hearing more from you in the final part of the episode.
Bill Carroll:Hi, Bill Carroll is my name. I'm the president of the World Federation of Nerology. I'd like to thank you for listening to the one voice for Neurology podcast.
Sam Pauly:You're listening to the One voice for Neurology podcast. And today we're talking about treatment. Now don't forget. We'd love you to join the discussion with us on Twitter. You'll find us at@OneNeurology_ and we're using the hashtag#OneNeurology. Now let me bring in our final guest for today, Dr. Simone Hiltl from global pharmaceutical company, Novartis. D r. Hiltl is the medical franchise head of neuroscience for Germany. Simone, thank you so much for joining us.
Dr Simone Hiltl:Thank you for having me.
Sam Pauly:I wonder if you could start by telling us what is your neuroscience pipeline, and maybe you could highlight an exciting project from that.
Dr Simone Hiltl:Innovation is really at the heart of our focus, and we are proud to be one of the most competitive pipelines within Novartis. But when looking specifically at neurological diseases, you really can see that they are having a dramatic impact on patients and families around the globe. So this is really very dramatic for patients itself. And so our vision is really to reimagine neuroscience through developing transformative medicines, but also delivering life-changing outcomes to the patients. And when asking about what is really the most exciting project, this for sure is for example, those projects where we can modify the course of a devastating disease, where we can create personalized medicine, as Maria Teresa just said and also where we can think towards prevention or even curing the future. So these are really the most exciting projects.
Sam Pauly:And, and you spoke about maybe finding a cure and that, uh, that of course, it's very exciting. We will talk about that later. So I don't want to leave that unspoken about. Before that, can you tell us what's changing at the moment in medical research?
Dr Simone Hiltl:We are coming from the past, where we really had a perspective and a focus on molecules and knowing that really the patient is really in the center of our research and it's really crucial really to identify the unmet need of the patients. And then a second step really focused t oward the targets that are effective in addressing those.
Sam Pauly:Why do you think treatment is such a challenging area?
Dr Simone Hiltl:Yeah, well, um, specifically within the neuroscience, we really have to be humble because the nervous system is not completely understood and we know that damage, what we see in the brain, that it can't be easily reversed. Having said that, so our experience and diseases, just like MS, it really shows that patients benefit greatly from early detection and early intervention with high effective treatments to maintain the function before it really is destroyed. But also, as Maria Theresa just said, the silent stages of the diseases they often started years before you can really see any symptoms. For example, in Alzheimer's, the protein they're building up, like up to 20 years before symptoms can even be seen by the physicians. And despite all the scientific hurdles, what we a re seeing in this field, we investigate ways really to address the conditions much earlier and help the patient to have perspective and to prepare for the future.
Sam Pauly:And then do you think efforts in one disorder could lead to progress in another disorder?
Dr Simone Hiltl:Sure. Well, ongoing research and really growing understanding of fundamental biological mechanisms. They a re really important because they are often really disruptive in many diseases. So it's not just one disease, it's much more than different diseases. As we are currently understanding much more the pathways and the targets more precisely, they sometimes turn out to be really relevant for one and the other disease. Let's say, for example, we are currently investigating in one molecule in Huntington's disease, but also in another disease. And so this is really quite crucial for patients because they don't have any approved disease modifying therapies to delay the progression or the start of the disease itself. And this really shows our commitment to really provide therapeutic treatment options.
Sam Pauly:Is this a long standing approach, looking at different disorders and looking for the commonalities or is that quite new?
Dr Simone Hiltl:It has been developing over the last years because we really, as I said, are understanding the pathways and the targets, to help us understand the disease in more detail, it really helps us a nd enables us to leverage one molecule for different diseases, actually.
Sam Pauly:Well, thank you very much, Simone, do stay with us again. We'd like to talk with you a little bit more at the end and our other guests in just a moment. But first let's hear about some of the innovative solutions that are being worked on, As we check in on our one voice for neurology podcast answerphone, let's have a listen.
Voicemail:Hello, you've reached the voicemail for the One Voice for Neurology Podcast. Please leave your message after the tone.
Annabel Descampy:Hi, it's Annabel here from Icomponian. Icompanion is a free mobile application created by icometrics for people with multiple sclerosis. They can use the app to monitor their condition at home. In between d octor's visits, a lot of information can go loss: how you feel, which symptoms you experience, how severe these are, how your disability, fatigue and cognition are changing, and so on. When I go to the doctor, I typically forget half of what I wanted to discuss. So just imagine what this must be like for someone with a neurological condition, which is often accompanied with memory problems. Especially with the current global pandemic, telemonitoring is more relevant than ever and gives neurologists much greater insights into the disease scores, allowing them to make more informed clinical decisions and help patients get on the right treatment sooner. The i dea t hat patients themselves can be part of their disease management can be a source of hope and empowerment and engagement for them.
Jonathan Schreiber:Hi, it's Jonathan Schreiber here from the digital therapeutics company Noroventis. At Noroventis, our mission is to elevate our collective ability to better care for people with neurological disorders and empower them to constantly overcome their journey. What are currently active in epilepsy and headache across three continents, with more than 200 healthcare professionals and 8,000 users connected to our tools. The vast majority of those users all go through the same basic therapy principle: trial and error. In epilepsy alone, there are more than 20 molecules from which the physician can choose to find the right treatment for each patient. Also, these treatments focus mainly on preventing symptoms, like an epileptic seizure. With the physician, understandably focusing on these symptoms on which he can have an impact, neglecting the stuff that might be more important for that person, like mobility, like quality of life, comorbidities, cognitive ability, or side effects. But there's hope, digital health also promise to empower both patients and healthcare professionals we see on our side, but also from other teams around the world that digital health enables a holistic understanding of the disease, Not only symptom focused, but quality of life focused. There's even more. We also see the rise of cognitive behavioral therapies, where people with neurological disorders are empowered to become true leaders of their health. So to conclude, we finally learning how to put the human at the center and it's coming soon.
Kim Baden Kristiansen:I think digital therapeutics will have a really important role to play in particularly neurological disorders because it's one of the areas that have proven to be the most challenging for traditional methods. And this is where some of the new methods that can be delivered by digital technologies can come in and play a role. Some of these may help with things such as lowering risk factors or changing lifestyles that can actually impact the symptoms of a disease. And so these types of behavioral therapeutic interventions that can be delivered digitally is one very interesting application of digital therapeutics in neurology. But there are also other, other ways of doing it such as for example, cognitive training, which is some of the things that we work with in, in brain+, and hopefully they're going in and helping to alleviate some of the symptoms, some of the cognitive symptoms through digital treatment interventions. In any case, the digital always relies on the user to engage some way. And I think this is probably one of the keys and what is sometimes missing from more traditional treatment methods is that there's actually something really valuable and impactful and effective in getting a user engaged in their own treatment somehow, rather than only just receiving a pill for example, and not to say that there's anything wrong with medicine, but here is a new era. And it has a lot of promise.
Sam Pauly:Kim Baden Kristiansen from brain+ there, in the last of our messages on today's One Voice for Neurology podcast a nswerphone.
Hariklia Proios:Hi I am Hariklia P roios, acting as president of SAFE. And thank you, you're listening to One Voice for Neurology Podcast.
Sam Pauly:Throughout this episode, we've been talking about treatment with our three guests. Frédéric Destrebecq, Executive Director of the European Brain Council, Maria Teresa Ferretti of the Women's Brain Project. And Dr. Simone Hiltl, from Novartis. Now, they all join me to finish today's discussion. Thank you. And let me welcome you all back. Thank you for being here with us today. Let me start by asking you all really. We've heard about innovation. You've you've all mentioned it, and we've just been hearing about it in our answerphone feature. How important do you think is it to look for innovative solutions? Maria Teresa, let me just ask you first.
Dr Maria Teresa Ferretti:It's absolutely crucial. And I have to tell you when we talk about putting the patient in the center of all our approaches, I always picture this patient with an iPhone or a tablet in his or her hand. And I think this is the future of a lot of things and also medicine. So there will be more and more this type of innovation where we use digital biomarkers, AI based solutions, apps for even for treatment, brain machine interfaces... And I'm super excited about it because these are the years where we are building solutions, that will be life changers for, you know, the next years. So I think now is the moment to really talk about these solutions, how we build them. Consider for instance, the databases we're using for them. Avoiding the existence of biases and making sure that we represent different populations, in terms of men and women, different ethnicities, regional origins, different types of characteristics and demographics and biological, so that we build solutions that actually can help the biggest possible number of individuals and patients.
Sam Pauly:Fred did you want to add something to that?
Frédéric Destrebecq:To echo what Maria Teresa has just said, I think that the extent of the unmet need is such that we should actually take brain research as one of the highest priority, in the policy area. I mean, that's at least what EBC is really striving for. But to come to those innovative solutions, I think we had in t he recent years, concrete examples, like certain breakthroughs- I'm thinking of deep brain stimulation or vagus nerve stimulation, for instance- that's really came as very promising c ompliments where there were limits to the, let's say, to pharmacology. At the same time, we are now experiencing in certain diseases, I'm thinking of multiple sclerosis, for instance, where we are coming up with d isease m odifying treatments. So clearly there is hope. We are coming really at this c rossroad where we can see a brighter future. And we a re on that edge of cracking the brain.
Sam Pauly:Simone, now, let me ask you a little bit about innovation because this last 12 months we've seen an incredible effort and an incredible achievement with COVID 19, and the vaccines that have been created. Has that set a precedent now for what we can really achieve?
Dr Simone Hiltl:We never have thought that we can really reach a vaccine within 12 months or within even, I don't know, eight or nine months. So this has been really unprecedented. And I think what we learned that we really have to have a joint efforts to come to solution, to find preventional therapies, to find cures for patients. And I think this is really, this is really key.
Sam Pauly:And, and do you think we can, we can do that? Fred?
Frédéric Destrebecq:Clearly we can. Now the big question is what will be the learnings of this crisis. Basically when there is a will, there is a way. And in all, what is now being prepared in terms of post COVID preparedness or all the COVID reaction, we really need to make sure that this is not only addressing, let's say the infectious space, what we put in place in order for such crisis to not happen again, clearly needs to be comprehensive in the way it would address our healthcare systems, because we cannot neglect the fact that there were people left out in the crisis response, and we need really to have a more holistic vision of our society in the future. I mean, all of this crisis has put really the light on certain issues, certain priorities, that EFNA, EBC and other organizations were really trying to put at the forefront, and all of a sudden they come to the light by themselves,
Sam Pauly:Maria Teresa, Fred said, where there is a will, there is a way- is the will there? Is the way there?
Dr Maria Teresa Ferretti:Yes, I absolutely agree. And, I actually think there are a lot of lessons from the COVID story, you know. The huge success in the vaccination is for sure one. I would also like to highlight if I may, that this whole pandemic, has, for instance, exposed another aspect, one that we were talking about, the importance of precision medicine, and now people, I think it becomes clear to people to understand this, because it's obvious that two persons can get the same virus and have completely different responses. Can we predict, can we find biomarkers or features of person A and person B that allows us to actually manage them, monitor them and follow them, treat them the optimal way? I'm hoping for, you know, a domino effect t hat from the pandemic, from infectology goes to other fields, especially i n n eurology,
Sam Pauly:Let me just quickly ask you about access. Is access good enough internationally across the world is everybody that's living with a neurological disorder getting the access they need? And what impact can having good access have on the wider society?
Dr Maria Teresa Ferretti:Thanks for this question. It's very important. I would like to start by saying that actually, there has been an amazing progress recently. So we do have drugs now that can support the management of a number of disorders. Now we have these drugs and the question is whether patients are getting access to them. And actually the answer at the global level, something we should address, we should look at. And t hese g oals, actually from issues i n developed countries, where there is not enough maybe awareness among patients and h ealthcare providers that some solutions e xist, but even more so at the global level issues of access in developing countries where some of these new, innovative, expensive treatments might not be available at all. And if you think of breakthrough treatments that can really improve the quality of life of individuals and families and in the end in the entire society, this becomes a crucial issue that we should tackle possibly from a human rights point of view, because we have the solutions, we have to find a way to make them available to everybody independently of where they live, what is their sex, their gender, their age, their ethnicity. So it's a big issue to tackle.
Sam Pauly:Just finally, I'd like to ask you all, I know it's incredibly difficult, there's so much innovation taking place, but if you could pick out one that excites you most- an innovative solution, what would it be. Fred?
Frédéric Destrebecq:Well, if I have to pick one, it's probably the spinal cord stimulation. So innovation that would restore the function of the use of a limb or ability to work for people paralyzed, to my mind and person, that what is really striking.
Sam Pauly:Simone?
Dr Simone Hiltl:When just looking at the COVID situation, I see we are much more open towards new technologies, and I really hope really to see transformative innovations and breakthroughs for devastating diseases. Like, as I said, for Huntington's, for example.
Dr Maria Teresa Ferretti:Yes. If, if I can be a little bit provocative, I think for the, so to go forward, I think we have to take a step back and realize that a lot of brain disorders they share, even though they are different disorders, we consider them silos, separate silos, but actually they share a lot of pathways and neuropathological processes. And so I think to really have innovation, what I'm dreaming of is a novel taxonomy. Let's say of diseases where we take a step back and we reconsider everything and we start, first of all, understanding what goes wrong at the molecular level. And then we start addressing with biomarkers and we drugs, the specific pathways that are involved in a certain disease for that given patient.
Sam Pauly:In all the things that we've been talking about today, and across the series, we've been talking a huge amount about the One Neurology initiative. What can the benefit of the one neurology initiative bring to treatment? Maria Teresa?
Dr Maria Teresa Ferretti:I think we should look at the brain as one organ that can become sick and raising awareness on these type of disorders and getting the message across to the lay public as well, that it's totally normal to have disorders of the brain. You know, why should it be okay to have a heart disease and should be stigmatized to have a brain disease? So once we start having this conversation about the brain as one organ that is part of our body and can get sick. I can, I really think we will have progress from the research point of view from the awareness point of view, the societal conversation. So I think it's extremely important.
Sam Pauly:Fred, how do you think the one neurology initiative can really drive change?
Frédéric Destrebecq:Well, I'm convinced that one neurology, I mean, actually, is making a change because it's taking this first step in bringing everybody together in this family of brain and neurological conditions. And this is probably the first necessary step to be taken before we can go out and advocate.
Sam Pauly:Let me just finish with the episode, asking the million dollar question, many disorders have become manageable. Is it time to start thinking big and start dreaming about a cure? Simone?
Dr Simone Hiltl:I would definitely say yes. So science and technology, they have been really transformative in the last years. So imagine what could really happen if you can really have a cure for neurological disorders. And I think our ambition at Novartis is really to pioneer prevention and really cure for selected neurological diseases. I strongly believe that the 2020s will be really a decade for breakthroughs in neuroscience.
Sam Pauly:Thank you. Fred?
Frédéric Destrebecq:Well I can't agree more with Simone. We mentioned a few examples in the field of multiple sclerosis, epilepsy, where we have cures available or d isease m odifying therapies that are coming in. Clearly we are about to find more, making every effort, e very d ay, i n o rder to achieve that.
Sam Pauly:Exciting times, Fred!
Frédéric Destrebecq:Indeed looking forward to the decades of breakthroughs.
Sam Pauly:Mary Teresa, would you like to finish?
Dr Maria Teresa Ferretti:I think it's mind blowing what we've managed to do, even just for exactly the management of some disorders. I'm thinking, in particular for patients with migraine right now, there are finally options to prevent their attacks, which was unheard of until a few years ago. And t his should give us confidence that with research and with understanding and with this i nteraction with the patients, we can actually really change, y ou k now, and move the field forward. So I'm confident that we should go for cure of diseases. We should understand neuropathological processes, which most likely are shared across different disorders. And with this novel approach we are for sure going to have breakthroughs in treatments as well.
Sam Pauly:Well, that's very exciting note to finish on. So thank you all for joining us plenty to look forward to in the next decade then. I would like to thank all of our guests and contributors for taking part in today's episode. I'd like to thank everyone that's listening for listening and joining us. Don't forget, we'd love you to join the conversation as well on Twitter, and you can share your voice or even better share a video. You'll find us at@OneNeurology_, and you can use the hashtag#OneNeurology. So we look forward to chatting with you there on Twitter. Do join us again next time for our following episode, number five, where we'll be discussing research and development until then. Goodbye. Thank you for listening to the One Voice for Neurology podcast, produced on behalf of the European Federation of Neurological Associations and the European Academy of Neurology, the umbrella organizations, representing patient organizations and neurologists in Europe, with active contribution from the European Brain Council produced and hosted by Sam Pauly.