The beginning of the end?

Picture: Shutterstock

You can take the headline like the one you see above in one of two ways: morbidly, you can be like me, in my mid-50s, wondering whether blanking the name of someone you haven’t heard of or thought about for a while is the warning sign of a bleak future already at a relatively young age. The other interpretation is that it echoes the comment yesterday of experts in the field ofAlzheimer’s research after the breakthrough of a drug, lecanemab, that has been found, for the first time, to slow the disease’s advance.

Although the drug is not a cure, it gives hope to millions of people in the early stages of Alzheimer’s progression - or those at risk - that quality of life should not decline as fast as it does now as the disease wreaks its havoc on the brain. Trials of the drug - delivered intravenously every fortnight - have demonstrated that memory decline can be slowed down by 27% over a period of a year-and-half. No wonder it has the medical world excited, and not in a way seen in more than 30 years of research into the dementia-causing condition which, since 2013, has surpassed heart disease as the second most common cause of premature death after cancer. 

Dementia has long been regarded - even dismissed - as the price of an ageing population, but it's a myth that Alzheimer’s only affects the elderly. A Dutch study found that so-called ‘young onset’ Alzheimer’s came occur in people in their 30s and 40s. Worldwide, it said, as many as 3.9 million people under 65 may be affected. It touches so many lives: my father died with it at the age of 90, a sobering thought for my own destiny. By 2040 it’s expected that 1.6 million people in the UK will have some form of dementia, with Alzheimer’s the leading cause, accounting for 60% of all cases in the UK. No wonder there is such buzz over lecanemab, though it’s not yet clear what impact the drug will have on the-near £35 billion cost of total care that dementia costs the UK. The point here, though, is that a condition previously thought untreatable now is, to a degree. And it gives further hope of preventative treatments for those at risk. 

Now, here are words that I never thought I’d commit to a keyboard, but former prime minister David Cameron made an excellent point when he told the BBC’s Newscast: “Imagine if you could wake up in the morning and simply take a pill that prevents the build up of proteins that cause Alzheimer’s, in much the same way as millions of people take statins to lower their cholesterol and prevent heart disease.” I’m no expert, clearly, but Dave has a point. He also has a personal connection to Alzheimer’s, having lost his mother to the condition, and being the president of Alzheimer’s Research UK charity.

While the excitement today is over lecanemab’s potential for mitigating Alzheimer’s symptoms, not far behind is the prospect of a cure. It is - to be clear - a long way off, but scientists not normally know for their ebullience have hailed the lecanemab breakthrough as the “beginning of the end” of Alzheimer’s, paving the way for treatments that could lead to an eventual cure. 

Some expectation management is, however, required: it has taken more than 30 years to reach this point, ever since UCL professor Sir John Hardy identified a protein called amyloid that causes a form of ‘congestion’ in the brains of Alzheimer’s sufferers. His discovery led to the medical industry pouring millions into drug research to target the protein. Lecanemab is one result of that research, and is a type of antibody that replicates the immune system to remove the sticky amyloid protein that attaches itself to neurons in the brain, progressively inhibiting the organ itself. Further more, the lecanemab could lead to further breakthroughs in research programmes into other drugs and bespoke treatments.

Indeed, Hardy himself has hailed the lecanemab success: “I truly believe it represents the beginning of the end,” he said, reflecting on the three decades since his own discovery. “We now know exactly what we need to do to develop effective drugs. It’s exciting to think that future work will build on this, and we will soon have life-changing treatments to tackle this disease.”

The last statement should not be disregarded, either, as hyperbole. “Once you’re diagnosed, the GP just says there’s nothing that can be done,” Cheryl Essam told the Daily Telegraph today about her husband David’s experience. 78-year-old David joined the lecanemab trial three years ago, receiving treatments every two weeks, but not knowing whether he was receiving the actual drug or a placebo. “People have been looking for hope for 30 years,” Cheryl said. “We weren’t really expecting a positive outcome.” Now, she says lecanemab represents “a light of hope”. 

Sir John Hardy

On Tuesday this week Hardy presented the trial results at an Alzheimer’s conference in San Francisco, revealing that over the years of research, voices in the medical profession suggested that he should have devoted his efforts to other more critical priorities. “I can understand that,” he explained to the Telegraph. ”It’s taken a long time. It’s been a difficult problem and some people have thought that we should have been doing other things.” Now, he says, “I do have a sense of vindication for sure”.

So what happens next? Hardy hopes that people in their 50s and 60s will be able to ask their GPs for an amyloid test which, echoing Cameron’s statin remarks, would be as easily administered as a cholesterol check. Before then, though, lecanemab needs regulatory approval and then adopted for use at scale by the NHS - not as easy as it sounds given the cost pressures the health service is under. Dementia today is chronically under-supported until often it’s too late, and sufferers are forced to sell their homes to pay for round-the-clock care, once it becomes too much for loved ones to take care themselves.

“We have to do better with diagnosis,” Sharon Brennan of the Alzheimer’s Society told the Telegraph, pointing out that symptoms don’t always present themselves until a sufferer turns up at an A&E department confused, in a distressed state, or the victim of an accident caused by the undiagnosed condition. A further complication is that Alzheimer’s is not easily diagnosed, and even when it is, the lack of effective treatment means that doctors and patients alike are reluctant to do anything more than let it progress until the ultimate decline. Thus, the lecanemab breakthrough should not be underestimated.

While no one is getting carried away, the uncharacteristic excitement the drug has generated amongst usually quite stoic scientists has generated hope that there will be a newfound enthusiasm by everyone to press on with developing effective treatments. And, yes, why not a cure. If a vaccine for Covid-19 can be developed in record time with the right momentum behind it, why not an equivalent vaccine for a disease that robs millions of their lives, at a cruelly debilitating pace? Now that would be a breakthrough.

Why I'm resigning. From politics, that is.

July. The time of year we all look forward to for a holiday. My Finnish colleagues have already been enjoying theirs, taking their traditional summer solstice escape to absorb as much Vitamin D as they can before darkness returns. Last week my American friends had their annual summer break, celebrating the colonial uprising of 1776 with barbecues and road trips. Soon it will be my French neighbours, disappearing south so fast on the last day of the month that their portals are left swinging like saloon doors in a Western bar.

I, too, am looking forward to a holiday this month. A holiday from politics. I'm done with it. I've had enough of it. In a year that started unconsolably with the death of David Bowie, and became steadily worse with a never-ending parade of celebrity deaths, we seem to be stuck in a Somme-like, unmoving frontline of hand-to-hand political combat which shows no signs of abating.

Incredibly, the Brexit referendum result only became known two and a half weeks ago. Since then, British political life has imploded, consuming all of us who watch or read the news with it. As if the Brexit result wasn't bad enough, the Prime Minister of the United Kingdom - who'd rolled the dice to begin with - announced his resignation, waking up Her Majesty's Opposition, whose front bench suddenly realised that the physics teacher leading them was no good. This was followed by a gathering of leading Tory Brexiters to vie for the vacating leadership of their own party (oh, and prime minister, too), only to gradually drop off the contest by either Machiavellian knifing or realisation of their sheer inadequacy (and that must also include the hideous, gurning, casual racist Nigel Farage). And now we have the prospect of a leadership contest in the Labour Party, dragging this dull Westminster summer on further. And don't get me going about Euro 2016 or even Chris Evans doing the decent thing and walking the plank from his lousy Top Gear reboot.

I can at least afford a break from all things football, at least for the five weeks until the Premier League gets going again. And I've got enough episodes of 'old' new Top Gear on DVD and Netflix to not particularly bother missing Evans at all. But the one thing I really - really - need a break from is politics.

As I posted on the eve of the Brexit vote, I have little time for politicians at the best of times. And although I recognise that the murdered MP Jo Cox was that exception - a politician with integrity and a genuine concern for her constituency - what has followed since June 23 has left me exhausted. Exhausted by the naked ambition, the step-over-your-dead-grandmother egomaniacism and the fawning inconsistencies (viz Jacob Rees-Mogg, who first backed Boris, then backed Gove, then backed Leadsom - "all the horses", in his words - only to then throw his weight behind Theresa May as the anointed new Tory leader and PM). 

In 2002 May herself asked the Conservative Party conference in Bournemouth: "Why has the public become so cynical about politics and politicians? If we're being honest I think we know the answer. In recent years a number of politicians have behaved disgracefully and then compounded their offences by trying to evade responsibility. We all know who they are." These last few weeks in the UK - and, to some extent, the US too - have given fullsome answer to that proposition.

I wouldn't care less if I didn't hear another word from the political class again. That might sound like I'm sticking my head in the sand but, to be honest, the only thing I want to do with sand right now is to flop out on it with a good book and the entire John Martyn catalogue on-loop on my iPod.

Woke up this morning with 'dem post-referendum blues

"Good luck," said the simple coverline on today's edition of Libération, the left-leaning French newspaper. This wouldn't have been so acerbic (one Twitter wag claimed that France "was now trolling the UK") had it not been accompanied by a full page image of a Union Flag-waving Boris Johnson dangling clown-like from a zip wire. Magnifique.

This, ladies and gentlemen, is the man who aspires to be the next prime minister of Britain, whose de facto leadership of the Leave campaign in the EU referendum was largely to facilitate his ambition of being the next tenant of 10 Downing Street. Not much, mind, about the future of the UK's prosperity but - hey! - what's in a detail?

Of course, the picture of BoJo, taken of the former London mayor during the 2012 Olympics, could easily be excused as a good old piece of self-depreciating British fun. I'm always told by foreign friends that they love the English sense of humour. I wonder what has become of that now?

Make no mistake, as Leavers echo Margaret Thatcher's borrowing of St. Francis of Assisi's poem (you know - discord/harmony, error/truth, doubt/faith, despair/unity, etc...), the seismic outcome of Thursday's referendum has done more to spread discord than it may have sought to repel. Because if you boil down its intentions, and the intentions of those who voted, to their bare bones, two truths emerge.

The first is that the referendum was, to begin with, an act of appeasement by David Cameron to the Tory party's ever-present Eurosceptic schism, which was then seized upon by Johnson as his chance to go for No.10. Quite what he would be qualified for when he gets in there remains to be seen, but if nothing else, his reputation for buffoonery doesn't bode well for Britain's reputation abroad (though no doubt he will find a kindred spirit in a certain prospective US presidential candidate with equally manic blond hair).

The trouble is that, post-referendum, Britain is anything but amusing. The last thing it needs is a Ken Dodd figure with a mad bouffant to tickle our funny bones into feeling better about the future. Now BoJo has achieved his aim of being Britain's prime minister-elect under the banner of "taking back control", I wonder what he actually has in mind to achieve that?

What is his plan for stabilising the markets that saw millions of pounds wiped off British pension funds during yesterday's financial freefall? What will be the strategy for addressing the balance sheet, and access to borrowing now that credit rating agencies are beginning to downgrade the UK?

How does he plan to mitigate the inevitable decision of Airbus to move the skilled manufacturing of aircraft wings from Lancashire to sites in the EU, where exporting for final assembly in Hamburg and Toulouse will be easier?

What about Nissan, which employs 7000 people in Sunderland and exports to all over Europe and even back to its native Japan? How will they be persuaded that a UK with more restricted access to European trade will be worth investing in? Same with other Japanese car manufacturers, Toyota and Honda, who together with Nissan, have restored the British automotive industry to the extent that in 2014 the UK exceeded France for car manufacturing for the first time ever.

The second truth is that the referendum, David Cameron's gamble on direct democracy, can at least be cited as the British people having their say. 33 million votes - a turnout of around 75% - is impressive (by comparison, the 2015 general election saw just 66% of those eligible voting). And it is clear that the demographic divide between Leave and Remain speaks volumes: that working class people in the north of England and those over 65 expressed their frustration at austerity,  economic malaise and the influence of the metropolitan elite - and, of course, immigration - by voting Leave; and that 70% of those under 25 voted Remain, along with Scotland and London, who have somewhat different allegiances to the European ideal.

Understandably, people on both sides of Remain and Leave are calling for the UK to move on. The Leavers say that the 48% who voted to remain must accept the decision. But look at it another way: the margin between Out and In was just a million votes. A technical majority, yes, but it indicates just how divided the UK is now.

Even if the referendum can be pared down to the competition between two Old Etonians for control of the upper sixth common room, it would be impossible to ignore the extent of British sentiment - for and against - which has been expressed by the referendum. But it's this that makes the actual campaigns so disingenuous. Facts would have been helpful, and I mean actual facts, not spun half-truths and outright lies. Like the £350 million claim, which UKIP's Nigel Farage has admitted was "a mistake". Not that Farage has exactly been blameless - his entire narrative has been one of peddling fear and paranoia, underpinned by grotesque jingoism.

Reuters

His 'breaking point' poster was not only a low point for the Brexit debate, it was a low point for British politics, and a tacit encouragement of the racism becoming ever more prevalent (increasing stories of people of various ethnic and national backgrounds being abused on buses, trains and in high streets - chilling echoes of the American segregation era and 1930s Germany).

Even if one of the central points of the Leave campaign was to free Britain of the overbearing bureaucratic nature of the EU machine, the bid to escape it unleashed an unpleasant tone to the Leave narrative. The soft version of this has been the pro-Leave, Middle England-representing newspapers, The Sun, Daily Mail and Daily Express, peddling (and swallowing) jingoistic references to Spitfires, green fields, Elgar and pints of ale, as if "taking back control" means restoring Britain to some anachronistic ideal.  

Everyone has their right to an opinion, but we've been left with a Britain less "great" as fractured and angry. And still somewhat at the mercy of Farage, a politician who makes Boris Johnson look credible, and whose first comment after the result came in yesterday morning was to crassly declare a bloodless victory, "without having to fight, without a single bullet being fired". Tell that to Jo Cox's children.

Farage can, easily be depicted as the bogeyman of the referendum, and while he might appear to invoke popular support, he has so far failed on several occasions to be elected to any major political institution other than the European Parliament, which he loathes. Johnson might be a clown, but Farage is a joke, flip-flopping on everything, from his own party leadership (resigning after the General Election, having failed to be elected for the seat of Thanet South, only to be reinstated almost immediately) to the actual outcome of the referendum itself. For him to declare yesterday morning that the result was a victory for "ordinary people" and "decent people" both underlined his opportunism and his insensitivity. Were the near-half of all voters not ordinary and indecent then? Probably, in UKIP's eyes, given the affiliations of some of their number with the dehumanisation narrative of the extreme far right.

That said, if those who voted Leave on Thursday truly believe the campaign's Trumpist rhetoric about  taking back their country and making Britain great again, they should now wonder what they've reacquired. On top of the financial and business instability, the political landscape is about to grow ever more fractious.

Just 150,000 Tory party members will choose the next British prime minister, as opposed to the 33 million voters who took part in the actual referendum that led to David Cameron's resignation.

So much for his message that the country had just taken part in perhaps the biggest democratic history in its history and that "We should be proud of the fact that in these islands we trust the people for these big decisions."

Maybe, but what will it mean? What will be the impact of Scotland choosing, decisively, to exit the United Kingdom and re-attach itself to the EU? What will happen to the peace process in Northern Ireland if republicans agitate - and succeed - in securing a referendum on unification with Ireland? How will Wales respond, given that it is already conflicted over whether EU subsidies have been of any help, as the principality's industrial base has been eroded by declines in mining and the steel industry.

The British are famous for their stiff upper lips and stoicism. The sentiment on social media, at least, is, in some places, one of resignation and 'let's just get on with it, shall we?'. Wales and Ireland play each other this afternoon in Euro 2016 so, after a 72-hour hiatus from the football, our summer opiate will provide some relief from the doom, gloom and division of the last couple of days. But after today, after tomorrow, after next week, next month, reality will sink in.

The Tories will tear themselves apart, as usual, as they elect a new prime minister, without anyone else in the country having a say. And the Labour party will do much the same, as it implodes over Jeremy "lukewarm" Corbyn's dismal performance in the Remain campaign, his thinly-veiled euroscepticism diluting any opportunity to convince Labour voters of what they actually stand to lose by voting with their hearts rather than their heads.

Libération's front page gesture may have been in some jest, but the reality is that Great Britain - or what's left of it as a result of the referendum - will need more than just luck in the future. And the hard work begins now. I never thought I'd ever find myself invoking Thatcher, but the job now for whomever runs the country next will indeed be to bring harmony to discord, repair errors with truth, replace doubt with faith, and resolve despair with unity. If there is any left.

Clearing up the toxic mess of Brexit

I don't, as a rule, 'do' politics. On this blog and its predecessor, I have studiously avoided an institution I have little time for, one whose practitioners have - whether they like it or not, and whether warranted or not - the reputation of being self-important egomaniacs.

Of course, that's not to say there aren't diligent and hard working politicians who have something to contribute of genuine benefit to the communities they serve. It's just that those are the politicians you rarely see, let alone hear of, largely because they're busy getting on with their actual jobs, rather than trying to position themselves for a job they would very much like to have next.

Taking this further, I've also stayed well clear of the build-up to today's EU referendum. One reason is that I have genuinely been conflicted by sound arguments from both sides. Another is that I've also been revulsed by arguments which have been seriously flawed. A third reason is that I don't, actually, have any formal say in the debate, having lived outside the UK for more than 15 years and am therefore ineligible to vote. But, as Britain goes to the polls, it's hard to resist some reflection, particularly as the referendum is one of the most important decisions my country will have made in my lifetime.

One further reason is that the debate has brought out the very worst of the institution of politics - and its worsening state of being. Neither campaign, frankly, has been particularly impressive. Both sides have overplayed on emotion and frailty rather than hard, stand-up facts. And even when the factual approach has been pursued, Pinocchio's nose has visibly extended. My natural instinct is to support the Remain position - I couldn't really countenance any other view, having benefited in numerous ways from being an EU citizen. My employers have benefited greatly from trade within the EU, as well as employing me in two EU member countries, with the freedom of movement between them. This freedom, moving between the UK, the Netherlands and France (with a two-year sojourn in the US), has enriched me professionally, culturally and socially. And immeasurably.

Later this year I will be returning permanently to the UK, and I worry what country I'll be coming home to. For the last ten weeks it has been dragged into a pit of toxic political division, with towns, communities and even individual families split along rival referendum lines which, in earlier centuries, would have amounted to the conditions of civil conflict. The blame for this must fall on the politicians and the political rivalries at the root of the Brexit debate, who have, from their central positions in their respective campaigns, spun and even lied to achieve their aims.

Twitter may not be the most faithful barometer of rational thinking, but it has also opened the window on the very worst of the sniping, carping and cynical snidery that has been part and parcel of the referendum. Social media has accentuated and worsened its toxicity: to spend any time on Twitter over the last few weeks is to have observed an encroaching, rabid madness, worsened by the extremes of the right and the left in equal measure. I was left in utter despair the other day by a tweet posted from an account festooned in nationalist sentiment which concluded with a call to the new mayor of London and the Remain-endorsing prime minister, "FUCK OF SADIQ FUCK OF CAMERON". That an argument could have been expressed this way suggests both the unrestrained lack of respect afforded by social media platforms as well as truly appalling standards of spelling, grammar and punctuation. EU or no EU, what kind of moron is being turned out by British schools?

I don't wish to trivialise, however. The EU referendum is too important. It will be a decision that will have very real ramifications for British prosperity. Yes, the UK will still trade with the rest of the world if it leaves the EU, but at what cost to manufacturing jobs in Manchester, Sheffield, Glasgow, Sunderland or Swansea when tariffs impact the business of trading? Will Nissan, Honda and Toyota - Japanese companies all - still want to invest in British factories making cars for export? Will London remain the world's financial capital? I would, though, disagree with the idea that the arts and culture would suffer - The Beatles did perfectly alright in Hamburg before the old EEC came along. But these are the arguments we should have been examining, rather than xenophobic nonsense about Syrian refugees fleeing for their lives or Latvians taking British jobs that British people didn't want anyway.

There's no doubt that the European Union can be its own worst enemy. In my work I've seen at close hand how bloated and bureaucratic Brussels can be; I've bought into the argument that a community formed to facilitate free trade has allowed itself to oversee issues about things it has no need - or right - to be involved in. But as a European citizen in every sense, I've also seen what European political and economic unity has achieved, and what the UK stands to lose if it goes it's own way.

This, however, has been masked from view by the sheer crassness of the Leave campaign, and for that we must lay blame at the feet of its leaders: a former London mayor, who extolled the brilliance of his city's multiculturalism while in office only to dive into the murky waters of immigration control while bumbling his way through the Brexit debate, attacking "the agents of Project Fear" while spreading fear himself. Boris Johnson built his personality cult around his Bunteresque, public school clown persona. It was amusing, seeing him on Have I Got News For You, with his manic blond hair and his classical Latin quotations, but throughout this campaign he has too often let his guard down and shown both his naked ambition as well as his unsophisticated, unreconstructed self.

Then there have been the outright lies that Johnson and the equally duplicitous Michael Gove have peddled: the claim that the UK sends £350 million each week to the EU, apparently; the lazy comparisons with pre-war Germany and Nazi scientists discrediting Einstein; the preposterous idea that 78 million Turkish people are preparing to suddenly leave their homes for the UK (any more so than 81 million Germans or 66 million French would). Worse, though, is the Leave leadership's tacit endorsement of that bombastic golf club bore Nigel Farage, a man whose xenophobia is eclipsed only by the outright racism of the swivel-eyed Little Englanders who dote on his every word.

The immigration issue isn't one that can be taken lightly. I've seen the best of immigration and the worst of it. It's a thorny topic, and no amount of saloon bar philosophising from me will even scratch the surface of how to resolve it. But its presence in the darker pockets of the EU referendum has depressed me, and its manifestation within the Brexit debate by those at supposedly the unacceptable extremes of the Leave campaign has been deeply troubling.

Which brings me to Jo Cox. At the top of this post I said that my disdain for politics is largely the result of those who practice it. I've rarely met or seen a politician I like. But in Jo Cox - an MP I hardly knew anything about since she entered Parliament in the 2015 election intake - you sensed something rare and good. To earn the sort of genuine cross-party outpouring Cox's murder stimulated said more about her than any cause she may have stood for or against. She was just doing her job, and by all accounts doing it well - representing her constituents, helping them, supporting them. 

It is right that the Leave and Remain should not have exploited this for their own interests, and for the most part they haven't. But the sight, yesterday, of a Vote Leave campaign banner being flown over Trafalgar Square, not once but three times, during a memorial rally for Cox, in full, cynical knowledge of the hurt and upset it would cause, is a sign of just how far British politics has sunk during the Brexit debate. We've seen something similar in the US, with a presidential election running along even more extreme lines, with one candidate in particular trading hate, fear, paranoia and division for votes. But the US election is not for me to worry about until November. The more pressing event is today.

I can't vote, but I implore those who will to think as long and hard about their choice based on those who presented it. Because, really, would you want a country to be handed over to the likes of Gove and Boris, their lies and misinformation? Worse, their dirty little secret Farage, yapping away from the 19th hole, pint of IPA in one hand, rancid views about immigrants (of which he is one) in the other? It's not the Britain I want to move back to, frankly.