This August, a correspondence playing out in the pages of The Lancet crystallized something I myself and the Global BHP BrainTrust have advocated for years: failing to treat established Alzheimer’s disease is not the same as failing to prevent it.

Two major trials, evoke and evoke+, tested a well-known diabetes and weight-loss drug, semaglutide, as a treatment for people who already had Alzheimer’s symptoms, starting in 2021. The result: the drug didn’t work. But I think it’s worth looking at that result more closely rather than simply writing the drug off.

The trials enrolled people who had already entered the clinical phase of disease, with substantial brain damage already in place. That the drug couldn’t reverse damage already done tells us very little about whether it could delay or prevent decline if given years earlier, before symptoms ever emerge. This is precisely the gap regulators, scientists, and pharmaceutical companies should be looking at more closely.

Researchers from Imperial College London and Oxford made this same case in their response, and I agree with them: a drug’s failure to treat existing disease should not be mistaken for a failure to prevent it in the first place.

This critical distinction is precisely the gap regulators, scientists, and pharmaceutical companies need to keep sight of, and it is exactly where the next real opportunity lies.

It is also why this conversation couldn’t be more timely. Coming up this October 6th at CEOi/Lausanne XIII, the Global BrainTrust is convening a high-level international working group of leading scientists, policymakers, and global networkers. Together, we will focus on what it will take to move women’s brain health higher on the global agenda across research priorities, cross-border collaboration, regulatory thinking, and policymaking.

The field is moving fast. Our responsibility is to ensure that women move right along with it.