I 118th CONGRESS 2d Session H. R. 10175 IN THE HOUSE OF REPRESENTATIVES November 20, 2024 Mr. Bera (for himself, Mr. Fitzpatrick , and Mrs. Kim of California ) introduced the following bill; which was referred to the Committee on Foreign Affairs A BILL To authorize United States participation in the Davos Alzheimer’s Collaborative.

1. Short title This Act may be cited as the “ Global Alzheimer’s Initiative Now Act ”. 2. Findings Congress finds the following: (1) Alzheimer’s disease and dementia currently afflicts nearly 60 million people across the globe, a number that is projected to jump to more than 150 million by 2050. (2) There are now more global cases of Alzheimer’s disease and dementia than cancer and HIV combined, with 39 million diagnosed cases of HIV/AIDS and 20 million cases of cancer in 2022. (3) The pace of populations aging will challenge countries’ sovereign funds and health and social safety systems. (4) By 2050, the world’s population of people aged 60 years and older will double to 1.6 billion and reach a proportion of 22 percent of the world’s population. While the number of persons aged 80 or older is expected to triple by 2050. (5) The old-age dependency ratio, expressing the relative size of the older population compared with the working-age population, is projected to more than double by 2075 in the majority of the world. Rising dependency ratios will result in increasing pressures on old-age support systems, with fewer people of working age for each older person. (6) The prevalence of Alzheimer’s disease and dementia is growing most rapidly in low- and middle-income countries, which comprise more than 70 percent of the world’s Alzheimer’s disease and dementia cases. (7) Every year, Alzheimer’s disease and dementia costs the global economy more than $1.3 trillion and this is doubling every decade. (8) By 2050, the number of Americans living with Alzheimer’s disease and dementia is expected to reach 12.7 million, bringing the total cost to nearly $1 trillion each year. (9) Women are disproportionately affected by Alzheimer’s disease and dementia, both directly and indirectly. Women experience higher disability-adjusted life years and mortality due to Alzheimer’s disease and dementia, but also provide 70 percent of care hours for people living with Alzheimer’s disease and dementia. (10) The Davos Alzheimer’s Collaborative (DAC) is a public–private–patient venture, launched in 2021, that is transforming Alzheimer’s disease and dementia research, prevention, and care in low-income, middle-income, and high-income settings globally. (11) DAC seeks to raise and deploy over $700 million over 6 years to accelerate innovation in drug development and transform the way healthcare systems prevent, diagnose, and treat Alzheimer’s disease and dementia for all people in all places. (12) In 2023, DAC supported 19 healthcare systems in 12 countries, including the United States. (13) The United States Government is the largest funder of global health programs, with approximately $12 billion in annual funding for programs that cover the full range of global health challenges. (14) USAID and the Department of State are lead funders of multilateral health initiatives, such as Gavi, the Vaccine Alliance, the Global Fund to Fight AIDS, TB and Malaria, the Coalition for Epidemic Preparedness Innovations, and the International AIDS Vaccine Initiative. 3. Statement of policy It shall be the policy of the United States— (1) to lead global cooperative efforts to combat Alzheimer’s disease and dementia, including in countries with low-income economies and countries with middle-income economies (as such terms are defined by the World Bank) that represent the majority of future cases; and (2) to lead multilateral health initiatives, including the Davos Alzheimer’s Collaborative— (A) to develop diagnostics and treatments for diverse populations in the United States and across the globe; (B) to promote international development cooperation; and (C) to provide substantial leverage and burden sharing for United States investments. 4. Authorization for United States participation in the Davos Alzheimer’s Collaborative (a) In general The United States is hereby authorized to participate in, and contribute to, the Davos Alzheimer’s Collaborative (DAC) in order to advance international efforts to prevent, diagnose, and treat Alzheimer’s disease and dementia. (b) Designee (1) In general The President is authorized to designate an employee of the relevant Federal department or agency providing the majority of United States contributions to DAC to serve on the Advisory Council of DAC and, if nominated, on the Board of Directors of DAC, as a representative of the United States. (2) Qualifications The individual to be designated pursuant to paragraph (1) should demonstrate knowledge and experience in the fields of development and public health. (3) Cooperation In carrying out this section, the individual designated pursuant to paragraph (1) shall coordinate with the USAID Administrator, the Secretary of State, and the Secretary of Health and Human Services to promote alignment, as appropriate, between DAC and United States global health and Alzheimer’s disease and dementia research and development programs. (c) United States contributions (1) In general Amounts authorized to be appropriated and made available to carry out chapters 1 and 10 of part I and chapter 4 of part II of the Foreign Assistance Act of 1961 ( 22 U.S.C. 2151 et seq. ) are authorized to be made available for United States contributions to DAC. (2) Matching requirement Amounts made available under paragraph (1) may be obligated and expended only to the extent that DAC secures funding from sources other than the United States. At any time during fiscal years 2025 through 2029, no United States contribution to DAC may cause the total amount of United States Government contributions to DAC to exceed 33 percent of the total amount of funds contributed to the DAC from all sources. (d) Report Not later than 180 days after the date of the enactment of this Act, and on an annual basis thereafter, the President shall submit to the appropriate congressional committees a report that includes the following: (1) A description of any planned financial contributions from the United States Government to DAC. (2) The manner and extent to which the United States will participate in the governance of DAC. (3) A summary of private and governmental contributions to DAC. (4) A description of how participation in DAC supports relevant United States Government strategies and programs to combat Alzheimer’s disease and dementia and to promote global health. (e) Definition In subsection (d), the term “appropriate congressional committees” means— (1) the Committee on Foreign Affairs and Committee on Appropriations of the House of Representatives; and (2) the Committee on Foreign Relations and the Committee on Appropriations of the Senate.