MS Prevention: the elephant in the room

"At our research day on Saturday one of the attendees asked me if I a wealthy donor gave me a large sum money for MS research what would I spend it on?"

"Would I spend  it on another progressive MS trial or on more animal and basic research?"

"No! I would invest it in MS PREVENTION."

"The incidence of MS is rising, more women will be diagnosed this year than last. Why? It is not that we have no idea what causes MS; we have clues. Low vitamin D levels, smoking and EBV infection increase your risk. All these factors are modifiable  If we know how they interact we can prevent MS. Therefore, why are we  not doing prevention trials? The problem is the current people working in MS, myself included, don't necessarily have the skill set, or resources, to run the studies necessary to tackle prevention on the grand scale that is required."

"So I would use the money to set-up an Institute of Preventative Neurology; I would not only target MS as some of the ideas and methods needed for MS could be used for other neurological conditions. In addition for any new Institute to be successful it will require critical mass. For MS prevention, I would hire an team that consisted of an epidemiologist and a public health expert and provide them with what they need to study MS at a population level, in particular administrative and statistical support. They will also need the tools for launching a public health campaign; these include public relations, advertising and marketing staff. The unit would also need virology, biomarker and genomics groups, not to mention IT and logistics group to run and maintain the websites, databases and public engagement tools that would underpin the studies and interventions envisaged. Embedded in the unit would be social scientists, in particular sociologists. The emerging importance of social science for the hard sciences cannot be over stated. The adoption of any preventative strategy and measuring its impact will need to be done by social scientists; neurologists and immunologists are relatively clueless when it comes to the social impact of their research."

"Yes, prevention is the Elephant in the Room. We are neglecting it at our peril! The next generation of MSers are going to look back and ask us why we didn't start prevention studies sooner. Will they accept our excuses? I wouldn't!"

"This reminds me of a story about a new Viceroy to India. When he arrived in India he asked his private secretary: 'Why has nobody planted trees on the estate?' To this his private secretary responded: 'By the time they have grown you will be long gone'. The Viceroy responded, 'Even more reason to plant them today.'"

"I doubt I will forgive myself if I don't launch an MS Prevention study before I die. May be it is time to stop blogging and to write grants; prevention grants?"