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The Current Transcript for March 29, 2019

Host: Piya Chattopadhyay

STORIES FROM THIS EPISODE

Prologue

[Music: Theme]

SOUNDCLIP

I literally was heartbroken. I was holding on to him being on this trial and it was slowing it down. So it is. It's very emotional.

PIYA CHATTOPADHYAY: For many who suffer from Alzheimer's and their loved ones, it was long a reason for hope an experimental therapy designed to attack a particular protein linked to the disease. But now that promise is fading fast. The drug trials have been canceled and some say it is more evidence for getting Alzheimer's wrong. Also today sharing the burden of birth control.

SOUNDCLIP

We should be constantly given birth control. When you leave a restaurant instead of mints, it should be birth control. When you push the door instead of pull it, birth control should pop out - Like, you're not ready yet.

PC: For years women have felt the pressure of that when it comes to birth control, it is their responsibility. But nowadays there are new options for men to prevent unwanted pregnancies. They're getting closer to market. The big question is, are the guys ready? We'll talk about that in half an hour. But first we're going to Quebec and the debate over symbols of faith. I'm Piya Chattopadhyay and this is the Friday edition of The Current.

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Teacher opposed to Quebec secularism bill says she should be able to choose what she wears

Guests: Bouchera Chelbi, Leila Bensalem, Christopher Skeete

SOUNDCLIP

[French speech]

[Applause]

PC: That is Quebec minister of immigration trying to do with several previous Quebec governments of different stripes have attempted and then abandoned. So he may Simon Jolin Barrette tabled a bill that would bar some public servants from wearing visible religious symbols. Supporters say Bill 21 is intended to guarantee the neutrality of the state on religious matters, but Opponents including Prime Minister Justin Trudeau see it rather differently.

SOUNDCLIP

Canada, and indeed Quebec are places where we are a secular society. We respect deeply people's rights and freedoms, including the expression, freedom of conscience, freedom of religion. It is unthinkable to me that in a free society we would legitimize discrimination against citizens based on their religion.

PC: The proposed ban on religious symbols applies to many categories of public servants including prosecutors, judges, any public employee who carries a firearm and teachers. In a bit we will be hearing from Christopher Skeete, a parliamentary assistant at Quebec Premier Francois while ago. But first we have to beg teachers with very different views on 21 Bouchera Chelbi wears a hejab and teaches at two elementary schools with Montreal's a French language school board and Leila Bensalem is a retired teacher from Montreal who continues to work as a substitute teacher. Both of them are in Montreal. Hello.

BOUCHERA CHELBI: Hi.

LEILA BENSALEM: Good morning

PC: Bouchera, let me begin with you. What are your biggest concerns about Bill 21?

BOUCHERA CHELBI: I think it's discriminatory towards minorities. Not only discriminatory, it's not inclusive. It's also limiting one's aspirations. Some students who are studying to to become teachers are not going to be able to it unless they sacrifice their religion. So I think is really discriminatory towards minorities in Quebec.

PC: Part of the proposed bill is that sort of a grandfather clause and that people who are wearing religious symbols already teachers will be allowed to continue to work, but new people will not be able to wear them. Leila Bensalem, Quebec's premier Francois Legault a while ago said he has made compromises with Bill 21. What do you think? Does it strike the right balance?

LEILA BENSALEM: Well first of all I would like to say that globally speaking I agree with the bill, but I have a few more reasons to express. First of all the grandfather clause because I think the bill should be applied to everyone. It will become a law helpfully and I thing that all citizens are supposed to be law abiding, so it should be the same thing for everybody. And the reason is you know in schools I would be talking about school because this is what I know about because I am a teacher. You have many other people in schools who are not teachers who are not concerned about the bill. So we end up having people wearing religious signs at the same place with other people who are not allowed to wear them.

PC: You mean you mean caretakers and others who work within the schools.

LEILA BENSALEM: Yes exactly. You know you have receptionists, you have lab technicians, you have all sorts of you know other people who are teachers but who work at the same place. For me its a matter of being coherent.

PC: Let me ask you this Leila Bensalem, you don't wear any religious symbols yourself. You have been advocating for a ban on religious symbols in public service for years now. Why is this issue so important to you?

LEILA BENSALEM: It is very important for me. You know I come from a country where religion is a part of the Constitution, and it’s a part of your daily life and I have always thought that religion should be separated from the state, from the government. It's something that is private and that has nothing to do with your work and the people you're supposed to serve. So for me it is a matter of separating religion from the state. It’s very normal for me. And if you represent the state, you are supposed to represent as well the neutrality of the state.

PC: Bouchera Chelbi, let me bring you in because you just heard Leila say you know this is a private matter, and supporters of Bill 21 will say that religion should be a private matter. First of all I mean feel free to say what you want to there but why is it important for you to continue to wear a hijab at work?

BOUCHERA CHELBI: Leila and I, we come from the same country. I decided to wear has arrived when I was 17 and in my family we were not religious. It's true that the constitution of our country says that religion is a part of the religion of the state. However I cannot really say that it could be imposed on people. In some countries, it's been imposed upon people. It is very important for me, because I am free to do whatever I want to do. Even before that I was not living in Quebec, I was living in Algeria, and I chose to wear the headscarf. My family was against it but they ended up accepting it. I still have my sisters who do not wear the hijab, and it's okay. We are family. When I came to Quebec, the first thing that struck me is that you can be whoever you want to be. No one is going to judge you upon what you're wearing. But it's changed a bit because no matter what you do you will always going to be -- you could try very hard, as hard as you can. There'll always be voices that are going to try to politicize your faith. So if you talk about secularism, secularism is about the state. The state should be neutral. But it cannot compel its citizens to be neutral as well. There is this freedom of religion, and we as teachers are professionals, we are neutral. I've been teaching for 10 years in Quebec and I've always been professional, I've always been neutral. I do not teach my religion beliefs to my students. I have a curriculum and I do it. You could ask any unions, you could ask in this school boards . So far there were no complaints whatsoever of our teachers wearing religious symbols to practise [unintelligible] or whatsoever. However I've known many teachers who do not wear religious symbols but they do look neutral. It's true, but they were not neutral in their in their teaching or whatsoever. So telling me that because I decide to wear a religious symbols is going to hinder me from doing my job correctly, from being neutral towards my kids -- I say kids - my students or towards my colleagues it is completely false. I've never seen that in Quebec.

PC: I want to bring Bensalem in on this. You know Bill 21 covers all religious symbols and you heard Bouchera say you know I'm choosing to wear the hijab. There are other religions for example, Sikhism, which importers are dictates that people wear outwardly religious symbols. So what do you say to people those faiths who feel targeted?

LEILA BENSALEM: Well it is but it has to do with being neutral, Bouchera, I was talking about being neutral, but when you wear religious signs, you don't have to talk about them, you don't have to talk about your religion, but at the same time you are sending messages. And when doing so, in fact you do not respect this students or the citizens' freedom of conscience. If you represent the state, if you are a civil servant. You are supposed to be neutral about religious signs. And it's not a big deal, I mean it's just a matter of wearing them seven or eight hours at work and then you leave your place of work and then you can have them and the weekends and the holidays you know.

[Cross talking]

PC: Bouchera, she says seven or eight hours a day. Just take off your hijab, come to work, put it on as soon as you get home.

BOUCHERA CHELBI: Wow. That's really that's really like depriving me from my freedom to dress. You know what, I've never met anyone tell me what to wear and when to wear. So it might be better for her to dictate this, women should take of their scarf before going to work and then it's no big deal for her. But for me it's a big deal because it's about my freedom. Before my religious freedom, it's my freedom as a woman. I am a feminist. Do you think that I am going to allow anybody to dictate me, 'okay, if you want to go there you should be dressed like this. When you get out then you can dress like you want'. It doesn't work this way. It's about basic freedom.

PC: I know that both of you have a lot more to say on this and that this debate is very rife in Quebec and elsewhere, and we'll continue to hear about it the following but I'm going to have to leave it there. Thank you to both of you.

BOUCHERA CHELBI: Thanks you for having me, bye.

LEILA BENSALEM: Thanks.

PC: Boucehra Chelbi teachers two elementary scores with Montreal's French language school board and Leila Bensalem is a retired teacher but still does some substitute teaching in Montreal. Well we heard Prime Minister Justin Trudeau condemn Bill 21 earlier, conservative leader Andrew Scheer and NDP leader Jagmeet Singh have done the same. The bill is also receiving significant backlash in Quebec itself. Here to defend his government's plan to ban religious symbols for some public service is Christopher Skeete. He is the coalition Avenir Quebec member for Sainte-Rose Lavale. He is also the parliamentary assistant to the premier for relations with English speaking Quebecers. We have reached him in Laval. Hello.

CHRISTOPHER SKEETE: Good morning.

PC: Let me first get your reaction to what you heard from our previous two guests.

CHRISTOPHER SKEETE: Well I mean I think that basically it's a testament to the debate that we need to have collectively as a secular society. I think both are bringing important points of view. On the one hand Bouchera makes a compelling case for individual rights. On the other hand Leila makes a good compelling case about collective rights and I think that's exactly where we are. I think our proposed legislation really is an excellent compromise about that. We want to make sure that because the power of the state remains neutral but individual citizens, people in their homes walking in the streets, people receiving services. We believe that those people should be free to exercise their religion beliefs.

PC: Why did you included that grandfathering clause? What is your government trying to achieve with Bill 21?

CHRISTOPHER SKEETE: That was a doozy. When you try to be, first of all reasonable, how to be moderate in our approach. We certainly didn't want to see people losing their jobs. So the grandfather clause is something we knew we mulled over for a while within our parish but at the same talk we decided that it was the more reasonable thing to do, and it was a compromise. All the polling shows that Quebecers want us to o what it is we're doing. The only thing that they don't like is this grandfather clause. But I think in the end it pays more to be considerate to those people who are already employed and who are already wearing religious symbols. For u sit was a difficult decision but I think that's right.

PC: This legislation does not include a specific definition of what counts as a religious symbol. And many people interpret religious symbols differently. Why does it not include a list per se?

CHRISTOPHER SKEETE: Well a list would have been to go down a slippery slope of just trying to be exhaustive or not. I think religious symbols are one of those things that you know we can't list them all but when we see one we know we're looking at it.

PC: Okay, dreadlocks?

CHRISTOPHER SKEETE: I think that was a language we saw yesterday during a press conference. Dreadlocks of course are not a religious symbol.

PC: For some people they are.

CHRISTOPHER SKEETE: Well, if let me finish. So with regards to hair as well that more difficult. I think in the case of the dreadlocks, let's assume you were police officer, dreadlocks would not be allowed. Not necessarily because of what it is that we're doing but mostly because police officers have an obligation to be discreet in their attire. I think that's why it doesn't really apply.

PC: And how would you enforce if someone said look I'm wearing a headscarf for fashion, not as a hijab. How would you enforce that? How would you prove their motivation?

CHRISTOPHER SKEETE: I think what we're seeing in example like that- I don't want to get into a hypotheticals like that, because I believe that people of good faith will act in good faith. And ultimately we are counting on people's judgment. You know we cannot forget that legislation as a broad sort not a [unintelligible]. What we're trying to say here is we're trying to say that we believe in a wider secular society and we believe that government should be free from religion. Now within that we hope that citizens will help us in that endeavor. But you know getting at the hypotheticals I think dilutes the wider debate that we need to have about making sure that our state is neutral.

PC: Some will see the use of the Not Withstanding Clause which our government says it will do is proof of your government knows it is violating the charter of rights and freedoms with its Bill 21. So why is the CAQ prepared to go ahead with this legislation anyway?

CHRISTOPHER SKEETE: It's funny that people say that by invoking a clause in the Constitution were not following the Constitution. In fact the clause, Section 33, exists for this very reason. When provinces and jurisdictions are trying to say I have an individual rights question on one hand and I have a call I give my question on the other. Right now with our current legislation we're making a source for collective right.

PC: Prime Minister Justin Trudeau suggested the bill would legitimize discrimination against citizens based on their religion. The National Council of Canadian Muslims, and the word Sikh organisation have made similar points, and I want to play a bit. This is from Harvey Levine from the Jewish organization B'Nai Brith.

SOUNDCLIP

We just don't believe that any person in authority, working in the government, teacher etc. will do any less of an effective job just because they're wearing a religious symbol. They are not trying to invoke their religion on any of the people that they serve, it's just racism and discriminatory.

PC: Christopher Skeete what do you say to that and other observant, Sikhs, Muslims and Jews in Quebec, who are feeling targeted by this legislation or proposed legislation?

CHRISTOPHER SKEETE: Well first of all I think the Prime Minister as I said the prime minister meant legislate and I don't think he meant legitimise, because certainly no one is speaking about legitimizing discrimination. Second of all quite to the contrary, our law confirms the rights and liberty of conscience and it is the right to freedom of religion. What we're saying now is that when you have coercive power of the state when you're prison guard, when you're a police officer, when you are a prosecutor you must be free from that only religious symbols. In fact the appearance of any potential bias that supersedes any type of individual question that we can think of. And I think if I go a little bit further we're not telling anybody not to wear their religious symbols that they're proscribed. What we're saying is when you come in to work - in that very specific capacity - we ask you to check your religion at the door.

PC: What you are saying when you are at work you cannot wear your religious symbols. For seven or eight hours or nine hours at your work you are not allowed to wear them is what this bill proposes.

CHRISTOPHER SKEETE: Were saying when you come into work for a group of very powerful individuals in our society, we ask you we do religion at the door because you were representing the state and the amazing and awsome power of the state when doing your function. I don't think that's unreasonable.

PC: The Autonomist Teachers Federation - I mean this debate right now is really being badly dealt with the teachers, and the Autonomous Teachers Federation represents 43,000 teachers across Quebec. It is condemning Bell 21. So is the Quebec Provincial Teachers Association. Are you worried about creating labor strife with teachers?

CHRISTOPHER SKEETE: I don't want to speculate as to what individuals are going to do. What I do know is that the people are behind this. Just this morning there's a poll that shows 74 percent of people are in favor of prosecutors being free from religious symbols. 74 percent favor prison guards and police officers should be exempt. And even teachers are included in that call.

PC: What are the numbers of teachers?

CHRISTOPHER SKEETE: Sixty nine percent in favour. So we are way ahead in terms of approval from the wider society. The only place by the way that they're not in agreement with that is the grandfather clause. So I think you know I think we are making some concessions here. I think we proposed the motion to remove the crucifix from the National Assembly. We proposed the grandfather clause to be reasonable and moderate. I do think that were being reasonable in the way that we're doing this. I do think that we are being moderate approach.

PC: As I understand it the moving of the cross from the National Assembly is from the chamber into the hallway. Am I right on that?

CHRISTOPHER SKEETE: I actually no. What we've proposed to remove it from the place where we make laws. I think it would have been a little of a--

PC: But it'll still be in the building.

CHRISTOPHER SKEETE: We are going to move it somewhere, but that have to be determined by the committee in charge of the National Assembly. That's a sovereign group of people. They get together to discuss what is going to have to happen, It is too early to say where will end up. Yes it's going to be removed from the place where we pass laws. I have no idea where it's going to do.

CHRISTOPHER SKEETE: Christopher Skeete, we will have to leave it there. Thank you for your time.

PC: I appreciate yours. Thank you.

CHRISTOPHER SKEETE: Chrisopher Skeete is a CAQ member of Quebec National Assembly. He is also the parliamentary assistant to the premier for relations with English speaking Quebecers. He was in love. I know you want to weigh in on this debate and I welcome you to do so. You can tweet us @TheCurrentCBC. You can post on Facebook, facebook.com/cbcthecurrent. Or if you prefer it e-mail us please do so. Go to cbc.ca/thecurrent and once you're there click on the Contact Us link. The CBC News as an exit and then after that: Trials of male birth control have come a long long way. But the real hurdle may be convincing men to take it. I', Piya Chattopadhyaya. You're listening to the Friday edition of The Current and for a back in a bit.

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Researchers are getting closer to a male birth control gel, but will men use it?

Guests: Jonathan Eig, Stephanie Page, Lisa Campo-Englestein

PC: Hi I'm Piya Chattopadhyay. And you're listening to the Friday edition of The Current.

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PC: Still to come a setback for Alzheimer's research how the failure of some promising drugs are challenging popular ideas about the disease. But first why all is not fair when it comes to love and sex.

[Music: Theme].

PC: If you a woman looking for birth control there are a lot of options. Pills, IUDs, patches, sponges, shots that goes on and on. If you are a man that list is much shorter, but the science is catching up. Researchers are getting closer to bringing male birth control to the market. Recently in the United States a pill for men passed its first round of safety trials. There is also promising research into a gel that men can rub into their shoulders every day. But even if their gel made it to market, would men use it? Our producer Daniel Carr as some men and women run on what they think.

SOUNDCLIP

VOICE 1: Male birth control. What do you want to know?

DC: Would you ever take it?

VOICE 1: Sure. Why wouldn't you? Why not take all the birth control you can?

VOICE 2: Seems like a good idea, probably will be willing to at least try.

Any preference over a pill or gel?

VOICE 2: Seems like you may have to get help putting on. The pill I think is easy and you can just do it yourself.

VOICE 3: I'm 21 and my name's Emily. I feel like it's always been our responsibility and I think now it's really good that it's also the responsibility of the man to do it. This is my partner, his name is Jimmy and he's 22.

VOICE 4: And I think it's a good step like in a relationship with a two way street. It doesn't sound like it's a difficult thing.

VOICE 5: I do not support male birth control. I do not support the whole topic whether it's male or female. I'd say they should probably research about all the side effects. What are the positives. I would rather recommend try using natural stuff.

VOICE 6: I don't see any issue with that.

DC: Would you ever take it?

VOICE 6: Sure, yes, alright. I'll rub a gel on my shoulders I guess, yes.

PC: Well one of the medical scientists leading North American research efforts into birth control for men happens to be a Canadian, Dr. Stephanie Paige. She is a professor with the University of Washington School of Medicine and we've reached her in Seattle Washington. Hi.

STEPHANIE PAGE: Good morning.

PC: So you know you're in the process of developing three methods of birth control for men and I want to go through them. Where are you? How far along are you in terms of an injection?

STEPHANIE PAGE: The injection is still at early stages so we're giving the first doses and men. We've given the injection to about 40 men enrolled in our clinical trials.

PC: And what kind of injection? Once a day once a month how does it work?

STEPHANIE PAGE: Well we're still working that out. The goal is to produce something that men would injective every three to six months so a longer acting form of birth control than a pill. And so far we've seen that it's working for about two to three months but we're still working on that aspect.

PC: Then where are we on the pill. The pill for men.

STEPHANIE PAGE: Yes. So we have two prototype pills both of which have been safely used for men for a month and one of which is currently undergoing a trial that lasts about three months. So we've still got a ways to go with that as well that that's moving forward.

PC: A third option you're looking at is as a gel where you rub it on your shoulders or someone rubs and on your shoulders for you, where is the science on this today?

STEPHANIE PAGE: So a little further with that. That's product is actually in trials in couples. So the other two products were still testing in men to show that they suppress the production of sperm. But we actually have a multinational study going on right now of the gel where couples actually use it as their only form of birth control. But all of the products work similarly in terms of their mechanism.

PC: And how is it working out in terms of a results, the gel?

STEPHANIE PAGE: So the gel worked great for men for six months. So we know that it suppresses sperm production. So we know it can work. The trial in the couples is really just getting underway but we expect to have those results in a couple of years.

PC: What are the scientific challenges in developing birth control from men?

STEPHANIE PAGE: Well they're very similar to what they were for women but they're more complex. So remember that women ovulate and they produce about one to sometimes two eggs a month. For men the challenge is a little different because men make millions, literally millions of sperm a day. And so part of the challenge has been determining how low we need to go. Did we need to get rid of all the sperm with these products, or where a few okay in the ejaculate. It turns out that that took a while to determine. But then the other challenges are similar as they were for women. So trying to understand side effects, potential side effects and how to make sure that those are minimized.

PC: And with women I mean there are lots of choices in terms of birth control and many women choose one over the other because of the potential side effects. So what or what were you watching or in terms of these trials in men in terms of side effects?

STEPHANIE PAGE: So we look for a lot of the same things. So changes in mood, changes in sex drive, changes in sexual function, weight gain. Really all the same things that we look for in hormonal contraceptive trials for women. And in fact those are the things that we do see little [unintelligible] with various products, but we're really excited that particularly the gel doesn't seem to be associated with the large number of side effects.

PC: You know have we heard some of this in the tape that we played earlier. But you know a lot of women have strong feelings about: 'What? They could use a gel and I got to take a pill every day, or 21 out of 28 days' or 'I got to have an IUD'. They are frustrated that it seems easier for the guys. What do you make of their frustration?

STEPHANIE PAGE: I think that women are little tired of bearing the entire burden of contraception and so having options for men were probably welcome among a number of couples and you heard there in your tape. So I think you know they are really interested in men being engaged and as you also heard the men are very interested. So one of the reasons we think men haven't been as engaged in contraception is they kind of have - or they certainly have limited choices and some of those choices aren't that great or effective. And so again by providing a menu of choices for men we really think that couples will have more options and that men will be more engaged.

PC: I'm curious from a cultural level. Was it hard to get people, men, to enroll in your study given through the culture that women take care birth control. And I know I'm being a little stereotypical there but generally that's the message sent culturally.

STEPHANIE PAGE: Yes I think that you're right. But you know you'd be surprised. Men are actually very interested in the studies that we do. We don't have any trouble recruiting men for these studies. The couples study is a little more challenging because it's much longer. And of course there are some risks. We design the trials to really minimize the risk of pregnancy. But that's a little bit more challenging because again more people involved long growing of time, but men are very interested and there's actually multinational studies asking men if there were products like this available, they would use them. And really the vast majority are interested. So we think that there's going to be a lot of uptake.

PC: It sounds to me like the three things we've talked about; the pills are in the injection and gel, were quite early in the stages of research. Where are we in terms of a general timeline? Like how far off do you think we are actually from seeing new kinds of male birth control on the market?

STEPHANIE PAGE: So as you point out we do have a lot of work to do and these studies do take time. But we're pretty optimistic that within a decade we might be able to see one of these products available for men. Of course that is dependent on all of these studies being successful but we think you know 10 years is realistic.

PC: You are working from a university I'm curious where the pharmaceutical industry is in all of this?

STEPHANIE PAGE: That's a great question. So historically the pharmaceutical industry was actually interested in investing, in development of male contraceptives. That dropped off about eight to 10 years ago.

PC: Because?

STEPHANIE PAGE: Well I'm not in the pharmaceutical industry but I think you know there there's concern about the lack of guidance from regulatory entities. So you know for products to get on the market they have to be approved and since there's nothing like this available they not really know what, for example, the FDA is going to require in terms of long term testing and side effects. So I think that's a little bit risky for them. And it's actually also because there's not other products on the market. The market is unproven. So we can have this survey data about hypothetical products, but again there's no demonstration that the market is there and I think that that's left them uneasy.

PC: You are not the only group working on developing male birth control. We're seeing adverts in populous countries, India and China for example. What does that tell you that developing countries are also getting in on this?

STEPHANIE PAGE: I think it tells you that men are ready and women are ready. So the fact that we actually see product development in other countries really goes against this dogma that we have that men won't do it and men aren't interested. So I think it's really exciting that other countries are participating in our trials, as well as trying to be innovative in this area as well.

PC: Dr. Stephanie Paige we'll leave it there. Thank you.

STEPHANIE PAGE: Thank you for having me and thanks for your interest.

PC: Dr. Stephanie Paige is a professor with the University of Washington School of Medicine. And we reached her in Seattle Washington.

SOUNDCLIP

Men are not going to take birth control because pregnancy just doesn't affect our bodies. What woman would even trust to do the keep up with birth control. I mean if guy is responsible enough to keep up with his birth control, he wouldn't need, because he'd probably make a great father.

PC: Over the years there have been a lot of jokes about male birth control. Michael Chave Saturday Night Live isn't the first to riff on the idea that it just isn't for men. For more on the added [unintelligible] around birth control we're joined by Lisa Campo-Englestein. She teaches bioethics in Albany Medical College in New York State. She is in Albany New York. And Jonathan Eig is the author of The Birth Of The Pill: How Four Crusaders Reinvented Sex And Launched A Revolution. He's in Chicago. Hi to both of you.

JONATHAN EIG: Good morning.

LISA CAMPO-ENGLESTEIN: Hello.

PC: Lisa let me begin with you. What are you thinking as you're seeing these advances, early stages, advances nonetheless, in male birth control?

LISA CAMPO-ENGLESTEIN: Well as Stephanie mentioned I think both women and men have been interested in this for a while but unfortunately there hasn't been some other funding for it. And that's based partially I think cultural beliefs at least by the pharmaceutical companies, that women and men won't be interesting in this. But I think times are changing and people are ready.

PC: Jonathan Eig, what are you thinking as you hear about these advances in male birth control?

JONATHAN EIG: Well I'm interested in the historical perspective which is driving where we are today. The pill has been so successful that it has been very little incentive for men to even think about taking responsibility for birth control. And that's part of the design it was designed because women needed that control. Women needed to be able to take control of their bodies and lives the way Margaret Sanger saw when she conceived of this idea, almost 100 years ago. It wasn't the 1950s that she found a scientist willing to work on it. And that scientist suggested that they also used the same hormones to experiment with male birth control. And Sanger said absolutely not. She cut off funding for that part of the research because she was worried that - as the comedian said during the break - men could not be counted on, and women had to have the power to do this in order for it to be effective. Those were the conditions that she was operating on in the 1950s, and were still living with the consequences of that today.

PC: That's so interesting because she said, look, men aren't going to be responsible. So there is no point doing. This is Margaret Sanger. How did ending those tests for male birth control back in the 50s then influence the way we've sort of come from there, the way men viewed and have viewed birth control do you think?

JONATHAN EIG: I think as a result of that men have viewed it as completely the woman's responsibility you know. It's her body. She is the one who's going to get pregnant. And men have assumed that she's got it covered. And as a result of that, even couples who were making long term commitments, moving in together, getting married they seldom have serious discussions about sharing the responsibility. And I like to think that it's beginning to change but it is going to be a big shift required and it's going to take a lot of work.

PC: Lisa Campo-Englestein, where do you stand on this? I mean culturally how did the rest of the culture come to view birth control for men since the 50s, since the pill for women came on board and then became very popularized over the next decades?

LISA CAMPO-ENGLESTEIN: I agree completely with Chaliapin that human action for women and then it became a mandate, because there were no other options or good options for men. I mean we had discectomy and condoms, no long acting reversible contraceptives for men. And so when women are equipped with the only good option with low failure rates, then it became a no brainer that women would be the ones to assume contraceptive responsibility. But then it's got reinforced as the default option where men then were absolved of contraceptive responsibility, because there were no options for them. And I think things are changing. We see that men are becoming more involved in child rearing, more men are taking paternal leaves, there are more stay at home dads. And so men's responsibility for reproduction and childcare, they're becoming more involved and they think that allowing an interest in the male pill to move forward. But I agree that it's going to take a huge cultural shift for men to assume more responsibility.

PC: You know over the decades it hasn't just been women going into their doctor’s offices and saying I want to talk to you about some kind of prevention of pregnancy. And often times were offered the pill as a first option. But the media has also covered the pill and other forms of contraception for women very largely through the decades. Lisa Campo-Englestein, you've been looking at how the media covered the issue going back to the late 80s. What have you seen?

LISA CAMPO-ENGLESTEIN: We have seen specifically how the media has covered the male pill. All over time from the 80s until the last couple of years the media response has been more and more positive to be the male pill. Interestingly however it depends on whether the author is a woman or a man. When the author he other is more likely to be a woman she's more likely to talk about the positives of this. When it's a man he's more likely to talk about some of the challenges involving contraception. Overall what we found in articles in the 2010s and beyond, the majority of them said male contraception is good. However even though they're saying this at the same time they're pointing out a lot of challenges and they're still concerned about the safety and side effects. Another trend we noticed is that articles are less likely to talk about trust over time, and that's become less of an issue of whether women will trust men. And I think that's because there's been this shift from understating male contraception as something that men do for the sake of their female partner to something they do for themselves. So there is this shift in men's sexual reproductive identity. They now see themselves as reproductive beings who need to take responsibility for themselves, and who should have reproductive autonomy just like women do.

PC: Jonathan Eig are you hearing echoes in anything that Lisa is saying there, in terms of how we've both by the media but culturally, talked about male birth control in terms of in comparison to how we culturally saw the birth control for women come online.

JONATHAN EIG: Yeah I think everything we've said is true I think men are taking greater interest and greater responsibility, but the hurdle and it's not an insurmountable hurdle. You know these things always take time. History moves slowly. The hurdle is getting men to accept even just some of the small side effects like weight gain or you know little mood changes that women have been enduring for decades, and in much higher levels before we really finally calibrated the pill, the side effects were much worse. And women were willing to tolerate that because obviously they wanted to avoid pregnancy. Men don't have that risk of getting pregnant so that's one of the reasons that they are willing to assume fewer side effects.

PC: They do have the risk of getting someone pregnant.

JONATHAN EIG: Yes they do. But I think that there's less urgency about that for many men. Unfortunately they don't view them with a similar weight even though they clearly should. So it's something that the culture needs to work on and I think we are working on it. I think that younger men are getting more hip to this and are being more involved in these discussions and that's a start. And I would also say that Madison Avenue was really good at convincing people of things. Look at commercials for Viagara and how effective they are. You know if they were to get behind a product and there’s money to be made in a product for men I think that attitudes would change much more quickly.

PC: And do you think that's part of the hold up? These things aren't available for market anyway right now but it's part of it just like, unless we think guys are going to buy it spend money on it, we're not going to make it fashionable, quote unquote fashionable.

JONATHAN EIG: Well the part of the problem here is that the pill has made a lot of money over the years and the drug companies don't have as much incentive to develop something new when they're still taking in money, taking in such great sums of money on female contraceptives.

PC: Lisa Campo-Elgenstein, we heard from Dr. Stephanie Paige that we're talking about the research here in North America, but we talked about it also taking place in countries like India and China. Culturally where do you see that conversation happening over male birth control?

LISA CAMPO-ENGLESTEIN: Well one of the reasons some of the early research in female contraceptives took place in China because they have these booming populations. Their thought was that we need to do whatever we can to reduce the population. So we're going to look beyond just contraceptives into male contraceptives. I think there is a stereotype that men don't want contraception, especially men are certain cultural backgrounds, but we've seen that that's not the case that many men from all different countries are interested in this. Stephanie mentioned multi national surveys have shown interest from both men and women. However I will say that some studies have shown that certain types of men are more likely to be interesting. These are usually young men, educated, affluent and partner men, but overall there is a growing interest.

PC: Jonathan Eig what do you think needs to happen to convince drug companies that there really is a demand for male contraceptive? What do we need to see?

JONATHAN EIG: Well I think we need to see men stepping up and taking responsibility. And just as women- women demanded the pill. Even before it was approved by the FDA, women will go to the doctors and saying I heard about this thing. I read about it in the papers that it's being researched. I want it. I need it now. And the drug companies finally began to get behind it as a result of it. So I think the men need to drive this right now. You know women are twice as likely as men to undergo sterilization procedures. The vasectomy is much less invasive and has far fewer complications than female sterilization. So men need to start taking some responsibility accepting it, taking an interest in letting it be known that they are ready for this. And then maybe the drug companies will listen.

PC: And to what extent do you think women have a role in as much as saying, 'Look here it is. You do you do it. I'm not going to do it', like what role do women have to play in bringing the male birth control pill that it's out one or a gel if it's available to market?

JONATHAN EIG: It's got to be the conversation. I think you know any good relationship is based on mutual trust and that's assuming that your partner is going to take responsibility for everything.

PC: We asked three pharmaceutical companies who manufacture female birth control why they are not researching and developing male birth control. This time I want to read you part of the response I got from Pfizer, who manufactures the female birth control pill Alesse. Here's our quote: "Our priority is researching and developing products and treatments in areas of unmet medical need. We are dedicated to developing therapies to treat slow or prevent disease progression and improve the quality of life for patients".

PC: Lisa what do you make of that?

LISA CAMPO-ENGLESTEIN: I think birth control improve quality of life for so many people. And as Jonathan mentioned this risk benefit analysis people say well women suffer the consequences of unintended pregnancy. And then tends to assume that women are going to be the primary caregivers. Yes women experience pregnancy but women are usually the ones who are also do most of the child rearing. But that's changing. And so if we recognise that that's changing, then men have serious consequences unintended pregnancy. Also we tend to hold men socially and financially responsible for any children they father regardless of the circumstances. And a lot of younger men are saying I want some tools here to equip me to prevent pregnancy because it's unfair and hell socially and financially accountable for this by having your way safely and successfully preventing this.

PC: Lisa you can weigh in on this. I mean where do you think we're going in terms of the shift in attitudes and culturally? We heard our previous guest Dr. Stephanie Paige say these kinds of things these could be online as early as a decade from now.

LISA CAMPO-ENGLESTEIN: I would love to believe they would be on that soon or sooner. However we've seen it said numerous times ,it's going to be ready in 5-10 years for the last few decades. So it just unfortunately has not come to fruition yet. But do you think the changing cultural ideologies are paving the way for the technology to emerge. As Jonathan pointed out, we have options for sterilization both women and men. Yet in most countries there certainly is much more common than tubal ligation, and that's because contraceptive responsibility is in line with femininity, that women are assumed to be the ones responsible for this. But that's changing. And Canada is one of the countries where vasectomy more common than tubal ligation and a few others not many. But I think that showing that men are taking this responsibility. So it makes me hopeful for the future.

PC: Okay we will leave it there. Thank you very much and thank you to Jonathan Eig as well. Lisa Campo-Englestein is an associate professor of bioethics at Albany Medical College. She was in Albany New York. And Jonathan Eig is the author of The Birth of the Pill How Four Crusaders Reinvented Sex and Launched a Revolution. We reached him earlier in Chicago. As I said we did reach out to Pfizer, Merck and Bayer who all manufacture female contraceptives to ask if they are researching and developing male contraceptives. Merck and Pfizer told us that they are not researching male contraceptives at this time and we did not hear back from Bayer. All right. Coming up in our next half hour some say the end of an Alzheimer's trial is also the end of a popular theory about what causes the disease. We'll talk about that. I'm Piya Chattopadhyay. This is the Friday edition of The Current. And we're back in just a bit.

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Are scientists asking the right questions when it comes to testing Alzheimer's drugs?

Guests: Simone Fishburn, Sandra Black, Saskia Sivanathan

PC: Hi again. I'm Piya Chattopadhyay and this is the Friday edition of The Current. It was one of the most promising clinical trials for a potential Alzheimer's drug and it had reached the crucial third phase after which it could get FDA approval. But all the sudden last week two pharmaceutical companies Biogen and Eisai pulled the plug on the trial. An international effort that included participants in Canada the cancellation was devastating for a 54 year old patient Jeff Borghoff and his wife Kimberly. Jeb has early onset Alzheimer's and had been enrolled in the trial for three years. Here's what Kimberly and Jeff said about the news in an interview with the site Being patient.

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KIMBERLY: I literally was heartbroken. I was holding on to him being on this trial and it was slowing it down and that was my hope, that was what I was holding onto. So it is. It's very emotional.

JEFF: I think what's important though I need to continue to remind myself this is that this is research. This is why it's called a trial. I sincerely believe that the last three years as succeeding in this clinical trial, even as exhausting as it has been and more sure as it has been and that it was just abruptly canceled like that, I don't feel that it's in vain. My hope is that information has been gleaned from this clinical trial will ultimately serve the larger scientific community for research for a cure for this disease.

PC: That's Jeff Borghoff and his wife Kimberly. The compound they were testing on Jeff was to attack amyloid. That is a protein that accumulates in the brain. And for years most researchers have believed that this protein, amyloid, is the culprit in Alzheimer's and that getting rid of it or slowing it down would be the key to treating the disease. The theory is known as the "amyloid hypothesis" but this failure of the clinical trials is yet another blow to that theory. In fact none of the clinical trials done on amyloid related drugs has ever been successful. Simone Fishburn is the vice president and executive editor of Byle century which does research and analysis about the biopharmaceutical industry. She's also got a PDA and molecular pharmacology. And she took to Twitter earlier this week saying this latest news should serve as the death knell for the amyloid hypothesis. Simone Fishburn joins us from Redwood City, California. Hello.

SIMONE FISHBURN: Hello.

PC: How big a blow was this latest news about the end of these clinical trials?

SIMONE FISHBURN: I think it's a huge blow. Some people think it's another blow. I think what separates this may be is that people held on to this because it was the first drug that really connected where people had previously shown their the drug actually reduces the amount of amyloid in the brain. So the idea is if you reduce the amount of amyloid would you actually improve cognition. And so people held on to this one. But actually as you pointed out there's really just been a series of failures and it leaves you asking how many more times can you try to tap data.

PC: And so in simple terms what were these clinical trials testing exactly?

SIMONE FISHBURN: Well as you pointed out the amyloid hypothesis holds that these gunky protein deposits called amyloid plaque somehow causative of Alzheimer's disease. The idea is that the clumps of the protein trigger the degeneration that causes all of the cognitive changes. And there's actually a lot of good reasons for that hypothesis. Deposits are seen in a large proportion of patients but then on the other hand the patient but no deposit and there are people with lots of amyloid who don’t have disease. So the clinical trials are really trying to get at this idea of can we remove amyloid. Can we somehow block this process of neuro-degeneration and see improvements in patients. The truth is there have been about 22 phase three trials and another two phase two or three trials in the last I think since 2007. They've been six drugs there have been more than 23,000 patients involved and millions and millions of dollars have gone into this and it really has yet to bear fruit.

PC: How widely accepted has the amyloid theory been within the scientific and research communities?

SIMONE FISHBURN: It's hard to say widely accepted it's a very big community and I would actually say that there are two very big camps. So it's very widely accepted within part of the scientific community and another part of the scientific community says it's enough, it's time to move on.

PC: And for the believers you have described them that it was almost like a religion. What makes you say that?

SIMONE FISHBURN: I have seen both in personal conversations with people, in public forums and even on Twitter. The amount of passion that goes in to people arguing this is really almost beyond like a religion in that it's really talking about whether people believe the hypothesis, not whether people are looking at the data. You can always in science say that we didn't test the hypothesis properly and that's true. You can always say maybe we weren't attacking amyloid with the right tools. Maybe we didn't have the right antibodies. Maybe they didn't get in the brain. Maybe we're looking at people at the wrong stage. You have to catch them earlier in the disease not once they've already got it. There are many ways that you can knock something down and people have clung on to those, in scenarios where I think with most other hypotheses they would have said by now we have enough information to say either we're throwing good money after bad or we need to explore other ways of doing this. And to be fair some people have taken that second approach.

PC: As you know not everyone agrees with your views on this. I want to play some tape. Dr. Donald Weaver is a scientist here in Toronto whose work focuses on amyloids. He's the director of Crimble Research Institute at the University Health Network. Take a listen.

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There is a wealth of information which supports that amyloid probably does play a role somehow in the cause or worsening of Alzheimer's disease. So it certainly was the best target that was available and it continues to be a very good target. Good but I don't think it should in any way negate our desires to look after and look for other possible targets and to pursue them as well. I don't think that these trials necessarily spell the end of the amyloid hypothesis. What they do clearly indicates is what particular approaches we shouldn't be pursuing in going after the amyloid hypothesis. The amyloid hypothesis is very complex, very complicated and it really hasn't been fully explored and fully tested even to this point in time.

PC: Someone Fishburn what's your reaction to what he has to say there.

SIMONE FISHBURN: Well I agree with a lot of that amyloid probably does play a role somewhere. It was the best target available. Part of the reason it was the best target available for so long is that people put so little money into looking at other targets. And I think the way to look at this really is that everything, every clinical trial we do uses this patient and not to mention the large amount of money and with doing something at the expense of doing something else. So in in drug development to some degree it's a zero sum game. Companies can't afford to do millions and millions of Phase three trials. So while they're doing Phase three trials on this it means they're not going after something else. And I think that's really the problem. I do have to say though especially in the last couple of years and you know we at I and she has been covering this. There are a lot of new areas emerging. People are thinking about neuro inflammation and ways of attacking neuro-inflammation to stop this disease. There are new series coming through. There are new funds coming through like the demented discovery fund in the U.K. which is specifically targeted or aimed at bringing in new funding for new hypotheses.

PC: You're a scientist. What are the lessons here for the broader scientific and research community?

SIMONE FISHBURN: I think the question for the scientific community: have we gone too far? Too often people do experiments to prove that they're right. You know there is a part of science philosophy says that you should do experiments to prove that you're wrong to disprove a hypothesis. And so people keep going after; is there another way to show that I'm actually right? And I think the amyloid hypothesis is an extreme example of this. I actually think it goes on all the time when people won't let go of theories but science advances by failures, and maybe one lesson is it should be more acceptable to fail. Maybe researchers need to think about what actually constitutes an advance in research and not just actually having your theory proved right be the way that you get ahead. And I think scientists, inside industry and in academia need to look at how they're asking questions and are they really doing it to get at the answer or are they really doing it just to double down on something that they've invested so much time and effort in.

PC: Simone Fishburn, we'll leave it there. Thank you very much for your time.

SIMONE FISHBURN: Thank you.

PC: Simone Fishburn is vice president and executive editor of Biocentury it is a publication aimed at the biopharma industry. And we reached her in Redwood City California. For more on what this means for the future of Canadian Alzheimer's research I'm joined now by two guests. Dr. Sandra Black is a cognitive and stroke neurologist. Whose research includes work on amyloids. She directs the Toronto dementia research alliance and Hurvitz brain sciences research program at Sunnybrook Health Sciences Centre. And Saskia Sivanathen is a neuroscientist and chief of Research at the Alzheimer Society of Canada and they're both with me in Toronto. Hi.

SANDRA BLACK: Hi.

SASKIA SIVANATHAN: Hi.

PC: Dr. Sandra Black let me begin with you. What did you think of what we just heard from Simone Fishburn particularly at this point which I'm kind of paraphrasing, but she says scientists have been too stubborn about pursuing this line of research or trial after trial just aren't working?

SANDRA BLACK: So I agree with part of what she says and in fact back in the early 90s when amyloid and tau had finally been identified as proteins that you could actually see and begin to consider as targets. Amyloid is in the plaques and all of these and the plaques and tau is in the tangles of Alzheimer's disease. There was a joke about how they were the 'bauest' and the 'tauists' because tower was also very very important. And you can ignore it. The truth is that Alzheimer's disease syndrome is a very complex disorder both in how it presents. It's very heterogeneous. It's very complex. We heard comments from Jeff, a young onset individual who had a fairly sensible calm approach. I was extremely impressed by his comments, because well he was saying we have to learn from these mistakes. Now the question is how many mistakes do you keep learning from? I because of my interest in stroke in dementia I've been aware of the importance of the vasculature and vascular risk factors for Alzheimer's disease. And how there is an intertwining of vascular disease in Alzheimer's pathology in a way that means of the amyloid hypothesis by itself is not sufficient. But the truth is if you're younger and you have amyloid present in your brain, which we can now see, because it only used to be at autopsy. In autopsy you'd see there's Plaque, Tangle there is a bit of protein that's a Parkinson's, there's a hardening of the arteries hardening is a very complex thing. The problem is that it's not only amyloid that's involved, but early on it is a driver of the pathology. And amyloid and tau interact and they actually drive each other. And what are they doing in the brain to start with. Well they're part of the development of the brain system where they prune, they help to prune connections that are good connections that are not good are cut off. They're also they're part of the way we react to injury to the brain in a stroke or head injury or infections. Amyloid is actually your brain's anti-bacterial agent. So when whenever we mess around with it we go to be careful.

PC: So fair to say that amyloid is important but here's that here's the question do you think it is fair to say that there has been almost a religious fervor or religious attachment to this theory beyond what is reasonable?

SANDRA BLACK: Well yes people have fashions and fashions rule. Scientists are supposed to be objective but they get very attached to their own hypotheses. So there could be more balance and I think it's probably where the where the devotion has gone has been maybe easier to have anti-amyloid therapies than anti-tau therapies, but anti-tau therapies are now struggling to develop. And I think you need a more balanced approach and eventually we're going to need a cocktail for these diseases. But really the key thing may be what stage of the disease do you attack. We're hitting the terminal stage when people are symptomatic. And part of the problem may be it's too little too late. Also maybe with a large Markels like the antibodies they can get into the brain very well, so 0.1 Percent of the anybody actually gets into the brain. So may we have to think of new ways of delivering these drugs.

PC: Let me bring Saskia Sivanathan into this conversation. Should the end of these clinical trials prompt some soul searching in the Alzheimer's research community?

SASKIA SIVANATHAN: Well I think as Simone mentioned, the Alzheimer's dementia research community is vast. It's big. And I don’t think we can say amyloid does not have a role. It's clearer does but absolutely we do need to start exploring other hypotheses and investing research in those other areas.

PC: And have some of those other areas been sacrificed because too much energy and time has been going into one hypothesis?

SASKIA SIVANATHAN: Well it's hard to say. It depends on where your funding is coming from and it depends on what's driving the clinical trials. If you think about the trials themselves they are driven by the basic biomedical research. You've got to have the funding that goes into that area that then finds those therapeutics molecules that can be used for testing and go into those trials. So we need to actually start investing more within basic research as a whole and I'd like to point out that we also don’t really consider very often the quality of life research. And so when you talk to people living with dementia who are reacting to these clinical trials, the response has actually been quite a spectrum. You have people who have said just say, like Jeff I believe, you know if it's heart wrenching. It's a blow. Because theres so much hope attached to finding a cure. But on the other hand you've also had people who say, well why are we not investing in research and interventions that can support me now. I'm living with dementia now. What about my quality of life? What about helping me figure out how to live well now? There is there is an imbalance in that.

PC: How significant was it, given that this was a phase three trial. Just remind people this is like the last phase before you get approval from the FDA in the states, Health Canada. I mean before it’s readily available on work its of to. How significant was it in this particular trial that it was a phase three one?

SASKIA SIVANATHAN: It's significant. It's huge it's difficult as it is to get to Phase three exactly as Sandra mentioned. You've got to go through Phase one and two. You're testing the dosage. You're testing the efficacy. And when you get to Phase three, these are large trials, they're more expensive. You're recruiting patients from all over the world including Canada. So it is significant when you hear the sort of failure. But again to bring it back we're learning there is a lot of data that gets collected and that was part of the decision that went into pulling out from this trial. They analyzed that preliminary data at the midpoint and were able to make the decision about whether the trial should continue or not. So all of that is very important for helping us move forward.

PC: Dr. Sandra Black you have also been involved with work related to something called focused ultrasound, we all know what ultrasound is. How would that work?

SANDRA BLACK: So it's called Lowfield Focused Ultrasound and the technical innovation is to be able to get ultrasound waves through the skull which required some ingenuity. Dr. [unintelligible] is the inventor of this concept, but it's been under investigation Alzheimer's disease to open up the blood brain barrier in a special way you inject micro-bubbles into the veins, and you have a device fitting on the head that can precisely open up areas of the brain that you choose to stimulate without ultrasound, allowing whatever is in the blood to get in. So the idea is that you may be able to deliver higher doses simultaneously to especially effective parts of the brain, over time in a way that might make the use of large molecules more feasible.

PC: And how promising is it at this point?

SANDRA BLACK: Well it still is going into a Phase two trial to see if it's safe. Six people in Phase one appeared to tolerate your case. Now 30 people are being investigated. We'll see how it goes from there.

PC: Saskia Sivanathan what other research ideas? Because as everyone has said look there's a lot out there that we could pursue, that don't relate to amyloids that would you like to see explored?

SASKIA SIVANATHAN: Oh yes absolutely. I mean and part of what the Alzheimer society does is we fund Research in Dementia across the spectrum. And we've really try to invest in all of these other hypotheses as well. I'll give you some examples. We have some really good hypotheses that have been developed here in Canada. We've got Apple-e which is a molecule that was identified that really relates to how your body breaks down fat, but it's also been shown that there are veriants of that Gene and depending on the type of gene you have you may be at higher risk of dementia. There is another hypothesis around inflammation, neuro inflammation. Again it links to tau and amyloid but there are upstream molecules that we can explore and examine. Another third one is around caspase. These are molecules that are involved with cell death. Again exploring them early on looking at how they are involved in those pathways. Those are some very pioneering pieces of work. There are hypotheses that are already available.

PC: So one other thing that you know has been in the news and we've read about is the link the connection between sleep and Alzheimer's. Tell me more about that.

SANDRA BLACK: I just want to make a point that anything we do has to be also link to lifestyle choices. Good treatment of all the vascular risk factors like high blood pressure high cholesterol diabetes and also sleep apnea, so disrupted sleep is important because part of what happens in all their onset Alzheimer's disease is not so much that you overproduce amyloid. In older age it's you're not clearing employed you're not clearing it along blood vessels or the microglia are no longer up to the up to the task. So vascular disease in aging starts to make it harder for the brain to get rid of the daily production of amyloid and tau and other toxins from the rain. So they tend to accumulate. And so having a deep sleep, where you get slow wave sleep is very important for your brain to clear itself of the toxins of the previous day.

PC: As we [unintelligible] earlier. I mean at the center of all this are people who have Alzheimer's and their loved ones who are - some are participating in the study some people are just like- everyone wants cure, help, hope. They are wondering many of them like where are the researchers heading? How much will help them? I want to play more tape from Dr. Donald Weaver.

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I is a cure or disease modifying drug imminent? Are we gonna have one you know within the next 12 months? No. Are we vastly ahead of where we were 10 20 years ago? Most definitely. And all these failed trials, you know we have to use the word so your carefully. Even from a failure, you get a lot of information you get a lot of valuable data. So I know it's tough to tell people to keep up the optimism but I think they should keep up the optimism. There is light at the end of this tunnel and the tunnel is getting shorter.

PC: That is Dr. Donald Weaver who is the director of the Crimble Research Institute here in Toronto. Do you, each of you, both of you share his optimism?

SANDRA BLACK: Yes can I speak to that because I think it's going to be one cure. I think is going to be a cocktail just like in cancer. We're going to have targets biomarkers that help us to identify this person actually has the pathology, and then we're going to target them. We have to target them simultaneously or some kind of sequence. There are still pills that will do the production of amyloid. Secondly there's repurposing of drugs. So for example there's an [unintelligible] convulsant that may well micro seizures in the memory circuits in the early stages of Alzheimer's disease. Also different [unintelligible] hypertensives may have beneficial effects against Alzheimer's disease. And so we could repurpose their use.

PC: And so given all these together I mean are you optimistic?

SANDRA BLACK: As well as anti-tau and anti-amyloid antibodies may play a role. So I am optimistic I think we just have to learn from our mistakes and and find out where things went wrong. The design of the studies or sometimes also not ideal. But I think the real future is going to be prevention through starting these drugs way earlier. But we have to have drugs that are safe enough to use in people who are otherwise normal.

PC: Okay. Saskia Sivanathan we always want optimism when we are treating difficult diseases. We want the cure. Rewind the hole. Where do you sit on this? Should we be optimistic?

SASKIA SIVANATHAN: I'd say yes absolutely we do need to be optimistic because as I said there are so many other hypotheses that can be tested and should be brought forward. So really the call to action here is that we need to invest more in dementia research and invest it broadly. And I'll give you a statistic. Looking at the year 2000 forward there were over 6500 phase three trials. In cancer in Alzheimer's disease there are 234. That's also a five time fold difference between those. And part of the driver for that as well is the basic research that needs to be invested in those hypotheses to bring those molecules in therapeutics through the phase one and phase two through the phase three. And this is despite knowing that the cost of dementia to our health and social care system is more than cancer and heart disease combined.

PC: Okay. We'll leave it there. Thank you both.

SANDRA BLACK: Thank you.

SASKIA SIVANATHAN: Thanks for having us.

PC: Saskia Sivanathan is an earth scientist and chief of Research at the Alzheimer Society of Canada. AndDr. Sandra Black directs the treatment or dementia research Alliance and the Hurvitz brain sciences research program at Sunnybrook Health Sciences Centre and they both joined me here in Toronto. And now a word from the team that made The Current this week.

JULIE CRYSLER: Hi I'm Julie Crysler, one of the producers here at The Current. This week the show was produced by: Idella Sturino, Howard Goldenthal, John Chipman, Karin Marley, Imogen Birchard, Samira Moyyehdin, Ines Colabrese, Alison Masemann, Danielle Carr, Jessica Linzey, Allie Jaynes and Julianne Hazlewood. Special thanks to the CBC's Mary-Catherine McIntosh in Halifax.The Current's writer this week is Vanessa Greco. Our web producers are Padraig Moran, Kirsten Fenn and Mac Cameron.Transcriptions are provided by Rasha Shehata and Shamhan Bhuiyan. Our technical producer is Gary Francis. Our documentary editor is Joan Webber, and our presentation producer is Liz Hoath. Our director this week is Karin Marley. Our senior producers are Pacinthe Mattar in Toronto, Kristin Nelson in Ottawa, and Cathy Simon in Vancouver. The executive producer of The Current is Willow Smith. And of course, the host of the Current - Anna Maria Tremonti.

PC: Stay tuned to Radio One for a Q Tanpa is going to be talking to both ZiyaTong and Max Eisen. Ziua successfully defended Max Eisen's Holocaust Memoir by Chance Alone. And she went on to win Canada Reads so stay tuned to that. Reminder on Sunday at noon you can catch me in my regular gig hosting Out in the Open here on CBC Radio One and I'll be speaking with Andy Parker. Andy's daughter Alison was shot and killed while reporting on live TV. Soon after that conspiracy theories began to spread stories in videos online saying that the killing was staged. We'll be talking about when a falsehood catches fire, how do you get ahead of it? That is Sunday at noon on out in the open. Just a reminder also that today could have been very different across the pond. Today is the day when theU.K. was supposed to leave the EU, the European Union. Instead Brexit has been delayed for at least a few weeks and the British parliament is voting again today on a withdrawal agreement. Meanwhile a lot of Britts say they feel stuck in a movie that never ends. If you search online for Brexit playlists you'll find songs like Stuck in the Middle with you. Should I Stay or Should I Go by The Clash is also a popular choice. And so this song we're going to leave you with today. It's called Road to Nowhere by talking heads. I'm Piyaa Chattopadhyay. Thank you for letting us your you're here on the Friday edition of The Current.

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[Song]

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CBC would like to acknowledge the support of the Broadcasting Accessibility Fund.

Friday 29 March, 2019 Full Transcript

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