The Microsoft founder is heavily involved with programs to prevent disease across the globe, efforts that will likely ramp up in the coming years after he issued his philanthropic foundation with a task: He would donate the vast majority of his wealth, some $100 billion, to the body as long as the funds are spent within the next 20 years.

The funds, which will total approximately $200 billion between current endowments and projected growth, will focus on curing preventable diseases—one of which Gates hopes will be Alzheimer’s. The tech titan’s father, Bill Gates Sr., died in 2020 at the age of 94, having battled with Alzheimer’s himself.

Gates has unique insight into how an illness like Alzheimer’s—a progressive brain disorder which leads to a decline in memory and skills—can be cured, not only as someone whose family has been impacted by the disease, but also as a public figure with the ear of policy and decision-makers around the world.

From a U.S. perspective, on both an economic and social scale, curing a disease like Alzheimer’s not only alleviates pressure on families, but on the welfare state as well, he said.

“Whenever you have an aging society, you have lots of these chronic diseases that can be a huge drain on resources,” Gates told CBS Sunday morning in a clip aired yesterday. Moving forward, richer, older nations will see a shift from acute medical problems to chronic diseases. “So going after a few diseases, where Alzheimer’s is number one by quite a bit, the imperative is very, very clear,” he added.

As part of his work, Gates is supporting organizations developing blood-based diagnostic tests that identify a specific protein called amyloids, which can be markers for the disease developing.

Ideally, Gates added, patients would be cured of the disease before they ever even started exhibiting symptoms. When asked whether testing for Alzheimer’s should be embedded in wider health checks, Gates responded: “For the broad population, probably once you turn 60 or so, that should be part of the routine blood test. It’s a fairly inexpensive test, and so if these tools prove to work and we get the side-effect level down, then it would become routine that if you test high for the amyloid in your blood then you’d be insured to get those clearing drugs.”

Such medication may be in the form of a self-injection or an infusion, he added, “to prevent you from developing Alzheimer’s.” However, there are “a few steps yet to come together,” he added.

Working into your 90s

With a healthier-for-longer population also comes the benefit of having a larger workforce. At present, policymakers are grappling with the care and cost of an older population, without the same number of workers to replace them due to declining birth rates.

But Gates argues that thanks to prevention, people could work meaningfully longer if they wanted to. This, neatly, would also help rebalance the strain on the workforce needed to power the economy through increased costs of care.

Some people might be skeptical of such ideas, he added: “Many people look at some trends in society and they get a little bit negative. And I say to them: ‘What about a society where we can prevent almost all of Alzheimer’s, and your 70s. 80s, even if you’re luck your 90s, you’re fully capable as grandparent or if you want to continue working.’

“They’re a little skeptical that something like that is happening,” he continued. “They’ve seen progress in heart disease, they’ve seen progress in cancer, but in those, as well as the next 10 years, we are going to get a lot better. And so it’s possible, like wow that is a very positive thing.”