The diagram below illustrates the path to a cure.   The column on the left illustrates the primary emphasis on basic science of the NIH along with academic research organizations (Universities, hospitals) and private foundations .  As illustrated, there is a gap between basic medical science and new treatments and between scientific discovery and CURE.  Basic science provides the knowledge base from which medical applications are derived through translational research. The development, testing (with extensive clinical trials) and manufacture of treatments is the emphasis of private industry and regulated by FDA and EMEA .  The rigorous process of demonstrating that treatments are safe and effective can take as long as 15 - 20 years.

symbols: =  pipeline =  outside influences		FDA Pharmaceutical Manufacturers (Industry and Regulators)						Health Care System Epidemiology &  Services Research  Access to Quality  Specialty Services
Medical  Science								New Treatments
Government   Foundations   Academic       Institutions **Scientific		Translational  Research				Clinical  Trials		Provider Education Care Rendered Patient Outcomes
Discovery**

Health Care System

The diagram also illustrates that the products of science and industry are part of system of health-care which modulates the realization of cures by the population. The right hand column  describes elements of the health care system that affect the availability of the cure to the population.  Clinical research on outcomes, services, systems, and epidemiology sets the stage to plan community interventions that will enhance access to specialty care and comprehensive care systems.  Proper use of new treatments by physicians, necessitates education of doctors, other providers, and patients.  Variation in causes, symptoms, and progression of PD from person to person requires planning and management of outcomes as well as costs of patient centered treatments.

Issues of quality and access to care are addressed by the Parkinson's Disease Foundation. The QuADPaC (Quality, Access and Delivery of Parkinson's Care) program addresses the system factors that effect the availability of a cure.  A working group has been formed to plan a “quality initiative” aimed at preventing complications from Parkinson's that result from inadequate diagnosis and treatment.  Included are plans for guidelines and public-professional education on new developments in detection and treatment.