Finding a cure and a preventive treatment for Alzheimer’s disease and other dementias must be the long-term goal of global dementia research policy. This would transform the lives of millions of people by relieving them of the burden of disability and save the billions of dollars every year that dependency costs. But working towards an effective therapy requires that we rethink the systems and incentives that drive biomedical research and health innovation. Under our current model, progress in dementia research and drug development has stalled and investment is just a fraction of what it is for other diseases of similar importance and profile. Areas where progress should be made include: greater patient and public engagement in the innovation process; increased collaboration and stronger public-private partnerships; a more convergent and synchronised regulatory environment; flexible and adaptive clinical trial designs; greater use of open science and data; enhanced public research funding and increased risk sharing as well as respect for access to medicines and payers’ perspectives. While finding a cure is paramount, policy makers should also strengthen the focus on risk reduction and foster the development of better symptomatic treatments. Finally, better data on the public resources devoted to research and health innovation on dementia are required.