Imagine a future in which you rarely visit a doctor, in which your joy of life and bank account are not drained as you age, in which you live well past a hundred in good health, vibrant in mind and body. Imagine that the words you are reading are not click bait or science fiction.
The exponential technology of the information and communications revolution took us from typewriters, physical newspapers, and a few broadcast TV channels to the then-unimagined, now-reality of PCs, smartphones, the internet, millions of websites, streaming services, Google, Facebook, Zoom, and VR. The coming medicine and life extension revolution can transform our biology and, with it, our economy, society, and culture in ways wonderful but beyond the imagination of most people today.
If we want to unleash that future, we must understand it, and retain the liberty that will allow us to create it.
Masters of our Biology
Current medical progress is built on the information and communications revolution, along with computational power that, since the 1960s, has doubled every two years in accordance with “Moore’s Law.” Consider:
- Robots and robotic systems assist with hospital services, from delivering meals to administering medical tests. Such tech even allows surgeons to perform operations remotely, using special goggles, 3-D imaging, and gloves that can manipulate medical instruments.
- Smartphones and watches already offer us wearable diagnostics that track exercise, heart rates, hydration levels, calories burned. Many include ECGs to monitor the heart. Lab-on-a-chip devices can analyze a tiny amount of a patient’s fluid for various medical conditions. We’ll soon see widespread use of wearable diagnostics. Imagine a shirt embedded with sensors that can perform full checkups. The Oura ring currently helps track bio-rhythms in persons with sleep disorders. Imagine a future ring or wrist device that detects when we might be in imminent danger of a heart attack, and alerts medical personnel to speed to our doors before the emergency occurs.
- Artificial Intelligence and machine learning will play a central role in future healthcare. Already, the IBM Watson supercomputer has reviewed thousands of MRIs, making medical diagnoses as good as teams of physicians, and even making new medical discoveries.
- The mapping of the human genome, the underlying code in DNA that generates we human beings, was completed in 2001. The actual cost of sequencing a human-sized genome at that time was estimated at around $100 million. (The projects that led to this mapping cost much more.) By 2007 the cost was around $10 million. Today, it costs only about $1,000. Companies now can determine exactly the medical problems to which we as individuals are prone so we can take preventive measures. Big data, with AI systems, will certainly lead to even more breakthroughs that will allow medical treatments tailored to each of us as individuals.
- Gene editing tools like CRISPR-Cas9 now make it possible to modify genetic material that dispose us toward particular diseases. Imagine a world in which such tools can head off Alzheimer’s or Parkinson’s!
Science Conquering Senescence
These emerging, life-enhancing technologies are just the start.
In April 2018, the enzyme telemerase was sequenced. This is important because each chromosome has little lengths of materials called “telomeres” on its end. As chromosomes reproduce over time, the telomeres shorten and when they are no more, reproduction stops. This is called “senescence.” That is, we age and die.
Researchers now can work with telemerase to keep telomeres intact, that is, help keep us as individuals intact, — that is, keep us alive!
Aubrey de Grey has worked for several decades to isolate seven factors that contribute to cell damage and aging. His SENS Research Foundation is developing “Strategies for Engineered Negligible Senescence,” explained well in his book Ending Aging, to repair cell damage or render these factors harmless. That is why he understands aging not as the inevitable path to death but, rather, as a treatable medical condition.
David Sinclair is another anti-aging pioneer. His research is explained well in Lifespan: Why We Age—and Why We Don’t Have To. If we think of the genes that determine our individual biology as keys on a piano, we can see that epigenetic factors, which involve everything from our diets, lifestyles, and physical environmental, determine how the keys are played and how the music is expressed. Sinclair’s work in understanding epigenetic factors has allowed him to devise ways we can control our own aging.
The Liberty to Live
Through such work, we are approaching the most profound revolution in human history. And just as it took entrepreneurs such as Steve Jobs and Bill Gates working in a free market to make the innovations of the information and communications revolution accessible to all, so liberty will be necessary so entrepreneurs can innovate and commercialize medical and anti-aging breakthroughs.
But the government is in the way. The U.S. Food and Drug Administration (FDA) in its current iteration was created in 1962 to certify the safety and efficacy of proposed new treatments and medical devices. A 2014 Tufts study found it takes 10-12 years at a cost of almost $3 billion to bring a new product from research lab to patient, with the certification process accounting for much of that time and costs. Thousands of people suffer and die in the interim, and many researchers in small labs simply can’t afford those costs, so innovations are stillborn. Some innovators simply go elsewhere. Bioviva CEO Liz Parrish, who has made herself “patient zero” to test the gene therapies she’s developed to target aging factors, had to go to South America to administer the treatment to herself because of government regulatory barriers in the US.
FDA’s testing requirements are often not applicable to exponential medical technologies. Indeed, in April 2019, the FDA sought input on how to regulate AI and machine learning software as medical devices. AI software is not a medical device, but FDA must fit this square AI peg into its regulatory round hole.
The COVID pandemic highlighted FDA’s inadequacies. With over a thousand Americans dying each day, FDA stuck to its practice of limiting the number of patients given promising vaccines in efficacy tests. If access to experimental vaccines had been made available to anyone seeking them, with informed consent, the suffering and death would have been far less, and FDA could have more quickly identified the most promising vaccines.
An important and obvious FDA reform would be the Free To Choose Medicine (FTCM), pioneered by entrepreneur Bartley Madden. Once a promising new drug passes FDA Phase I safety trials and at least one Phase II efficacy trial, a manufacturer could offer the product on a parallel FTCM track. Patients, in consultation with their physicians, could either access these promising FTCM medications or continue to wait for drugs still languishing for years in the current FDA process.
A predecessor parallel track to the FTCM system was created in in 1992 that allowed some 12,000 AIDS suffers to access a life-saving medication still in FDA trials. The Japanese government has created a similar track for regenerative medicine products. A patient-choice empowering FTCM track would require data about patient experiences with a treatment to be logged in a tradeoff evaluation drug database. Such a flow of real-world data would more quickly reveal which treatments work best, speeding up certification.
This would likely be just the start, because innovative exponential technology in medicine and life extension certainly will require innovative ways to determine more quickly and accurately which treatments and cures are best, cutting costs and much faster alleviating suffering and death.
From Sickcare to Healthcare
Today we have a sickcare rather than a healthcare system. When you get sick, you go to the over-worked doctor, hoping to get treatment, possibly being shuffled from one specialist to another. Because of the incomprehensible spaghetti-tangle of government regulations, you fight with your insurance company, Medicare or Medicaid about who pays how much of the bills. Even if you’re healthy most of your life, you know as you age that doctor visits likely will be more frequent, ailments more serious, bills higher, and the end of your life closer.
It need not be this way. Exponential technology can give us healthy lives of well past 100 years. But this will necessitate allowing innovators in a free market to create the institutions and incentives for a real healthcare system, a system that will encourage us, educate us, and empower us to preserve and protect our most valuable possession, our own lives.
Edward Hudgins, PhD, ([email protected]) is founder of the Human Achievement Alliance. He has a decades-long career in free-market public policy, with a specialty in science and technology, and promoting the values of reason and individualism. He will be speaking live and in person at FreedomFest July 21-24 at the Rushmore Plaza Civic Center in Rapid City, South Dakota.