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One of the great stories of the 20th Century was the dramatic extension of the human lifespan.
Advances in medical technology, disease eradication, and improved living conditions made it far more common and normal for people to live into old age. In 1900, global life expectancy was 31. In 1950 it was 48. In 2010 it was 70.
So the question is: What’s next?
Some people claim that the trend will continue apace, and that people will soon live to be 150, 200, even 1,000. More sober analysis suggests there’s an upper limit to the human lifespan, and we’re getting close.
The challenge, then, is to help more people reach the full extent of their lives, and do so more healthily and more comfortable in their own bodies and minds than medical science currently allows. Already, there are projects on the table that show tremendous promise — and others that are unlikely but fascinating to think about.
Welcome to the next 10 years of human longevity.
First of all, what’s the difference between research into longevity versus other kinds of medicine?
The hardest patient to treat is the patient who’s already sick.
Longevity research happens almost entirely in the domain of public health — figuring out how to prevent people from getting sick, and connecting people who do get sick with the best possible treatments as quickly as possible.
Most doctors and policy experts agree that this is the sector of medicine with the most potential to save and extend lives. But it can be hard to get funding; a terminal patient in need of a new drug is a much more tangible motivator than five hundred everyday people who don’t get sick in the first place and have no idea they were ever in danger.
Efforts to extend a few people’s lives to 200 or 1,000 years may get lots of media attention, but the most exciting research seeks to help 50-year-olds live into their 70s.
This kind of research can save millions of lives. Just look at lung cancer.
When some people think about longevity research, their thoughts might turn toward science fiction: rewritten genes, bubbling tubes of anti-aging juice, full-body transplants, the singularity.
But one of the single-most successful longevity efforts in living memory was much more straightforward, and it began in 1964.
US Surgeon General Luther Terry published a report finding that cigarettes — the 20th Century’s blockbuster luxury good — cause cancer. The following five decades saw an unprecedented public policy and awareness effort to curb smoking.
The result? Eight million lives saved from premature death over 50 years, while 20 million people still died early as a result of tobacco. The average person reached by tobacco control efforts gained 20 years of life.
There’s a long road still left to travel on the way to a tobacco-free society, but that’s what a massively successful longevity effort looks like.
So the question is: What will the big advances in longevity look like in the next ten years? Let’s look at the options.
If you want to extend lives, think about changing the way people live.
If turning around people’s smoking habits saved millions of lives in the 20th Century, it seems likely that a similar lifestyle-changing effort might pay dividends in the 21st.
One big target for such an effort is sugar.
Lots of research has shown that the sweet crystal is by far the most dangerous elements of the average American diet, ravaging bodies, inducing diabetes and shortening lifespans. And there’s evidence the American sugar industry deliberately misled the public about these dangers, gaslighting us all with lies about oils and weight gain — a close parallel to how the tobacco industry lied about cigarettes.
People who cut sugar out of their lives tend to dramatically outlive those who consume it regularly.
Major efforts to control sugar consumption are already underway. Taxes on sugary drinks have arrived in places like Philadelphia and Mexico — where there’s some early evidence they’ll be successful in saving lives. San Francisco and three other cities voted for similar measures on Election Day.
A radical reduction in sugar consumption will likely take more than a hike on the cost of Coca Cola. But political momentum for such an effort seems to be building. Sugar control even has its own billionaire backer, former New York City mayor Mike Bloomberg.
Of all the longevity efforts we’ve described, the war on sugar likely holds the most promise for extending lives in the United States, where obesity and diabetes are major challenges.
In the next ten years, results will come in on those efforts already underway to fight sugar consumption. And more experiments in sugar control will likely launch.
Down the road, expect the battle against sugar consumption to transform and extend people’s lives in the next five decades as significantly as the fight with the tobacco industry did in the last five.
On a population level, disease eradication can make the difference between life and death for millions.
Many of the most significant developments in longevity in the last century have come from concerted efforts to take on and reduce — or even wipe out — diseases that kill millions every year.
Smallpox and polio are probably the most famous examples of killers beaten back through massive public health and vaccination efforts. (Polio still infects people in some parts of the world, but its impact is much more limited than 100 years ago.)
More recently, the non-fatal but horrible-to-live with Guinea Worm has neared extinction — largely through the efforts of the Carter Foundation.
One big target for disease eradication in the 21st Century? Malaria.
The human war on malaria has gone on for centuries, all over the world. And it’s amazing how many places where mosquito’s once carried the disease are now malaria-free, and treatment efforts continue to improve. Deaths from the parasite have declined 60% since 2000 as a result.
Major donors like Bill Gates are funding projects to beat the disease back even further and fight drug-resistant strains. There are also projects to release genetically-modified infertile or malaria-resistant mosquitos into the wild, and disrupt malaria’s global vector.
If good malaria infection trend lines continue for the next ten years, that will be very good news for the world.
Mark Zuckerberg and Priscilla Chan want to ‘cure all disease.’
Silicon Valley is actively involved in efforts to extend the human lifespan, both by funding research and by pursuing technological and engineering solutions. (Billionaire Peter Thiel, for example has expressed interest in companies working on human parabiosis — that is, injecting old people with the blood of young people.)
It’s not surprising that some of those projects make more sense than others.
Back in September — and more within the realm of normalcy — Mark Zuckerberg and Priscilla Chan pledged $3 billion to a plan to cure all disease by the end of the century.
It’s both a staggering sum of money and a pile of cash so tiny compared to annual research funding in the US that you’d be forgiven for finding the goal a bit lofty. After all, the National Institutes of Health spends ten times that amount in a single year.
But here’s the case for the project:
Zuckerberg and Chan, through their foundation, aren’t just dumping money into the existing medical research pipeline. Instead, they’re setting up a system of investment and reward for projects that break the mold. They’re funding longer-term, higher-risk projects, basic science, and collaborations between doctors and engineers. The goal isn’t to just improve on existing methods and medicines. Rather, they want to come up with whole new approaches to fighting disease.
If the project sees successes, they will be the product of a rethinking about the direction of medical science. And it will be part of a wider story. There’s a fast-developing body of research into not just addressing illness once it develops, but fighting it at the cause. The goal is to help people live longer, healthier, safer lives.
The potential promise of active bloodstream monitoring
Zuckerberg and Chan, in their announcement, highlighted their interest in active bloodstream monitoring. That is, technology that would allow for high-reliability, general-purpose blood tests conducted automatically and regularly — perhaps by a patch or an implant — over the course of a person’s life.
The idea: to detect diseases from infections to cancers the moment they arise, hopefully when they’re easiest to treat.
There are challenges to this kind of technology.
First of all, a spate of false positives could impose massive costs on the healthcare system, so it would have to be very accurate before rolling out in a big way.
Second, we’ve seen that cheap, painless blood tests are not at all easy to do well.
But as far as transformative longevity technologies go, this is one of the more plausible ideas we could see the beginnings of in the near future.
Another technology that’s in the middle of a boom? Gene editing.
Many of the factors that cut short people’s lives have their roots in genetics — including evidence that changes in genetic structure over the course of a lifetime are a key driver of aging.
CRISPR, a cheap and effective tool to line-editing genomes, is revolutionizing biology. Research into genetic therapy protocols is already well underway — and the first human CRISPR trial began in China this year.
It’s likely that in the next ten years we’ll begin to see the first glimmers of results from efforts to extend people’s lives with altered genes, though we’re still probably a long way from widely-available treatments.
Unity Biotechnology wants to clear your body of aging cells — and just got a $116 million investment.
Unity Biotechnology is a startup with a plan to help human beings age more healthily.
Here’s how it works: The cells in your body have a system — my colleague Lydia Ramsey compares it to emergency brakes — for stopping themselves in their tracks if they get too stressed out.
Your body doesn’t want genetic mutations or other damage to spread, so the stressed-out cell stops dividing. Cells like this are called “senescent,” and you build up more of them as you age. This protects you against cancer, but also may contribute to the various diseases of aging.
In mice Unity has found that treatments to clear out senescent cells can extend “healthy lifespans” — that is, the period of the creature’s life when it is able to move through the world like it did in its youth.
Unity has been, unlike some other longevity startups, rigorous and specific. They make it clear that they’re not trying to abnormally extend lives, just to make old age healthier. Their published research has been promising.
Human trials begin, they say, in the next year and a half.
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