Fight Aging!

You'll find some thoughts on research into aging and longevity at In Search of Enlightenment:

Yesterday I attended this interesting talk on the 5 year priorities and vision of Canada's Institute of Aging. Many interesting issues arose in the talk and the discussion that followed that illustrate the ongoing challenges which the field of biogerontology faces.

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For a population to approach a life expectancy near 100 years we would have to eliminate most cancers, heart disease and stroke. Considering we have not yet eliminated any one of these diseases, the suggestion that we will continue to increase life expectancy at the same rate as we have in the past is simply unfounded. Take mice in the laboratory. On average, they could life about 2 years if they are fed, protected from predators, etc. Can we get them to live significantly longer by trying to treat all the diseases that afflict them in late life? No. ... We should invest more research dollars into the biology of aging than we do into any one specific disease of aging (e.g. cancer, heart disease, etc.). Unfortunately my sense is that we don't come even close to this. Biogerontology continues to be disadvantaged as a field of scientific inquiry.

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My sense of things, from hearing about the vision of the Institute and the new priorities it has identified, is that the Institute of Aging in Canada still struggles to get the respect, funding and support it deserves. This is no doubt due to many factors, such as the dominance of disease research, misconceptions about the true causes of health disparities, misguided sensibilities of fairness, ageist attitudes, and a general ignorance of the biology of aging and evolutionary biology in general. This makes selling the science to politicians and the general public a really tough sell. But I believe it is something that must be done if we hope to add healthy years to late life. So we must soldier on....

This is all quite true. People are surprisingly willing to write off and accept suffering and death in the old - see the various forms of "fair innings" arguments used to divert funds away from medical programs for the elderly, for example. At the same time, the research and clinical medicine systems in the most advanced regions of the world are a horrid centralized mess, in which most of the important actors operate under perverse regulatory incentives that encourage them to provide worse service, build poor products, and devote the lion's share of scientific resources to the least effective research programs.

In the US, this manifests most noticeably in the way in which the FDA forbids any application of science to treat aging - all medicine must treat a specific, defined, named disease, and there is no place or path forward within the existing framework to add aging to the list. This is characteristic of the late stage of regulation that has become so stifling as to completely block meaningful progress - all that is not expressly allowed is forbidden by default. This is exactly why there are not a hundred biotech startups working on technologies like those proposed in the Strategies for Engineered Negligible Senescence, many of which within a few years of the point at which it makes sense to build a product. But there is no realistic path to commercial deployment of a therapy for aging in the largest markets, so there is next to no venture funding for these goals.

What little research does happen takes place in parts of the field that will never produce meaningful rejuvenation biotechnologies, but which can be shoehorned into the existing regulatory straightjacket because they sort of look like drug development and can be tested on lifestyle diseases like diabetes. Billions have been spent on such ends already, an example of the way in which regulation produces massive waste by constraining the engines of competition and progress to research and build only shoddy incremental advances on yesterday's known goods. But that is not where true progress comes from - true progress comes from disruptive new advances that look nothing like the technology of yesteryear.

For so long as the US regulation of research, medical development, and clinical provision of services looks much as it does today, the future of rejuvenation biotechnologies lies in medical tourism to other parts of the world. Research and development once conducted here will be overtaken by that in parts of the world that do not forbid attempts to produce therapies to reverse aging. But it will take longer for all of this to take off and become an earnest, large development community than if there were no ball and chain attached to medical research in the US - and every day of delay bears an enormous cost in death and suffering.