Anti-aging technology is a relatively small, but rapidly-growing sector of research and development. Several research groups have been established, both in academia and in the corporate world. The corporate side is particularly interesting as venture capitalists are starting to throw money their way and even some big players, like Google, have directly entered the market. In Google's case, its start-up Calico, is clearly well-funded but shrouded in mystery, with little information provided publicly and seemingly few connections with academics or other companies working on anti-aging approaches.
It's an intriguing concept from a physician perspective, since our work is directly towards the extension and improvement of human lives, and age is a fairly significant non-modifiable risk factor in many, many diseases. Yet, it's hard to know what to make of these research efforts given the grandeur and complexity of the task, as well as the relative opaqueness of the field. So, I was glad to come across this interview with Aubrey de Grey, who rather passionately makes the case for continued anti-aging research, its plausibility, its potential, and then responds to societal critiques against the notion of anti-aging research entirely.
Dr de Grey's viewpoints provide an excellent window into the field of anti-aging research, but I admit to being a bit unconvinced on several of his points. First and foremost, on the technological side, there's promise, but in many cases, little more than that. One example Dr de Grey points to is the use of stem cells in degenerative diseases, like Parkinson's. While research on this issue is on-going and far from being exhausted, the promise of stem cell research has been touted for a few decades now without much success in reaching clinical treatments. I fully expect some breakthroughs in stem cell research, yet it's hard to have confidence that these will come soon, or that they will be as all-encompassing as has at times been promised. More likely, we'll see slow, incremental progress. Considering Dr de Grey's anti-aging framework requires such ambitious goals as effectively curing all major cancers - and I'd agree that's a necessity to substantially extend human life given that cancer incidence rises quickly with age - there's good reason to be skeptical that technologies are close to achieving his aims.
Regarding the societal critiques, namely inequality and overpopulation, I also feel the tone Dr de Grey sets is overly optimistic. For inequality, we already see fairly significant differences in access to healthcare based on cost. Any anti-aging costs stand to be rather expensive, if the level of investment in the potential anti-aging technologies is any indication. Even in a socialized healthcare system such as Canada's, this will be a concern. One example that springs to mind is the introduction of sofosbuvir (Sovaldi) for the treatment of Hepatitis C. It is a very expensive drug, but because it is so effective compared to previously-existing alternatives, it is actually a fairly cost-effective therapy by current metrics. Yet, provincial governments have been reluctant to fully-fund this drug due to its high cost. In Ontario, the sofosbuvir is only covered if a patient with Hepatitis C meets one of several requirements, even for those with provincially-funded drug plans, despite the indication for sofosbuvir being much more expansive than allowed for by these requirements. Even though sofosbuvir is effective and cost-effective, its upfront costs present a challenge for cash-strapped provinces. This is all for a drug that hits only a sliver of the population. Anti-aging drugs, which could in theory apply to everyone, will present much more a challenge, even if they work exactly as intended for a reasonable cost.
Overpopulation is, in my mind, a bit of a non-issue at this time since I'm skeptical anti-aging technologies will see widespread usage, but assuming they do, it becomes a serious concern. Dr de Grey notes that those who live longer can also contribute to society longer and thereby produce enough resources to justify their continued existence. This is absolutely true, but runs into problems when resources are constrained by more than manpower. Without starting down a whole different tangent, we are hitting the point where natural resources, which are independent of human work, are depleting far faster than they are being replaced. On top of this, we have a huge swath of humanity living on fewer resources than most of us would consider acceptable. While I believe this is a surmountable problem, it's not an easily-addressed one. Indeed, the world has been failing to adequately manage the shortcomings in our usage of natural resources relative to supply for decades at least, despite concerted efforts by many committed individuals, non-profits, and governments.
Lastly, an additional societal concern wasn't discussed in the article - the value of human turnover. That's a morbid thought, but our society relies on people moving onto new things, retiring from the workforce, or yes, even dying, in order to continue advancing forward. Older people carry with them older ideas and are more likely to have build up the power to implement them. Some of these are worth preserving. Others need to be let go. Longer life spans and longer careers means established ideas stay established longer, less pliable to the innovations of the young. Once again, this is a surmountable concern, and societies could adapt to a new normal of long-lived individuals, but I wouldn't be confident that this would be a seamless transition.
In short, I'm intrigued, but skeptical of this renewed anti-aging push. There are technical challenges that are far from simple to overcome. There are societal challenges that would have wide ranging impacts if not adequately addressed. Whether anti-aging efforts see success or failure, I'll be keeping my eye out for updates in this field.
No comments:
Post a Comment