Those of us who have been involved in advocacy for aging research and the development of therapies to treat aging as a medical condition for long enough will remember the early 2000s, a time in which a million dollars of new funding for a specific project or specific non-profit was an amazing, novel, rare event. Given that $3 billion, a sizable fraction of all investment into all forms of medical biotech in 2022, was invested into one entity focused on one approach to the treatment of aging, Altos Labs, we might forgive advocates who think that the job is done, that the argument has been made and heard, that it is time to go home and watch the progress rolling in.
However, the job is never done. The difference between a few million dollars in a year and a few billion dollars in a year dedicated to aging research and the development of treatments targeting mechanisms of aging is vast. But it is only a step forward in the bigger picture. It remains the case that aging causes so much harm and death, a vast and ongoing toll, that the real goal here is to grow the entire medical research and development investment field a hundredfold, and all of that focused on age-related disease, rather than merely claiming a little more of the existing field.
Medical research is dramatically underfunded in comparison to the costs of disease, and nowhere is this more apparent than in the matter of degenerative aging. There must be a great changing of minds, an education of everyone who thinks that present investment is anywhere near adequate as a response to aging. The world up-ended itself over COVID-19, a condition that killed a tiny fraction of those who die due to aging. Yet aging has always been with us, and only now is there the real possibility of producing rejuvenation. People are accepting of a vast toll of death and suffering from aging. That must change.
Andrew Steele: “A Mindset Shift Is Required”
After spending about a decade in this field, are you now more optimistic or more pessimistic than you were in the beginning?
I think I’m a mixture of things. Scientifically, the last decade has been perhaps even more incredible than the decade that preceded it. The Hallmarks of Aging paper came out in 2013. It has provided a rallying point for geroscience and became one the most cited biology papers ever. We’ve seen many incredible things, like actual treatments progressing. We’ve got senolytics now, a whole class of treatments that simply didn’t exist when I first started looking into longevity. We’ve got epigenetic reprogramming. We’d used it for individual cells, but we now have evidence that it can potentially improve aging in whole organisms. All those interventions are super exciting. The science is progressing. The respect in which I’m less optimistic is that making the case for longevity hasn’t moved on as far. Yes, there has been some increase in public perception and longevity is a real buzzword, but the ways people get exposed to it are less than ideal.
Many of them come across news stories about incredibly rich people doing a variety of, frankly, quite strange interventions to try and extend their lifespan. If this is people’s first exposure to aging biology, and they might start thinking that this is some kooky pastime for gajillionaires that isn’t for the likes of you and me. They don’t realize that a lot of what we’re talking about is drugs that could cost pennies per pill while making all of us live healthier, longer lives without having to go to bed at a very prescribed time every night and do four hours of exercise a day and only eat the same food every single day and so on.
Another challenge is that although longevity and preventative medicine have really increased in their prominence, when you talk about this in policymaking circles, so much of that discussion focuses on diet, exercise, and other lifestyle stuff. While those things are very important, and I am a huge supporter of public health, I think that it’s not as important as dramatically increasing the amount of money we spend researching aging. That’s because while we know that you can add a decade of life by going from the least to the most healthy dietary patterns and so on, the potential of aging biology vastly outstrips that.
If you drill down to what goes into aging biology per se, it’s about $350 million a year, which is a dollar per American. And this is for studying a process that kills 85% of Americans and is by far the largest cause of suffering in the United States. It just seems wildly disproportionate. Although it’s very exciting to see a lot of private funding come into the field, this is still a drop in the ocean compared to US healthcare spending, which is four trillion – not four billion, but four trillion dollars every single year. Just think about the economic impact that investing in aging research could have. It’s simply not being recognized. Although the scientific developments are exciting and cool and coming thick and fast, there’s this weird tension between the amount of amazing stuff going on right now and the fact that the field is still dramatically underfunded. Trying to communicate that tension is probably the hardest part of my job.
