Prioritising prevention

Dear Futurists,

Over the last few days, television news broadcasts have featured, time and again, instances of healthcare systems being under severe strain.

Medical staff are being called upon to work especially long shifts. Ambulances are being held in queues outside the entrances to accident and emergency departments, because there are no beds to receive new patients, and no free doctors to attend to these patients. Invalids who have been awaiting surgery for numerous issues are having their appointments postponed, by months or possibly even years, because hospitals are overwhelmed.

In the short term, in the face of this crisis, medical staff are being urged to work even harder, and to take fewer holidays. Doctors and nurses who have retired are being encouraged to return to duty. New beds are being placed in new buildings, and armed forces personnel are being drafted in to help address the staff shortage.

At the same time, the question is being asked: aren’t there longer term actions that should be taken, to prevent recurrences of this kind of crisis?

After all, the NHS in the United Kingdom reaches a state of near crisis almost every winter. Covid-19 is pushing it even closer to breaking point this year. There could be another complicating factor – another surprise – the straw that would break the camel’s back – sooner than we expect. What can we do to head off that risk?

For a futurist answer to this dilemma, read on.

1.) Targeting root causes

The Covid-19 pandemic has already accelerated a number of trends that futurists have long anticipated, but whose adoption curves had previously seemed slow.

This includes the use of video conferencing for remote working and remote education. It includes video conferencing for medical appointments. And it includes experiments with payments to people for not working (akin to a temporary version of “guaranteed basic income”). But that’s not all.

The latest “Omicron” phase of Covid is now highlighting, again, the crying need for society to understand and target root causes for illnesses, rather than simply responding to illnesses when they arise.

As Benjamin Franklin said back in 1735, “an ounce of prevention is worth a pound of cure”.

Hence the focus on developing and distributing vaccines, and on mask-wearing and other measures to reduce the spread of the virus.

There’s also greater discussion of which kinds of factors predispose people to have a particularly bad experience with Covid.

One highly significant causal factor is aging. The older someone is when they catch Covid, the greater the likelihood that the infection will result in their death.

Remarkably, that connection applies, not just to Covid, but to numerous other diseases. Here’s a chart shared at a recent event by geroscientist Nir Barzilai:

Note that the scale on the vertical axis is logarithmic. Therefore straight lines on this graph convert into exponential curves on normal graphs.

The data is from the United States, but similar data from other countries echo the same message: Aging is the strongest risk factor for death from a wide range of diseases.

We already know that factors such as smoking, obesity, lack of exercise, and poor quality of sleep, increase the likelihood of deaths from a range of diseases. Therefore, we try to encourage each other – especially our most cherished companions and family members – to make positive changes in their lifestyles and diet.

But the impact of aging dwarves these other connections. Far better, then, to encourage each other – especially our most cherished companions and family members – to stop or even reverse aging.

Until recently, such advice would have seemed like nonsense. Aging is inevitable, it was widely thought. But research over the last few decades is upturning that long-established notion. A slow initial trickle of interesting research findings has transformed into a powerful torrent of new results.

It’s now increasingly credible to say (paraphrasing Benjamin Franklin) that an ounce of age-reversal is worth a pound of hospital treatments for heart disease, cancer, stroke, and so on.

We’re not there yet, but the roadmap to that destination is becoming clearer all the time.

There are two main vehicles to propel us down that roadmap faster. These two vehicles are the subjects of the next two London Futurists events: political policy, and scientific research.

2.) Political policies to accelerate a 30-year jump in healthspan

Our meeting tomorrow – Saturday 8th January – looks at possible political policy changes to assist the development of anti-aging interventions.

The three speakers at this webinar are the principal authors of a recent study that makes the case for a number of policy changes. These policies are suggested in the first instance for the UK, but mainly make sense for other parts of the world too. The recommendations include:

  • Set ambitious, long-term targets: Publicly commit to delivering “30 in 30”
  • Ensure longevity is at the heart of life-sciences strategies
  • Employ innovative funding models to accelerate progress
  • Incentivise innovation and equity in the private sector
  • Model the fiscal and economic value of extending life and healthspans
  • Facilitate clinical trials
  • Give the NHS first refusal on publicly funded longevity therapies
  • Change and lead the narrative about aging

How well have other think tanks and political pressure groups responded to these recommendations? How can members of the public best support the proposed initiatives? And is there anything significant missing from these recommendations? These are among the questions I expect the discussion tomorrow to cover.

Click here for more information about this event and to register to attend.

Please note that the start time on this occasion is two hours earlier than usual.

3.) The case for stem cell treatments to repair the damage of aging

What are the most promising options for dealing with the biological damage that accumulates throughout our bodies as we age?

For example, should we concentrate upon better exercise, healthier sleep, a positive mental attitude, and on changes in our diets?

Are new collections of drugs likely to prove effective at undoing the metabolic damage of aging, without causing adverse side-effects?

Or should more attention be placed on the possibilities to replace parts of our body, using innovative tissue engineering and stem cell therapies?

The latter approach is favoured by Dr Jean Hébert, who will be sharing his views and describing his most recent research in the London Futurists webinar on Saturday 22nd January.

Dr Hébert is Professor, Department of Neuroscience, and Professor, Department of Genetics, at the Albert Einstein College of Medicine in New York. He is also the author of the recent book Replacing Aging.

Here’s a sample of what medical experts have said about that book:

“An impressive overview of how regenerative medicine may reverse aging and reboot the brain”
— Anthony Atala, MD, Director, Wake Forest Institute for Regenerative Medicine

“This is a scientist’s perspective on aging as a condition that can be treated. The ideas that seem most like science fiction, such as replacing parts of the brain, are actually edging toward reality”
— Jeanne Loring, PhD, Co-founder of Aspen Neuroscience, Director of the Center for Regenerative Medicine at the Scripps Research Institute

“Highly provocative and a great overview of recent progress in regenerative medicine and how it may at some point be applied in the fight against aging”
— Nir Barzilai, MD, Scientific Director for AFAR

Click here for more information about this event and to register to take part.

4.) Assessing the health of the planet

Alongside questions about the health of individuals, a larger set of questions loom. How is the health of global society as a whole? Are we headed toward major reversals, which could knock us collectively off course, akin to how Covid-19 has intruded, often horribly, on individual lives?

Indeed, in any such assessment of the overall health of global society, what should we be measuring? Which factors are “symptoms” and which are closer to being “root causes”?

The Millennium Project has been addressing that subject on a regular basis since its formation in 1996. It regularly publishes updates on what it calls “The 15 global challenges” and, in a wider survey, “The State of the Future”.

What distinguishes the Millennium Project analysis from various other broadly similar enquiries is the “Delphi” method it uses to reach its conclusions. This involves an iterative online interaction between members of an extended community, who are asked their opinions on a number of questions, with the option for participants to revise their opinions if they read input from other respondents that brings new considerations to their mind.

The reason I’m mentioning this now is that a new Delphi survey is now starting, and there’s scope for a number of London Futurists members to take part.

This survey is being structured differently from previous years, and is using a new tool. Participants will be asked to offer estimates on 29 metrics for the year 2030 – including the best and worst potential value the indicator might have in 2030. You’ll also be asked which of the metrics are the most important (and which are the least).

To help you provide answers, the system already contains data points stretching several decades into the past.

The metrics include:

  • Income inequality (income share held by highest 10%)
  • Unemployment (% of total labour force)
  • Life expectancy at birth (years)
  • Physicians (per 1,000 people)
  • Literacy rate, adult total (% of people ages 15 and above)
  • People using safely managed drinking water services (% of population)
  • CO2-equivalent concentration in the atmosphere (ppm)
  • Energy efficiency (GDP per unit of energy use)
  • Electricity production from renewable sources (% of total)
  • Individuals using the Internet (% of population)
  • Proportion of seats held by women in national parliaments (% of members)
  • Number of conflicts between different states
  • Refugee population

You won’t have to answer all the questions. Instead, you can direct your attention to the questions where you feel you have some particular insight. You can browse the other questions at a later time. And, as mentioned, you can revisit some of your earlier answers once you see comments made by other participants. Indeed, it is in the interaction between different comments where the greatest insight is likely to arise.

If you think you’d like to take part, please get in touch with me. Note that the Millennium Project will give priority to people with the following roles: professional futurists, scientists (including social scientists as well as natural scientists), policymakers, science and technology experts, advisors to government or business, members of NGOs, UN liaison, and professional consultants.

The Delphi questionnaire will remain open until 31 January, 2022. The findings of the questionnaire will feature in a London Futurists event later in the year.

// David W. Wood
Chair, London Futurists

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