Translator: Leonardo Silva Reviewer: Denise RQ
In the 1920s,
a state-of-the-art airplane looked like this,
a Nieuport 17, topping a speed of 200 kilometers per hour,
one of the most powerful airplanes of World War I.
Drugs, in the 1920s, looked like this.
This is aspirin, a champion drug of the 20s,
relieving pain for millions.
And aspirin came in the form of a pill.
Moving to the 60s, airplanes became even more powerful.
Here, a Tupolev 134, now traveling at a speed of 1,000 kilometers per hour.
Drugs, in the 1960s, looked like this.
And they came in the form of a pill.
Fast-forward to the 21st century:
an F-22 Raptor, one of the most advanced fighter jets of all time,
now traveling at a whopping speed of 2,400 kilometers per hour.
And drugs, in the 21st century, looked like this.
And they came in the form of a pill.
And today, aircraft can look like this,
SpaceShipTwo, by Virgin Galactic.
It goes to freaking space.
And drugs today still come in the form of a pill.
I know what you're thinking,
"The content that's inside the pills must have changed," right?
Haven't modern medicine and state-of-the-art chemistry
brought advances to this stuff that's inside the pills?
I spent ten years studying pharmaceuticals,
researching pharmaceuticals,
and obtaining a PhD degree in the pharmaceutical sciences.
And like every PhD student on the planet,
I had an existential crises every week in my lab.
And one day, I asked myself,
"Where the hell are we going with all of this research?
Why is progress in pharmaceuticals feeling so damn slow?"
Because progress felt slow to me,
because I've been a computer and tech geek since age ten,
and for the last 20 years, I've been obsessively following the progress,
the exponential progress of computing and technology.
And as many of you know, computing is an exponential technology,
which means it advances really, really fast.
So, why aren't pharmaceuticals advancing as fast?
Or maybe they are, but I just couldn't see it back then.
So I decided to find out.
But first, to make my point clear,
let me take you to a small journey
through the world of computing and technology.
The story starts with Moore's Law,
first described by Gordon Moore, cofounder of Intel.
And in the mid 60s, he discovered that computers became twice as powerful
roughly every second year.
And the data behind this phenomenon looks like this,
and it's an exponential curve.
An exponential curve can also be viewed on a logarithmic scale,
which means that the exact same data will, instead, look like this.
And now, we can see a smooth and clear trend,
which allows us to predict the power of computing in the future.
And the same goes for the cost of computing.
The price of computing power is decreasing exponentially.
And thanks to these trends,
we can predict the price of computing in the future.
These trends have been going steady for many decades now,
and we can see them in other technologies, such as megapixels in cameras,
the cost of genetic sequencing, the performance of LED lights, and so on.
And today, many industries rely on these trends to continue,
because if they don't, the survival of their industry will be at stake.
But looking at data like this can be quite deceptive sometimes.
There's a more truthful way to look at exponential progress,
and from a broader perspective, it really looks like this.
It's a series of overlapping S curves,
and in this example, we have the history of computing power,
and it began with the old electromechanical computers
that used punch cards.
And zooming in on their S curve, we will see three phases.
The first phase is the experimental phase, the exploration phase.
This is where experiments are happening with brand new technologies.
And things are often risky, there might be ethical concerns,
and new technologies are usually opposed by skeptics and critics,
but eventually comes a breakthrough,
and the technology gets adopted and rapidly developed
as new competitors in the field arise.
And now, we have reached mastery,
technology is progressing exponentially,
but eventually, all technologies will reach a limit.
This is the limit where progress, beyond this point,
will give little returns anymore.
And the electromechanical computers were replaced by the relay computers,
when they got to a breakthrough.
And the story continued with the vacuum tube computers,
and then the transistor-based one,
and then finally came the integrated circuit: the microchip,
the computing technology that's been with us for over four decades now.
And this technology will too reach its limit one day,
and then, we will be in a dire need of a replacement.
So, in a hundred years time,
computing has been revolutionized over and over, several times.
So, almost in the same period of time,
what has happened in the field of pharmaceuticals?
Did the content inside the pills actually become better?
Rest assured: they did. No doubt about it.
But I think there's an even more important question here.
I think the question is:
are new and groundbreaking discoveries in pharmaceuticals
coming fast enough?
I think that's the billion-dollar question.
So, after digging through FDA's publicly available database,
this is what I found.
So, the number of new pharmaceutical inventions available on the market
is growing, and it's growing fast.
And it's looking good: we can see the first half of the S curve,
and we've passed the breakthrough point, and the curve is just soaring, right?
So, according to this data, if we're looking to the future,
well, by the year 2050,
we will have 30,000 new pharmaceutical inventions on the market.
And that seems great at a first glance.
But the thing with S curves is that it's really hard to predict
when a technology is going to reach its limit,
and when the curve starts to dip.
Because how can we be sure that this trend is going to continue?
So, we need to dig deeper into the data to find out.
So, instead of market growth,
let's look at how many new inventions from the pharmaceutical industry
see the light of day on a yearly basis.
In other words, what's the speed of inventiveness
of the pharmaceutical industry?
Now, that's a totally different picture.
The peek of pharma inventions was in year 2010.
That year, 100 new pharmaceutical inventions were released to the market,
but after that, it's starting to dip.
And to add to the bad news,
the number of new discovered drugs per dollars spent on research
is actually decreasing, exponentially fast.
So, the data, so far, is not in favor of pharmaceutical progress.
But here's the most shocking fact:
of all the pharmaceutical inventions since 1945,
only 3% are actual cures.
And these cures are mostly antibiotics and antifungals.
As it turns out, pharmaceuticals are excellent at killing germs,
but for the majority of diseases that are due to malfunctions in our own bodies,
what do pharmaceuticals do?
They can only treat the symptoms.
That's what 97% of all pharmaceuticals do.
They treat symptoms.
We have no cures.
And I believe the ultimate goal of health science
should be to deliver cures.
And pharmaceutical technology has utterly failed to do so.
So, number one: pharma's speed of inventiveness is slowing down.
Two: research of pharmaceuticals is becoming more and more expensive -
so this is the opposite of Moore's Law;
this is the opposite of exponential progress.
And three, and most importantly:
pharmaceutical technology seems incapable of actually producing cures.
So, if cures are what we're looking for,
I believe pharmaceutical therapy has reached its technological limit.
And to find cures,
we're in a dire need of a replacement.
But here's the good news:
there is actually a new S curve in town,
and it's called genetics.
And it's been just 60 years
since Watson and Crick discovered the structure of the DNA molecule,
and that changed our understanding of life forever.
And our understanding of genetics is advancing exponentially fast.
"Scientists identify schizophrenia's 'Rosetta Stone' gene,"
from Cardiff University.
"Gene therapy restores auditory function in deaf mice,"
from Harvard Medical School.
"How to reprogram cancer cells back to normal,"
from Mayo Clinic.
And "Scientists successfully edit human immune cells,"
from UCSF.
And these headlines are just a tiny pick
from the last 60 days.
That's how fast genetic research is advancing.
And for the first time,
we're actually closing in on real cures,
real fixes to the defects of the human body,
because the power of genetics allows us to do so.
Pharmaceutical technology does not.
But here's the best news of all:
this is a revolution that all of us can partake in,
thanks to the rise of the biohacker movement.
For example, like Kay Aull,
who built her own genetic testing kit,
in her closet, for small-time money,
after her father got diagnosed with a hereditary disease,
as written in Discovery magazine.
And just like many other technologies, genetics is progressing exponentially,
and the price of doing genetics is dropping in the same fashion.
For example, you can now order an open-source DNA copying machine,
for 600 bucks, online.
This is something that would cost tens of thousands of dollars just a decade ago.
And as forward-thinking teachers are bringing programming
and hacking into their classroom,
the hacker movement will grow even faster every generation.
These efforts, together with the forward thinkers of academia and industry,
will help to hypercharge the science of genetics.
And for the first time, the art of actually finding cures
is finding its way into the hands of us, ordinary citizens.
But, of course, there is a lot of room for concern.
This is a new technology,
and the ethical dilemmas of genetics are just as mind-boggling
as genetics itself.
And I don't think anyone has the answers to these ethical dilemmas yet,
because we are, after all, playing with the code of life.
But this is how its supposed to be.
Genetics will be fought by skeptics.
Genetics will be fought by critics.
And we should welcome it,
or else it wouldn't be new and exciting groundbreaking science,
because that's what genetics is.
So, don't forget:
we're at the beginning of a new S curve;
the next generation of health,
the generation of genetics.
Let's climb it together.
Thank you very much.
(Applause)