Transcriber: Fran Ontanaya Reviewer: Capa Girl
All right. So they told me that I was going to have to stand
in the red circle
and they told me all the things they tell TED speakers.
But they didn't tell me about this.
(Laughter)
Too bad I guess. I'm just going to have to hope for the best.
So, this is the foundation that I work for -
that I'm the Chief Financial Officer
of and this is what we do.
I can reassure you that the technologies
that we work on do not include standing in a box of ice.
We are interested in, what I'm going to be calling
rejuvenation bio-technologies to combat aging.
We are interested in trying to do something about the problem of aging.
And I'm going to start just by telling you
what that means in slightly more accurate terms
than a lot of people think about it.
So actually I'm going to start this slide from the bottom.
Do I have a laser pointer on this? No.
So, most people think of aging as the right thing to die of.
They think that when you die of old age you die of natural causes.
In other words, you basically avoid all of the really horrible things
that we all agree we don't want to get.
Like Alzheimer's disease and cardiovascular disease
and cancer and so on.
And, you know, you have a good innings
and eventually you pass away relatively peacefully in a condition
that is relatively healthy for your age.
So first of all I don't like the term "healthy for your age."
As far as I'm concerned it's just a contradiction in terms.
You are healthy or you are not healthy.
And if you think there's such a thing as being healthy for your age
then it's just agism, really, it's just saying
that it's ok for old people to be sick, and I think that's stupid.
But anyway, so the big thing I want to say here -
Oh, ok if you want. All right. Let me see if it works. Yeah it works. -
So, the big thing that I want to point out
is that actually this supposed distinction
between aging on the one hand and the diseases of old age
on the other hand, is a forced distinction.
It's a distinction that some people like to suggest
just in order to, in some way, make their own work look
more important or something.
But, the fact is, it's not true.
The only reason why the diseases of old age
are diseases of old age,
is because they are the later stages of some process
that goes on throughout life.
Otherwise they would happen to young adults as well.
So, that's really the way that we should think about
the diseases of old age.
If we really want
to do anything about the diseases of old age,
the disabilities of old age,
we have really got to do something about aging itself.
You know, it's pretty easy to say that this would be a good idea.
If I go back for a second and talk about these numbers -
the hundred and fifty thousand people
that die every day, worldwide, two thirds of them die of aging.
If we remember that aging includes all the age-related diseases
- in the industrialized world it's 90% of all deaths -
that's fairly obviously the world's biggest problem.
(Laughter) And certainly the world's biggest medical problem.
And even if you were lucky enough to avoid
all the diseases of old age, and get to a stage
where you are in danger of dying of natural causes -
you know, what part of this slide do people not understand?
It's fairly obviously preferable to be in the state on the bottom photograph
rather than the state on the top photograph.
Even if the guy who's just jumping off the back of the boat
is about to have his head bitten off by a shark.
It doesn't really matter. (Laughter)
So, this is what we are interested in doing.
We are interested in maintaining people's health properly.
So that people are not just healthy for their age,
they are actually properly healthy.
They're in not only the same condition to look at them -
they don't just look like young adults
they actually feel like young adults
and they function like young adults however long they live.
That is the goal of my work
and the work of the people I work with.
So, of course this entails the cure of specific diseases
and the prevention of specific diseases.
It does have a side effect, which is that people
may live a great deal longer, but I want to emphasize
that that is a side effect,
it is not the primary purpose of this work -
the primary purpose is absolutely to keep people healthy.
And of course the social and economic benefits
of not having so many people getting sick
and decrepit and dependant and debilitated -
are rather obvious as well.
So it's fairly easy to say that this seems like a good idea.
But some of you may be aware that there is a certain degree
of ambivalence in society about this question.
And certainly when I find myself talking
to non-scientists especially about the problems
that we want to solve by [defeating aging]
then they tend not to be terribly interested in those problems,
they tend to be interested in the possible problems
that may be created by the defeat of aging.
You know, people say, "What if dictators live forever?"
or "How would we pay the pensions?" or "Will it be boring?" and so on.
Yeah, "Won't it be really boring not getting Alzheimer's disease?"
(Laughter)
It strikes me as somewhat incongruous that people should be able to put
this rather bad problem that we have today
out of their minds and just not talk about it
and not think about it in the same way
that they would be rational in every other walk of life.
And I actually used to be very unsympathetic about this,
but I gradually began to realize that it makes
perfect sense for people to think that way
while it is genuinely impossible for the foreseeable future
to do anything about aging.
Because clearly there's this terrible ghastly thing
that is going to happen to you in the relatively distant future
and you can't do anything whatsoever about it,
then it makes sense to try to put it out of your mind,
rather than to spend your miserably short life being preoccupied by it.
And if that's what you are going to do, then it doesn't really matter
how you put it out of your mind,
it doesn't matter how irrational your rationalizations actually are.
What matters is that they work -
that you succeeded in tricking yourself into the view
that aging is actually a rather good thing after all
and that we'd probably not better do anything about it.
So, I'm reasonably sympathetic to that point of view -
except, of course, for the minor fact
that I think that we are no longer in the situation
of having no chance for the foreseeable future
of doing anything about aging.
I think that we are getting close.
And I'm going to tell you why I think that over the next few minutes.
But of course, that does rather undermine the logic of this
what I'm calling, "rational denial".
And it's somewhat frustrating to me
that it's taking rather a long time for people
to wake up and realize that their previously rational approach
to this problem has now become an enormous part of that problem.
Ok. So I'm going to start talking about some biology now.
A long time ago a very famous guy named Peter Medawar
described aging as an unsolved problem in biology.
And many people since then have called it the major unsolved problem in biology.
But it isn't, it's a completely solved problem, more or less.
We know pretty much exactly what aging is in mammals -
certainly we have a pretty good idea how to describe it,
as I should be doing shortly.
And if we want to describe it in very simple terms
then it comes down to what I'm saying here.
I've said some of this already,
that aging is the lifelong process
that gives rise to debilitation in old age.
So, putting that in other words, there is a set
of what we may call damage, types of molecular
and cellular change in the body that accumulate
throughout life as intrinsic, unavoidable side effects
of normal, essential, metabolic processes like breathing.
Which eventually when they get abundant enough
cause, as I say, the debilitation and dysfunction of old age.
So, that's a nice straightforward definition of aging
and it's completely uncontroversial.
Pretty much everyone who studies the biology of aging
would agree with that definition.
But what we can say about aging is that,
no, it's not the major unsolved problem in biology,
but it sure as hell is the major unsolved problem in medicine.
Because the approaches that we have today
for doing anything about aging are not working.
The main approach we have today -
the approach that medical doctors are taking
is what I'm going to call the "geriatrics approach."
And the geriatrics approach basically says let's focus on old people.
Let's focus on people
in whom the pathologies of old age are already emerging.
Let's try in some way to slow down
the rate at which these pathologies progress
and are exacerbated, so that we postpone
the age at which the pathologies become life-threatening.
And that's a good idea in principle, clearly.
Another approach, which seems to be followed by people
who study the basic biology of aging, is to say,
"Well, ok, in principle, prevention is better than cure.
So, surely we might actually do more if we try to,
somehow, clean up metabolism.
If we try to slow down
the rate at which normal metabolic processes create
these various types of molecular and cellular damage in the first place.
And that's a fine idea as well.
So what's the situation?
Why are we doing so badly in actually getting these ideas to work?
In actually significantly, substantially, postponing
and controlling the diseases and disabilities of old age
in the same way that we can so well control
most infectious diseases, for example?
Basically the answer to why the geriatrics approach
doesn't work, is this - aging is very messy
and chaotic and complicated and horrible.
Lots and lots of different things go wrong all at the same time.
They interact, they exacerbate each other.
It really is a case of prevention being better than cure.
We just are not in the position to do anything about this
when it gets this late.
Really, what it comes down to
is that these problems are getting worse,
and getting harder and harder to treat all the time
simply because they are the consequences of something
that is getting worse all the time.
Something that is accumulating all the time, namely damage.
So that leaves us with the gerontology approach
but unfortunately that has got this problem,
which is that metabolism is very very complicated.
Actually, this is not really the problem.
This here is a small subset of what we know
about how metabolism works - a simplified diagram actually
of a small subset of what we know. (Laughter)
But that's not the problem, the real problem is
that this is a simplified diagram of a small subset
of what we know about how metabolism works.
Which is completely dwarfed, as any biologist would tell you,
by the absolutely astronomical amount
that we don't know about how metabolism works.
Even if we are completely ignoring all the stuff
that we don't even know that we don't know.
(Laughter) (Applause)
I mean, this, the gerontology approach, certainly,
in principle, could work a lot better
than the geriatrics approach ever could.
But it is an idea whose time has very very much not come.
We have to know just incalculably more
than we currently do about how biology really functions
in order to have the faintest chance of cleaning up -
of intervening in this process in a manner
that doesn't do more harm than good.
So well, all that sounds a bit miserable, doesn't it?
It sounds that maybe we are still in a situation
where it makes sense to engage in this rational denial
that I've talked about earlier.
But, no. There's a third approach.
And that's the approach
that SENS Foundation and an increasing number of other people
are paying a lot of attention to now.
I like to call it "rejuvenation biotechnology."
If you like you can call it the "repair and maintenance approach"
to the problem of aging.
Which says, basically, rather than trying to slow down
the rate at which metabolism creates damage,
or slow down the rate at which damage translates into pathology,
let's instead just uncouple those 2 processes from each other
by going in and periodically repairing the damage -
not necessarily perfectly, just reasonably well -
so that we will postpone the age at which
the damage reaches the pathogenic level.
There's no reason why we shouldn't be able
to do that indefinitely, just as we do already
with simple man-made machines,
like cars or aeroplanes or whatever.
The reason we have 100 year old cars is because we can.
Because comprehensive enough, periodic maintenance really works.
And let's face it, the human body is just a machine.
It's a really complicated machine, but it's just a machine.
So, in principle the same approach ought to work.
All right, that's in principle. What about practice?
How close are we? Well, I've only got five minutes
and twenty six seconds left, so I'm not going to tell you.
(Laughter)
But I will tell you in very brief summary
that the problem of aging, the damage of aging
that I've been talking about can, in my view
and in the view of a lot of people now,
be broken down and classified really rather nicely
into the 7 major themes that I'm listing on the left hand side of this table here.
Things like cell loss, which is simply the progressive death of cells in organs
that are not good at replacing those cells automatically
by the division and differentiation of other cells.
Parkinson's disease is a fine example of that -
of a particular part of the brain in which neurons die
unusually rapidly and are not replaced.
And in people in whom they die particularly rapidly
the consequence is the loss of ability
to create a chemical called dopamine,
and that's what leads to Parkinson's disease.
So that's just one example of an aspect of aging
that is caused by one type of damage
that accumulates throughout life.
And I could carry on down this list
and talk about all the others, but as I say,
I've only got four minutes and fifteen seconds.
So the question is, of course, can we fix these things?
And that is what the list on the right hand side is.
If I didn't have a list on the right hand side
then again, I wouldn't be able to come up and tell you
that I think the maintenance approach
is as powerful, as promising as I think it is.
But the fact is, we can what's going on here.
There's just a one word name - or a three word name
for each of the approaches that I think that are promising
for addressing each of these problems on this table.
But in the book I wrote a few years ago
there's an entire chapter on each of these things.
And that's a really important point that I want to drive home.
In any technology, in any new pioneering future technology,
the way in which you can describe the problem,
the details of how you can describe it
in particular the amount of detail is a really good measure
of how confident you can be in your estimate
of how long it's going to take to actually implement the technology.
And in this case we can say a very great deal
about what is already being done,
what technologies have already been developed,
and where we need to go, what we need to augment them with
in order to actually deliver the therapies that I'm describing here.
That's why I've been saying for a little while
that we may be only about twenty five years -
I would say that we have a fifty-fifty chance
of being only about twenty five years away
from the target that I have in the title of this slide.
Giving thirty years of additional life
to people who are already in middle age before we start.
As I mentioned earlier there's no reason why we shouldn't get
better and better at doing that, using the time
that we are buying each time we rejuvenate people
to improve the therapy, so that we can re-rejuvenate people
and give them another thirty years and so on.
Now what that does actually lead to, as a number of people have noticed,
is a rather extreme prediction
for the consequences on longevity -
That we may actually get indefinite lifespans
really rather soon after we get lifespans increased by only,
let's say, thirty years.
And a lot of people are terribly scared about this because they think
it's going to cause larger population, or how we pay the pensions
or as I mention earlier, when dictators live forever, and so on.
But to be faithfully honest I think it's rather important
to emphasize that we need to think maturely
about these problems, and not just be satisfied
with the negative reactions that so many people are prone to.
It's very very important to recognize, first of all,
that this is going to happen slowly.
We aren't going to have any thousand year old people
for nine hundred years, whatever happens.
(Laughter)
So, we have got to remember that, during that time,
there's going to be quite a lot of other technological progress
that is going to shape the context
in which this demographic change is going to occur.
And, therefore, it's actually quite sensible
to carry on and think again about the problem
that we want to solve, which is a very immediate,
clear, and present problem, namely, a hundred thousand people a day
dying an unnecessarily early and unnecessarily painful death.
Or rather at least it will be unnecessary
if we don't get on it and try as hard as we can, to fix this problem.
We would actually be quite happy
if nobody got Alzheimer's disease, and nobody got cancer and so on.
And that's we are talking about here.
Oh, I've been told to skip over this slide.
(Laughter) So, I just want to emphasize here
that it is fairly appalling that so little is being done
to combat aging, to actually develop therapies
that we may call "preventative geriatrics."
The rejuvenation bio-technologies that I've summarized today
are basically, simply,
the application of regenerative medicine to the problem of aging.
Regenerative medicine is a fashionable concept,
it's a fashionable area of research, but it's not being developed
by gerontologists, it's being developed by people
who tend to think that the main focus of their work
is acute injury - you know, spinal cord damage, things like that.
But the fact is it can be used against the gradual,
accumulating, chronic damage of aging too.
That's what we do, that's what I want to achieve.
We have to understand that the reason
why people are so apathetic, people are so ambivalent about this
is basically because they still don't quite believe it can be done,
that they have convinced themselves that aging is a good thing anyway -
maybe they think that the people who are working on this problem
are not really equipped to actually deliver these technologies
even if the concept of using regenerative medicine
against aging is valid.
But, ultimately, I think it all comes down to peer pressure.
It all comes down to not wanting to be laughed at by your friends,
because they haven't heard this talk.
So make sure they hear this talk. (Laughter)
I'll stop there. (Applause)