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Wake Up—Aging Kills!

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image How many lives do you think you could save, in your life?

This is not a trick question. But in order to make it even more precise, I’m going to modify it a little. When we speak of saving lives, we mean giving the beneficiaries of our action the chance to live longer than they could otherwise have lived. However, when we ask in detail about the importance of saving a life, we may not regard all lives equally. For example, saving an eighty-year-old from drowning may give him only a few extra years of life before he’s likely to die of something else, whereas saving a child from drowning gives him a probable seventy years or more of extra life. We may also take into account the quality of life of the persons whose lives we save—predominantly their health. So here’s my modified question:

How many healthy, youthful years in total do you think you could add to people’s lives, in your life?

The ultimate purpose of this book is to show you that you could add many more years than you may currently think. So many, in fact, that now is the time to decide whether you want to. The way you can do this is by helping to hasten the defeat of aging. The specifics of how you can help—by donating money or time to the Methuselah Foundation’s Mprize fund or its SENS research funding program—will be the topic of Chapter 15; in this chapter I’ll restrict myself to communicating the magnitude of what those efforts can achieve in humanitarian terms.

I’ll start with some numbers. Around 150,000 people die each day worldwide—that’s nearly two per second—and of those, about two-thirds die of aging. That’s right: 100,000 people. That’s about thirty World Trade Centers, sixty Katrinas, every single day. In the industrialized world, the proportion of deaths that are attributable to aging is around 90 percent—yes, that means that for every person who dies of all causes other than aging added together, be it homicide, road accidents, AIDS, whatever, somewhere around ten people die of aging.1

And it’s worse than that. Look again at my expanded question and you’ll notice a couple of adjectives: “healthy” and “youthful.” Many people, when thinking about the idea of adding years to life, commit the “Tithonus error”—the presumption that, when we talk about combating aging, we’re only talking about stretching out the grim years of debilitation and disease with which most people’s lives currently end.2 In fact, the opposite is true: the defeat of aging will entail the elimination of that period, by postponing it to indefinitely greater ages so that people never reach it. There will, quite simply, cease to be a portion of the population that is frail and infirm as a result of their age. So it’s not just extending lives that I’ll be telling you about in this book: it’s the elimination of the almost incalculable amount of suffering—experienced not only by the elderly themselves, of course, but by their loved ones and carers—that aging currently visits upon us. Oh, and there’s the minor detail of the financial savings that the elimination of aging would deliver to society: it’s well established that the average person in the industrialized world consumes more health-care resources in his or her last year of life than in an entire life up to that point, irrespective of age at death, so we’re talking about trillions of dollars per year.

In this book I will explain the scientific and technological basis for my view that we can probably eliminate aging as a cause of death this century—and possibly within just a few decades, soon enough to benefit most people currently alive. But first, I need to get you interested—not just in the sense of entertainment, the sense in which you might read a good story, but in the sense of realizing that as and when this becomes possible it will be rather a good thing. And I’ve been in this business long enough to know that a description of the level of suffering that would be averted and the number of lives that would be saved does not, on its own, convince most people that it would be a good thing if aging were defeated. So I hope you’ll forgive me if I am blunt and to the point in this chapter, before I move on to the science and technology that will get the job done.

image Why Did I Write This Book?

I’m a scientist and technologist, and in an ideal world I would spend essentially all my time working on the scientific and technological details of my life’s goal, defeating aging. I wouldn’t spend much time doing media interviews, or giving public lectures—or even writing books. But there’s something about people’s attitudes to aging that, for now, changes my priorities. I call it the pro-aging trance. I’m going to start my discussion of the pro-aging trance with a comparison.

Here in the United Kingdom, just as across the whole Western world, there is a campaign of increasing ferocity against smoking. All cigarette packets come with health warnings. Not just tiny inconspicuous health warnings in cautious scientific language, either—warnings of the most hard-hitting and in-your-face nature possible. The simplest and shortest consists of just two words, typically printed in black on a stark white background:

Smoking Kills

And, slowly but surely, smoking is becoming less popular. Just like drunk driving before it, smoking is becoming socially disreputable. It’s a long, hard road, though: not just because nicotine is addictive, but because youngsters continue to take up smoking despite the social stigma increasingly attached to it.

It’s that latter point, the continued influx of new young addicts, that is my focus here. I’ve used smoking as my chosen analogy not in order to condemn the smokers among my readers—not at all. No, my focus here is something altogether less controversial, because the battle to protect youngsters from taking up smoking is one that virtually all adults, smokers or not, support. My reason for mentioning it here is timeliness: this battle is still being waged, so we can examine at close quarters the contradictions in our attitudes, both as individuals and as a society, that make the battle so hard to win. With specific diseases, there is no argument: the more we can do to defeat them, the better. But with smoking, even though it causes some of those self-same diseases, somehow society is itself subject to an addiction that robs it of its rationality concerning new young addicts. We face every day the brutal disconnect between allowing cigarettes to be advertised and sold widely and seeing how much they blight and shorten the lives of those who fall under their spell. And it’s just the same, I claim, with aging.

There are two potential reasons why smoking is declining in popularity and in public acceptability. One is that many people find it unattractive—they don’t like the smell (or, in more intimate contexts, the taste). But it’s hard to believe that this can be the main trigger for the rather recent change of sentiment against smoking, because today’s tobacco is surely no more off-putting than tobacco of a century or three ago. Thus, I think it’s clear that the main reason so many people now disapprove of smoking is its other downside, which was not much appreciated even half a century ago: It’s really rather bad for you, and also for those around you. Most of all, it massively increases your risk of getting fatal lung cancer, which not only shortens your life but also makes your declining years really miserable.

My goal with this book, as for all my outreach work, is to inject momentum into a similar shift of public opinion concerning aging. I have been aware for many years that most people do not think about aging in the same way that they think about cancer, or diabetes, or heart disease. They are strongly in favor of the absolute elimination of such diseases as soon as possible, but the idea of eliminating aging—maintaining truly youthful physical and mental function indefinitely—evokes an avalanche of fears and reservations. Yet, in the sense that matters most, aging is just like smoking: It’s really bad for you. It shortens your life (see Chapter 14 for an assessment of just how much), it typically makes the last several years of your life rather grim, and it also makes those years pretty hard for your loved ones.

So let’s look a little more closely at why aging is so passionately defended.

image The Motivation for the Pro-Aging Trance

First of all, let me be clear that I realize there’s an immense gulf between people’s attitude to modest postponement of aging and their attitude to the topic of this book, the genuine elimination of aging as a cause of infirmity and death. The anti-aging industry is huge, despite the (shall we say) highly variable ability of its products to do what they say they can do, and that can only be because people are not very happy to see themselves falling apart, or to be seen to be falling apart. Yet, the prospect of eventually being able to combat aging as well as we can currently combat most infectious diseases—essentially to eliminate aging as a cause of death, in other words—strikes terror into most people: Their immediate (and, I must point out, often high-pitched) reaction is to raise the specter of uncontrollable overpopulation, or of dictators living forever, or of only a wealthy elite benefiting, or any of a dozen other concerns.

Now, I’m certainly not saying that these objections are dumb—not at all. We should indeed be considering them as dangers that we should work to preempt by appropriately careful forward planning. No: what shocks me is not that these concerns are raised, but the way they’re raised. People who are totally rational and open to discourse on any other matter approach the topic of defeating aging with a resistance to debate that virtually defies description. The determination with which people work to change the subject, to relegate the conversation to an exchange of witticisms, or simply to cast the opponent of aging as a deluded nincompoop has to be encountered to be believed.

Perhaps you’re wondering whether I’ve forgotten that I’m talking about you here. But understand that I’m not castigating you at all, because my remarks so far have dealt only with the logic of why aging should be fought, and life is not all about logic. There is a very simple reason why so many people defend aging so strongly—a reason that is now invalid, but until quite recently was entirely reasonable. Until recently, no one has had any coherent idea how to defeat aging, so it has been effectively inevitable. And when one is faced with a fate that is as ghastly as aging and about which one can do absolutely nothing, either for oneself or even for others, it makes perfect psychological sense to put it out of one’s mind—to make one’s peace with it, you might say—rather than to spend one’s miserably short life preoccupied by it. The fact that, in order to sustain this state of mind, one has to abandon all semblance of rationality on the subject—and, inevitably, to engage in embarrassingly unreasonable conversational tactics to shore up that irrationality—is a small price to pay.

image A Word About SENS Skepticism

This book is a description of SENS (Strategies for Engineered Negligible Senescence), my “project plan” for defeating aging. I expect that this will be many readers’ first encounter with SENS, but others will have come across it before. In particular, if you have had an interest in life extension for some time, there’s a good chance that you’ve already come across accounts of SENS in the mainstream media. If so, you’ll be well aware that, while many highly credentialed gerontologists have applauded SENS, others have greeted it with strong criticism—even derision. So far in this chapter I have only addressed the flaws in people’s reasons for feeling that the defeat of aging might not be desirable. But in order to ensure that you read this book with real care, and moreover that you then go out and do something to help the anti-aging effort, I also need to make sure that you understand that the defeat of aging is feasible. Therefore, I include here a brief account of where the debate about SENS’s chances of success currently stands.

I must first make sure you appreciate that it is the norm for radical new concepts that receive a lot of attention to arouse a sharp division of opinion among expert commentators. In many cases, the establishment detractors are absolutely right and the upstart new idea really is misguided. Very often, however, the detractors have failed to acquire—even avoided acquiring—a detailed understanding of what they are criticizing and have been driven more by vested interests than by scientific argument. If you are not a scientist you may feel that this is an unfair suggestion, but the intellectual and emotional investment that senior scientists have made in their beliefs is a powerful opponent to objectivity: all scientists acknowledge this problem privately, if not publicly. It has been memorably summarized by a number of the world’s most eminent scientists over the years; for example, the physicist Max Planck observed over eighty years ago that “science advances funeral by funeral,” and the biologist J. B. S. Haldane noted that “there are four stages of acceptance: (i) this is worthless nonsense; (ii) this is an interesting, but perverse point of view; (iii) this is true, but quite unimportant;(iv) I always said so.”

Since I work on aging in order to hasten its defeat, and not in order to become rich and famous, I am extremely keen to identify any major holes in SENS so that, if they indeed exist, I can go back to the drawing board without delay. To this end, I talk to my most prominent biogerontologist critics all the time about SENS. I am invariably driven to the view that they are indeed guilty of reacting to my conclusion (that SENS can totally defeat aging) without studying the reasoning behind that conclusion—but I of course appreciate that I, too, may be unable to be objective in this matter. For this reason, and also because the speed of implementation of SENS depends greatly on both public and academic acceptance that it might work, I have worked hard in recent years to generate unbiased evidence as to whether SENS is sense or nonsense. In 2006, I achieved this rather decisively, with the assistance of the prominent magazine MIT Technology Review. After publishing a rather negative portrayal of SENS in 2005, TR discovered that the mainstream gerontologists on whose opinions it had relied in choosing to do so were unwilling to back up their assessment with any scientific detail. TR then admirably put itself at risk of considerable loss of face by organizing a prize challenge to settle the matter.3

In order to win the SENS Challenge, one or a group of credentialed biologists had to write a demolition of SENS that I was unable to rebut to the satisfaction of a panel of expert judges. The panel of judges had to be demonstrably impartial, of course, with no connection either to me or to my critics, but yet well versed in biotechnology; TR succeeded in appointing a superb five-person panel including the biotech luminary Craig Venter. TR put up $10,000 as a prize, and the Methuselah Foundation contributed the same amount. A group of nine highly credentialed biogerontologists obligingly submitted a coauthored entry, as did two other scientists independently. All three entries were unanimously and emphatically judged to fall decisively short of a demonstration that SENS is not worth trying.

Now, I’m certainly not trying to say that this proves that SENS will indeed deliver the defeat of aging: there’s only one way to answer that, which is to implement it and see what happens. But my critics made the stronger claim that SENS is so implausible that there’s no need to try to implement it. That claim has been incontrovertibly refuted by the SENS Challenge process. So, if you find someone still eager to tell you that SENS is fantasy—especially someone who claims to have expert knowledge in this area—you’ll know, as TR now knows, that asking such people what they think about SENS is a great deal less reliable than asking them what they know about SENS. And after you’ve read this book—especially Part 2—you’ll be equipped to come to your own conclusions.

image Building a Case, Chapter by Chapter

I’m a fighter at heart; I would never have made my peace with aging, however lost the battle seemed. But that’s not the life everyone wants, and I respect that. Thus, I would probably not have written this book if I thought we were still too far from defeating aging to have any real chance of success within the lifetimes of anyone alive today. In the next chapter I’ll describe why aging is, in principle, just as amenable to modulation and eventual elimination as specific diseases are, and how an inappropriate way of looking at aging has led most gerontologists to favor eventual therapeutic approaches that I consider unlikely to bear fruit. Then, Chapter 4 provides an overview of my scheme for defeating aging within (if all goes well) only a few decades. That concludes Part 1 of the book. In Part 2, Chapters 5 through 12 elaborate on the individual components of that scheme. The book concludes with Part 3, a trio of chapters covering what I predict will be the response of society to initial successes in the laboratory a decade or so from now, how the advances of the next few decades will be progressively refined and aging permanently kept at bay, and how you can already help to accelerate that crusade.

Buried inconspicuously in that last paragraph was something that I want to make sure you don’t misinterpret: a tentative time frame. Yes, I consider that if funding is sufficient we have a 50/50 chance of developing technology within about twenty-five to thirty years from now that will, under reasonable assumptions about the rate of subsequent improvements in that technology, allow us to stop people dying of aging at any age—equivalent to the effect of today’s antiretrovirals against HIV. There are three big caveats in that statement, though. The first is that it’s only a 50 percent chance. Any technological prediction as far in the future as twenty-five to thirty years is necessarily very speculative, and if you ask me how soon I think we have a 90 percent chance of defeating aging I wouldn’t even be willing to bet on one hundred years. But I think a 50 percent chance is well worth shooting for—don’t you? The second caveat is that aging won’t be totally defeated by the initial versions of this technology; we’ll have to carry on improving it at a reasonable rate in order to keep aging permanently at bay. I will explain all the details of that in Chapter 14.

But the third caveat is perhaps the most important: the adequacy of research funding. I cofounded the Methuselah Foundation in order to address that problem: at present, the pace of most of the research avenues that we need to pursue in order to combat aging adequately is limited by funding. If you can help to change that—whether by giving money yourself, or by influencing friends, or by writing or broadcasting on the subject—you’ll be making as much difference to the speed with which aging is overcome as if you were doing the science yourself.

There’s a critical point about funding that I must emphasize here: the pivotal role of relatively small amounts of money at this early stage in the crusade. I’ve complained at length in this chapter about people’s reluctance to treat aging as the curse that it is, and I hope I’m making a difference to that attitude by my outreach activities, but realistically I know that most people are going to sustain their pro-aging trance for a while yet, and that will severely limit the availability of either public or commercial funding for life extension research. The point where that will really change—where the global pro-aging trance will collapse like a house of cards—will, in my view, be when middle-aged mice are rejuvenated thoroughly enough to extend their healthy lives by a large amount. This is a milestone that I’ve termed “robust mouse rejuvenation,” or RMR. The amount of money needed to achieve it is tiny compared to how much we’ll then need to spend to get the same result in humans; but when humanity as a whole is behind the effort, willing to pay for it with taxation, there’ll be ample funds available. It’s now, when private philanthropy is the only major source of funding for such work, that the magnitude of that private philanthropy is so critical. I’ll elaborate on this in Chapter 13.

I’ve discussed in this chapter why aging is defended, but I haven’t said much about how—about the common objections to the prospect of indefinite life extension. In many of my writings and public presentations, and on my Web site,4 I do address the many questions that arise concerning how society would be different in a post-aging world, and especially how we would handle the transition to that world. This book does not address those issues in detail; I’ve decided to deal here only with the practicality of radical life extension. I hope you’ll come away with a pretty good understanding that the genuine defeat of aging is a feasible goal. Whether it’s also a desirable goal is a question that you’ll then be able to consider more seriously—even, dare I say it, more responsibly and conscientiously—than you could if you still thought it was science fiction.