The field of longevity research, which aims to increase not just lifespan but also healthspan, has received significant investment from tech billionaires and pharmaceutical companies in recent years. While governments have also contributed to this area of study, private funding has far outstripped public funding, leading to debates about the role of governments in supporting fundamental science and the potential consequences of transferring early stage research to private institutions. Essentially, this implies that billionaires are seeking a cure for old age.
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Nir Barzilai specialized in anti-aging science 30 years ago as a hopeful effort. Now, the Israeli-American scientist believes the world is on the verge of converting hope into reality, with the discovery of transformational medications that prevent the effects of aging that were previously thought to be unavoidable, reports Revista de Prensa.
“We are done with hope and promise. We are at the point between having promise and realising it,” says the director of the Institute for Aging Research at New York’s Albert Einstein College of Medicine.
Following a positive UK study of real-world patients, he intends to do a large landmark experiment to see if a low-cost generic diabetes medicine called metformin can increase life by years.
He predicts huge pharmaceutical corporations and biotechs will enter the “longevity” industry if authorities authorize metformin to treat aging. “Once we prove it, I think it will be an earth-shattering moment for everyone,” he says.
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The desire to live forever has been around for centuries, from seeking rejuvenation in a fountain of youth to attempting to achieve immortality through a philosopher’s stone.
While we have yet to find a way to completely escape death, we have learned to postpone it: advances in science, including mundane measures like sewers and vaccines and new medications to combat chronic illnesses like heart disease, have significantly increased life expectancy. In the UK, the average life expectancy at birth almost doubled between 1841 and 2011.
However, as many individuals now experience poor health in their final years, researchers like Barzilai are striving to not only extend lifespan, but also improve healthspan – the number of years we live in good health.
Researchers of longevity, who are not attempting to “cure death,” still believe that their work has the potential to address some of the most pressing issues of our time: rising healthcare costs as the population ages and decreased productivity as people become too ill to work.
However, funding for longevity research is difficult to come by. Barzilai, for example, is still seeking funding for his trial, which could take four or six years and cost $50mn to $75mn. He has currently raised $22mn, including $9mn from the US National Institutes of Health. Healthcare investors typically want to see quick returns, which may not be possible with metformin since its patent has expired, and governments tend to prioritize research on specific diseases.
Tech billionaires like Jeff Bezos, Yuri Milner, and Larry Page and Sergey Brin of Alphabet are filling this gap by funding new models that aim to bring together the best of business and academia without the pressure to achieve short-term returns. Barzilai plans to pitch to some of these investors at an upcoming longevity conference.
While the billions being made available to longevity researchers could potentially be a benefit to humanity, there are concerns that if only wealthy individuals are funding this research, it could create an elite group of “designer elderly,” and widen the gap between the rich and poor in terms of health, wealth, and power. Bioethicist Christopher Wareham of Utrecht University even warns that dictators could potentially extend their lives through these advances.
“Suppose, for example, we had a kind of vaccine for the pandemic of age,” he hypothesised. “This is going to potentially exacerbate all the kinds of existing inequalities that we have . . . The longer you’re around, the more your wealth compounds, and the wealthier you are, the more political influence you have”.
Turning back the biological clock
As the field of longevity research progressed, scientists gathered to ask the most fundamental question: what is aging? In 2013, an influential group defined the “nine hallmarks of aging,” which are the genetic and biochemical processes that lead to impaired function and increased vulnerability to death.
Eric Verdin, CEO of the Buck Institute for Research and Aging in California, explains that scientists have completely changed their perspective on aging, shifting from the idea that it is a passive process (in which the body naturally deteriorates over time) to the belief that it can be modified.
Ultimately, a major breakthrough in this field could simply involve preventing the onset of chronic illnesses that often lead to death. “The biggest risk factor for all diseases is aging – it’s not cholesterol or smoking, it’s your age,” Verdin says.
James Peyer, CEO of Cambrian Biopharma (which incubates and invests in longevity companies), states that the “north star” for this field is the development of a new generation of preventive drugs, which he believes will have a similar impact on human health as vaccines and antibiotics.
Before developing these drugs, scientists must first investigate what is occurring at the cellular level. One significant discovery is that the “biological clock” on cells can be reset using “rejuvenation factors,” which have the potential to reverse disease. Another important finding is that senescent cells (which cease dividing but do not die) accumulate in older individuals and contribute to various health problems. Researchers at the US Mayo Clinic discovered that when they engineered mice to eliminate senescent cells, the animals became healthier and lived 20-30% longer.
However, the bulk of these breakthroughs have so far been made in animals rather than humans. “It’s a great time to be a rich mouse. And you could live for a long time as a rich mouse, but I think we want to have human beings that live healthier,” quips Vijay Pande, general partner at venture capital firm Andreessen Horowitz, which invests in longevity start-up BioAge.
Conducting tests on these hypotheses in humans presents significant challenges. It would be too time-consuming to simply observe whether humans taking a particular drug live longer. Therefore, scientists must identify “biomarkers” – indicators that track the aging process to determine if it slows.
Additionally, researchers must fit their trials into the existing regulatory framework, which does not consider aging a disease. As a result, they must focus on specific diseases, even though they hope the drugs will have broader applications.
Although Barzilai believes metformin has the potential to extend life, his trial will aim to demonstrate that the drug delays the onset of various diseases, including stroke, heart failure, cancer, dementia, and death.
However, the greatest obstacle to this research is securing sufficient funding for large-scale trials, which would accelerate the exploration of factors that influence aging and help identify additional factors.
Funding ‘engines of discovery’
When Rick Klausner was seeking funding for Altos Labs, he approached potential investors with a unique pitch. Instead of presenting them with a list of projects and a timeline of milestones, the former director of the US National Cancer Institute offered to create an “engine of discovery”.
Klausner’s proposal was to hire the most talented professionals in the field, including former GSK Chief Scientific Officer Hal Barron as CEO, and allow them to work on the big questions surrounding rejuvenating cells with the goal of reversing diseases. This approach was successful, as the company raised a record-breaking $3bn in a round led by Arch Venture Partners and reportedly featuring funding from Bezos and Milner, the co-founder of Mail.Ru and founder of tech investment firm DST Global.
The money, according to Barron, will enable them to fail several times in quest of their goal: an “incredibly novel way of thinking” about illness reversal. Pursuing such a “complicated, disruptive idea” will require $3 billion, he adds.
“If you had a typical $60mn or $100mn investment, it wouldn’t really be thoughtful to try to tackle this problem,” he explains.
Altos, which was established in 2022, is currently the most well-known company among the well-funded ventures attempting to advance anti-aging science. The first such company was Calico Life Sciences, an Alphabet company founded in 2013 where Barron used to lead research.
Klausner and Barron criticize the academic funding model for fostering a culture that does not encourage tackling the most significant questions. Rather than placing emphasis on their researchers publishing in top journals or being the first author on a paper, Altos will evaluate them based on whether they are tackling the most challenging problems.
“It’s an experiment, but I think it is an experiment that’s worth all of us committing the rest of our careers to,” Klausner concluded.
Robert Nelsen, co-founder at Arch Venture Partners, stated that the company was only interested in very long-term investors. His group can hold shares in Altos for up to 15 years if necessary, although he believes other investors will recognize the value long before the company achieves its “Holy Grail”.
“If this works, it doesn’t matter if we’ve waited. If you cure disease in my business, you are going to make money,” he says.
Jonathan Lewis, Chief Business Officer at Calico, mentioned that a “chunk of funding” from Alphabet (then known as Google) enabled the company to focus on early biology when it was founded in 2013. Since then, it has received funding from pharmaceutical company AbbVie, with both companies committing to investing $3.5bn after renewing their partnership twice.
The funding is significant for the 275-person organization, but relatively small compared to the market capitalizations of Alphabet ($1.2tn) and AbbVie ($292bn). Calico currently has three potential drugs in early clinical trials.
More traditional venture capitalists are also entering the field, but they tend to focus on companies that are testing broader principles of anti-aging science through specific trials that could potentially result in drugs being developed more quickly. However, this step-by-step approach could be slower, and if the first trial fails, it could potentially jeopardize a company’s larger vision and negatively impact its success.
The ethics of private research
The well-funded new players in the field have sparked debates about whether governments have their scientific priorities in order and the potential consequences of transferring more early stage science to private institutions.
Government funding for this research is increasing, but it still falls far short of the investments made by organizations like Altos. The US National Institutes of Health has an aging division, but the majority of the increase in its budget over the past decade has been allocated to Alzheimer’s research. The UK has started to pay more attention to this area, but the funds are spread thinly – the government’s national research funding body, UK Research and Innovation, spent £2mn establishing 11 networks.
James Wilsdon, Director of the Research on Research Institute at the University of Sheffield, asserts that public funds should be directed towards areas where they can produce more immediate benefits.
“The need is great enough as it is, without then taking on much longer term, more speculative questions,” he says.
He noted that there is a sense that individuals who emphasise the need for “long-termism” are essentially covering up their “individual, narcissistic, selfish desires to find ways of extending their own life as long as possible”. “You can paint as much lipstick on a pig as you want, but it is still a pig of an argument for allocating health funding,” he says.
Wareham, the bioethicist, says we need to get away from the “disturbing image of these kinds of vampire-like billionaires, concocting extension potions and experimenting on themselves,” and realise that even if they are self-interested, they can “afford to make a lot of mistakes,” which governments cannot.
Governments are also contributing to this field in less obvious ways. Lewis praised the UK for establishing the UK Biobank, a database of genetic and health information from 500,000 participants, which has proven so useful that Calico is helping fund additional scans to enhance its understanding of how diseases progress in older adults.
Within the field, some researchers envy their peers who no longer have to constantly apply for funding. Lynne Cox, an associate professor at the University of Oxford who specializes in aging science, spends much of her time “scrambling around for small amounts of money.” Even basic resources like pipettes can be in short supply.
She draws a comparison between this and a coworker who recently joined Altos. “He has the freedom to do science the way science should be done,” she says.
Cox has received funding from Jim Mellon, a former British fund manager who co-founded Juvenescence, a biotech company focused on longevity, and whom she describes as an “ideal donor” who does not excessively oversee her work.
However, others are concerned that private companies engaging in early stage research may restrict access to innovations. While Altos researchers are free to publish their findings and Calico declares itself “pro-publishing,” some suspect that they have less freedom than in academia.
The pharmaceutical industry already closely guards its intellectual property and has been accused of setting drug prices too high. As anti-aging science progresses towards the market, there will be significant ethical questions surrounding how treatments are fairly distributed.
Mehmood Khan, CEO of Hevolution Foundation, a non-profit organization dedicated to longevity research backed by the Saudi royal family which has pledged $1bn in annual investment, stated that their vision is to “extend healthy lifespan for the benefit of all humanity” and ensure that their efforts do not exacerbate the gap in life expectancy between the rich and poor. He added that Hevolution is only funding work that could be “democratized”.
“If this is going to be a gazillion-dollars’ worth of treatment for a handful of people, it is of no interest,” he says.
Altos maintains that it wants to assist as many patients with serious medical needs as possible, and is committed to collaborating with the healthcare ecosystem on access and equity.
Traditionally, governments have been the primary contributors to fundamental science in order to accelerate innovation and encourage broader access, focusing on essential questions that do not directly lead to products.
Ronald Kohanski, Director of the Division of Aging Biology at the US National Institute on Aging, pointed out that while in the Renaissance scientists relied on the financial support of wealthy individuals, in modern times western governments have supported open science.
“Not everybody who was offered the large salaries by Altos went. Some prefer to stay in academia,” he says.
He continues by saying that individuals who receive private funding are not under the same “compulsion” as those who receive government funding to make their findings open and to make any positive outcomes open to everyone.
“If you’re doing something to make money, you’re going to optimise your profit. That’s capitalism in a nutshell,” he says.