Top 10 Wicked Issues in Healthy Longevity: Insights and Solutions
Thank you to everyone who participated in the "10 Wicked Issues" survey. Below is a summary of the results, followed by my analysis and an announcement of an upcoming series of interviews where specialists will join me to address each of these issues in greater depth.
Public & Political Advocacy emerged as the top priority, underscoring the need for a new narrative around aging. Andrew Scott, at the recent ARDD Copenhagen meeting, called for increased funding and attention in this direction. A new narrative is essential to challenge outdated views and highlight the societal value of decoupling biological aging from chronological aging - it’s an essential prerequisite for both investment and policy change.
Gaps in Scientific Knowledge were highly ranked. The question is, which gaps? While we know the hallmarks of aging, there’s still debate about which biological mechanisms are causative versus secondary. For example, are somatic mutations more fundamental, or is mitochondrial dysfunction driving the aging process? This is an area that could spark further surveys and discussions.
Biomarker Convergence was another top priority, and I can see why. As new therapies emerge, reliable biomarkers will be critical for assessing efficacy. Fortunately, there are consortia at work to standardize these. However, with advancing technology, such as the emerging field of proteomics, there’s a need to consider whether these new tools will replace or complement existing methods. Once we have consensus on Aging Biomarkers 1.0, will we just need to start work on Biomarkers 2.0 and beyond?
Innovation Affordability remains a concern, as many of us believe that healthspan solutions, as I like to call them, should be accessible to billions, not just billionaires. Brian Kennedy, speaking in Copenhagen, emphasized the role of billionaires as volunteers for new anti-aging interventions. But I would argue that we need to examine early on, in our assessment of healthspan-improving technologies, their potential for cost reduction over time. This will ensure that progress in our field does not further expand the rich versus poor inequalities that we see in so many branches of healthcare.
I find it interesting that the structuring of Clinical Trials, overcoming Regulatory Issues and the development of consistent, and well-managed networks of healthy longevity clinics come lower on the list. But of course, if we could solve all of them, we would have the means to scientifically establish what works and what doesn’t—so maybe they belong together. And without robust trials, reimbursement by public systems is a pipe dream.
At the bottom of the league was Data Science & Personalization, though I personally believe that personalisation will turn out to be the biggest challenge in the field, and AI and data science will prove critical to achieving it. The aging process is, in many ways, unique to each individual. It’s a classic n=1 phenomenon, affected by everything from the environment in the womb to what we had for breakfast. How to bridge between science that inevitably looks at large groups of people, for example of clinical trial subjects, and what is happening with each of us individually, and what makes most difference for each of us? I just spoke to Jamie Heywood of Alden Scientific, which is actively exploring this area, and it will be exciting to follow their progress.
Introducing the upcoming specialist interview series
I’m excited to announce a new series of 15-minute interviews, where I’ll invite specialists from academia, the private sector, and government to - amongst other topics - dive deeper into these 10 Wicked Issues. This series will provide actionable insights and real-world strategies for advancing healthy longevity, while engaging with diverse perspectives to shape the future of this field.
I encourage you to share your comments on the 10 Wicked Issues and any additional questions you’d like us to address in the interviews. Have ideas for what’s missing or want to ask our experts something specific? Your input is invaluable as we shape this series.
Best regards
Richard
