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Fighting aging as effective altruism

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Ageing is the main cause of suffering but could be delayed by simple interventions which are not yet properly tested.

Publié dans : Santé
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Fighting aging as effective altruism

  1. 1. Fighting aging as effective altruism Alexey Turchin
  2. 2. 1. What is effective altruism • Doing good better • Cost-effectiveness • Act remotely, not locally • Malaria bed-nets case
  3. 3. 2. Aging is the main cause of suffering • Social problems • Physical sufferings • Death
  4. 4. 2.1.Social impact of aging • Old population is growing • Economic burden of ALZ • Over-stretched pension funds • Increase in the old-age dependency ratio
  5. 5. 2.2. Aging as a major cause of human suffering • There are more old people than poor people now • Aging is associated with illness • Peak of quality of life at 18, followed by decline (Easterlin, 2006).
  6. 6. 2.3. Aging is the main cause of death in the world • If there will be no age-related diseases, humans will live thousands years. • Gompertz curve of mortality is hyper-exponential (for total death probability). • Cancer, ALZ, heart diseases grow with age.
  7. 7. 3. The badness of death
  8. 8. 3.1. Negative utility of death in preference utilitarianism • How to calculate good? Pain or values. • Humans prefer not to die. • Non-exsitence as sufferings.
  9. 9. 3.2. Death of investor paradox • If we calculate utility as “money x time”, death should be taken into account • Better to live longer than to be reacher • Discount rate should be taken into account
  10. 10. 3.3. Willingness to pay as a measure of the preference not to die • The willingness of people not to die could be indirectly estimated by their willingness to pay for expensive cures or risk reduction. • It was estimated that humans are ready to pay between $100K-400K for QALY, that is only for one year while the median household income only $37,000 • US citizens in 1997 valued one year of their life 3–10 times more than the wellbeing of the whole family for the same period. • it equates to 9–30 years of economic wellbeing being equal to one additional year of life.
  11. 11. 3.4. Reasons why death is bad • Death is the end of everything. • Non-existence itself is known to create existential fear. • The moments before death are often the most emotionally and physically painful. • Death means that a person can't finish his projects. • Death is the loss of the information. • Death is unpredictable in both time and form. • Deaths of relatives create intense, long-term emotional suffering. • Death in the 21st century is an enormous opportunity cost.
  12. 12. 3.5. False arguments against badness of death • “Bad immortality”. • Overpopulation. • Stagnation, infinite totalitarianism, or other bad social outcomes. • Stopping death takes opportunity from non-born people, who would be born if resources were freed up by death of aging humans. • Death can’t be experienced, so it can’t be bad. This is so-called Epicurean conjecture. • Death is needed to bring “meaning” to human lives. • Torture is worse than death. • Most people believe, or at least hope, that there is some form of afterlife.
  13. 13. 3.6. Life expectancy is the best measure of cost-effectiveness, not QALY • “Healthy aging” doesn’t take into account “longevity escape velocity” • We could survive until immortality, if we survive until superintelligent AI. • It could appear in the 21 century.
  14. 14. 4. Aging could be slowed down by simple interventions
  15. 15. 4.1. Aging could be slowed down by simple interventions • Aging has been slowed down on animals by simple interventions • Negligibly senescent animals exist, like the naked mole rat • But we can’t know how the geroprotector experimental data would transfer to humans, without experiments with human participants • There are around 1000s potential geroprotectors
  16. 16. 4.2. Problems with clinical trials of antiaging therapies on humans • Such tests will take a very long time, because humans have long life spans. • Research on the aging of humans is difficult because aging is not considered a disease under WHO classification. • Many promising geroprotector candidates (drugs slowing aging) can’t be patented • There was an idea that extending human life is immoral even among gerontologists • The field is a case of market failure: despite large demand, only a small percentage of money is going into actual research. • Problem of will: Many interventions, which are known to slow down aging, and generally improve health, are not implemented by the majority of the population. • Need for highest safety, as antiaging treatment will be applied to healthy middle-aged people before the onset of age-related diseases
  17. 17. 4.3. Total research budgets on the fundamental problem of aging are small• The biggest player here is the National Institute of Aging in the US, with a budget of 1.2 billion USD annually • The next-largest player is Google’s Calico, with (not annual) funding of 500 million USD total. • All other players combined have smaller budgets, including the famous SENS by Grey, which in 2015, had a budget of around 4 million USD per year • If we exclude age-related diseases, the total budget on fundamental research on aging could be estimated at an order of magnitude of 100 million USD in 2015. • $25 billions for chewing gum
  18. 18. 4.4. Simple interventions criteria We could identify criteria of simple cost-effective interventions for life extension: 1) They are already implemented by large group of healthy adults on non-prescription basis, and cohort studies support their effects on life extension. 2) They are cheap enough to be bought by almost everyone. 3) They are easy to implement, without requirement of enormous will. 4) They could be quickly implemented globally without overstretching limited supplies of some types of resources, so billions of people could have access to it.
  19. 19. 4.5. Simple interventions types • Limiting smoking. • Mediterranean diet with large amount of fish and olive oil. • Physical activity. • Limiting sugar consumption. • Vitamin D. • Ten cups a day of green tea. • Red hot chili pepper lower mortality to 0.87 of control • Metformin • Enalapril reduce all-cause mortality to 0.87 • Aspirin addition after 50 could add 0.28 years of life expectancy
  20. 20. 5.1. TAME study of metformin is example of icebreaker study • Based on crowdfunding • Needs 65 mln USD • Double Blind Randomized Placebo Controlled Trial • 18 Month Recruitment • Range of Follow-up Times: 37-54 months
  21. 21. 5.2. TAME expected effects • Lower mortality to 0.9 which translates into 1 year of life expectancy • 10 per cent more people will survive until 2100 from old cohort who take the drug • If the size of the old cohort who take the drug is 2.5 billion, 250 millions more people will survive until 2100. • Each year of the delay of implementation means around 3 million less people will survive until 2100. • If TAME successful, spending 60 mln USD will save 250 mln people, which price for saved live = 0.24USD • The nearest competitor is malaria bed nets with 1500 USD for 1 saved live.
  22. 22. 5.3. TAME as icebraker • TAME study could fail • Biggest impact is the precedent • However, for 2 years they can’t start • Crowdfunding failed
  23. 23. lifespan.io • Crowdfunding platform for cheap tests on mice • Medium costs is 20-50.000 USD • Several successful trials
  24. 24. Open Longevity Clinical trials funded by patients • Openness of the research: the results belong to society, so there is no file drawer effect • Non-commercial approach: the measure of the result is life extension and the improvement of the biomarkers of aging, rather than commercial benefits. • Cost reduction due to the fact that experiments are conducted at the expense of the volunteers themselves. • Testing of simple interventions which are proven to have low level of side effects makes it possible to simplify experiments and remove the very expensive part: payments to clinics which organize clinical trials. • Collective activity increases motivation for some interventions, like sport • Acceleration of studies due to the world's first diagnostic panel of aging, which allows to shorten the time of the experiments • Potential exponential scalability of the project, which will lead to an increase in the number of experiments, improving their quality and attracting large donations. • Experiment participants benefit from the tests and enjoy the experiments, thus getting positive utility • The personal data collection system motivates the competition for rejuvenation, and also leads to the integration of experiments with future AI systems • Easiness to participate. People can join Open Longevity remotely by providing their data online. • A group of patients can promote needed regulations, like gay community did in 1980s for acceleration of research in AIDS.
  25. 25. Open Longevity The “Longevity School” in Montenegro organized by Open Longevity in 2017 was the first viable test of this approach.