Fight Aging!

We are fairly close to the existence of the first meaningful treatments for aging, therapies that align with the SENS approach of repairing the fundamental forms of damage in tissues and cells that cause aging. From the speculative list I put forward a year or two ago, we could look at the first item, removal of senescent cells. Nothing much would have to change about research funding or current directions for a therapy based on targeted removal of senescent cells to be entering human clinical trials in the mid 2020s. That therapy will be aimed at one specific age-related condition, not aging itself, because that is how medical regulation works: it is illegal to try to treat aging, there is no path to gain approval to treat aging, and so any promising technology is sidelined into use as a late stage treatment for people who are especially sick. Which is to say they are damaged enough by aging, and manifest one of its outcomes to a large enough degree that we give it a name and call it a disease or a condition. Whereupon it becomes legal to try to treat just that one facet of aging - or at least to try to convince regulators you should be allowed to treat it. Everyone who is damaged by aging to a lesser degree is called healthy and denied access to therapies.

This world of ours is packed with iniquity, unfairness, and stupidity, but the organization of medical regulation is of particular note. So, I'd predict that by 2025 there will probably exist a treatment for removal of senescent cells that would be of benefit to everyone much over the age of 30. However, it will be highly restricted - essentially illegal for use, illegal to provide to people, and illegal to aid people in using it. That is the state of the law for any advanced medical technology not approved by the FDA.

Now consider the way in which research and the clinical application of stem cell treatments has progressed over the past decade. Medical tourism emerged even in the comparatively early days, as soon as the trend towards greater reliability and lower cost for stem cell transplants started in earnest. Many clinics of varying levels of sophistication outside the US have for years offered procedures that until comparatively recently remained forbidden and illegal within the US. I'd judge that it was largely the existence of that growing market that pressured the FDA into allowing the use of these technologies - long years after they became available elsewhere. FDA leaders operate under incentives that don't align with yours: they are driven by how much public disfavor they receive, which means approving as few new technologies as possible, as they are blamed for any consequences, until such time as being a roadblock earns more disfavor than letting things through. Quality of medicine and any other declared aims of the organization are somewhat lower in the decision tree. You can look at the rapidly increasing cost of regulatory compliance, capricious demands placed on developers, and the falling number of approvals for technologies, drugs, and so forth as evidence for this viewpoint.

Given how things went for stem cells, it will be interesting to see what will happen in the case of legitimate treatments for aging that we would expect to lengthen human life in every recipient, but which are only available for the most damaged and closest to death. By 2025 we will know how much senescent cell removal lengthens life in rodents, but it will be speculation as to what exactly the benefit is for people in the long term: short term biomarker changes will be measured and found to be supportive of the idea that the treatment is improving health and turning back metabolic metrics of biological age, but that still doesn't say much about what the outcome is at the end of the day. Improvement in health is expected, but I think that the current view of SENS is that only complete implementation should be expected to radically lengthen life.

Still, imagine the availability of a "stem cell treatment for everyone" that would benefit you just as much as the stem cell transplants of five to ten years ago were of benefit to victims of heart disease. This will happen, and comparatively soon. It might be worth considering how to accelerate the wave, or use it to gain greater funding and interest for the other lines of SENS research aimed at human rejuvenation.