SENS, the Strategies for Engineered Negligible Senescence is a disruptive research and advocacy program that aims to build the foundations of rejuvenation treatments over the next few decades. It is the logical extension of the discovery over the past century of which forms of cellular and molecular damage characterize old tissues, and thus can be defensibly theorized to be the cause of aging. The key realization at the core of SENS is that researchers can work towards effective treatments for aging by repairing this damage even when they don't fully understand all the complex, intricate nuances of the progression from undamaged to damaged. To draw an analogy, you don't need a full molecular-scale model of rust progression to be able to effectively maintain metal structures: paint, oil, and regular inspection suffices. The knowledge necessary is much less encompassing and the costs much lower than those required to develop that full molecular-scale model.
So it is with aging, except vastly more complicated as a matter of research and development than dealing with rust on metal. We should expect it to cost a fantastic amount of money and time to develop a full understanding of aging, and the achievement of that goal lies a long way in the future. Meanwhile, repairing the damage we know about is a very viable large research program, something that could be brought to fruition at a cost of a billion dollars and ten to twenty years if all went much as expected.
SENS initiatives have nowhere near a billion dollars in funding at the present time. They are mostly coordinated by the fairly young SENS Research Foundation, with an annual budget that has grown to a little more than $4M, and include conferences that have been held every other year for more than a decade now. These events are attended by a range of noteworthy scientists from numerous fields of medical research, and the materials presented are always interesting.
The sixth conference was held at the end of last year, and as is usually the case it takes some months for videos of the presentations to be processed and uploaded to the SENS Research Foundation YouTube channel. I noted more presentations this year focused on the logistics of actually getting treatments to market, and it might be taken as an encouraging sign that more people think that it is worth spending time on planning at this stage. Two videos of interest are linked below, but there are a good fifty or so presentations to look through, so take some time and browse.
A number of compounds are known to have some anti-aging effects, reducing the rate of aging or extending the lifespan in animals and probably in humans. At the same time, these drugs are not widely marketed to the general public as cures against aging, which probably causes unnecessary losses of healthy life years for many people.
Health experts blame the international legal framework, which only allows registering drugs against certain diseases. This refers to Food and Drug Administration in the United States, and other national agencies which all follow the World Health Organization's guidelines for drug registration. As a result, some geroprotective substances are registered as either drugs against certain diseases (for example, diabetes) or food supplements.
One of the reasons named for this situation is that aging is not in the official list of diseases in the International Classification of Diseases. At the same time, there is a number of conditions which are not considered as diseases, like pregnancy, but there are medicines which are prescribed for these conditions.
Another problem is that most anti-aging drugs and therapies are supposed to have preventive rather than treating effects for a broad spectrum of diseases, and it would take long and expensive clinical trials to justify their beneficial effects. Registering geroprotective substances as medicines for more than one disease seems to be a workable solution. However, geroprotective effects can be more pronounced for some conditions, and much smaller for others, which would make it difficult for them to compete with drugs targeting specific diseases.
Another option is to promote the inclusion of aging into the official disease classifications which would require coordinated advocacy efforts at the global level. Alternatively, conditional registration of new drugs and therapies to cure and prevent aging should be developed and promoted. In any case, a system for testing drugs and therapies to cure aging effectiveness should be established.
In sum, the most promising strategies to ensure registration of new drugs and therapies to cure aging are: advocacy for acknowledging age related conditions like sarcopenia as treatable diseases; international lobbying to acknowledge aging as a treatable and partly preventable condition; promoting legal framework for conditional registration for the drugs and therapies to cure aging.
The productivity of medical innovation has been in decline, and this threatens the commitment of both public and private funders. However, there are both disruptive technologies and disruptive ideas that promise a turnaround. CASMI is exploring both, and developing testable models for change - including new open innovation-based discovery models, adaptive licensing of medicines, the use of real world data in development, and the personalisation of therapy on both genomic and behavioural grounds. With the support of SENS, CASMI is also investigating the translational issues facing cell therapy, so that the highly promising science delivers patient benefit as speedily and affordably as possible.