At a recent conference appearance, scientist-advocate Aubrey de Grey of the SENS Research Foundation made a point that I think bears repeating. The mainstream approach to medical science is to screen for drug compounds that produce beneficial alterations in cellular mechanisms observed in late stage disease. This almost entirely focuses on proximate causes of harm in a diseased, dysfunctional metabolism, far removed from the root causes that created the medical condition in the first place. It thus produces therapies that do little good in the grand scheme of things since they don't address the real cause of disease. They are rather efforts to make a badly damaged system limp along a little longer with patches and compensations, which is always expensive and doomed to failure, whether we are talking about a mechanical device or a human being.
This strategy for medical research and development must change radically if we are to see meaningful progress towards prevention and cure of age-related disease. It must be replaced with something more like de Grey's SENS programs, in which carefully designed therapies repair specific forms of cell and tissue damage to achieve rejuvenation. The form of these therapies is already known in great detail; it is clear what must be built. Some are already under development, such as senescent cell clearance and allotopic expression of mitochondrial genes. This is the future of medicine, not continuing to mine the natural world in the hope of finding compounds that do marginally more good than harm, and can at best only slightly slow down the aging process.
de Grey attributed the gains in longevity over the last century to one primary factor - the reduction of infectious diseases. With infectious diseases largely gone in the developed world, he said we need to turn our attention to the main cause of death. "There's almost one thing that kills everybody now in the developed world. It's the accumulation of these various types of molecular and cellular damage that the body does to itself as a side effect of just being alive at all." According to his research and theories, that molecular and cellular damage can be repaired with new regenerative medicines, including stem cell therapies, gene therapies, drugs and vaccines.
de Grey challenged the wisdom of modern pharmaceutical research leading to really expensive drugs that delay diseases by very short periods of time. "We will not cure cancer this way. We will not cure Alzheimer's this way." The incentive structure for modern pharmaceuticals perpetuates this because "it can be done reasonably quickly, sold for a lot of money and because people are desperate for anything."
"I think it's really important to understand that the relationship between quality of life and quantity of life is not as most people think about it. Today most people think about those two things as some kind of trade off, and that makes sense today because there are many things we like doing that are not very good for us. But we are talking about a world in which quality will confer quantity, in which you will live longer because you are living better. That's the critical thing here."