Fight Aging!

The effective altruism movement is a good example of the sort of thing that can only arise in the modern information-rich environment of easily available data and cheap communication. It is half a reaction against the waste, fraud, and general ineffectiveness that characterizes all too much large-scale philanthropy, and half a chance to meaningfully reexamine what everyday philanthropy can look like in an age of greater communication and knowledge. It is easy to salve the conscience by donating to a group that one believes are going to do good, and most people go no further than this. That allows charities to become inefficient and self-serving, and in the worst cases results in organizations that have become symbiotic with the problem they are allegedly solving, and supporting them actually makes matters worse. Is it possible, with minimal additional effort, to do better than feeling good as an individual and actually donate in ways that achieve good in the world? The effective altruists would like to pave the way to make that possible for everyone.

When it comes to human aging, one doesn't have to run the numbers all that rigorously to determine that more suffering and death is produced by aging than by any other single cause. Aging is something like 600 times worse than malaria for the human race, for example, when only considering mortality. It is probably worse than that when also considering disability and duration of suffering. From the point of view of whether or not something is a glaring problem that we should all devote a little time to helping with, it doesn't much matter whether aging is 100 or 1000 times worse than malaria: either case should be a clarion call to action. Yet people don't think much on the topic of doing something about aging, even though most are generally supportive of research into treatments for specific manifestations of age-related disease.

I suspect that most people who debate the numbers are somewhat skeptical of the prospect for increasing human life span. Near all modern medicine for age-related diseases introduced over recent decades produces gains of just a few years of additional life expectancy at most. Exercise does just as well, spread over a lifespan. When the choice is between spending funds to gain a few years for older people or spending funds to improve quality of life for younger people, the philanthropic institutions of the world have tended to bias strongly towards the latter option. Fair enough. But the technology has advanced. It is no longer about determinedly wrestling with the inexorable damage of aging to gain a few extra months of life expectancy for someone with a low quality of life. Rejuvenation therapies will produce large and ever-increasing gains in health and life expectancy for older individuals, where "large" will soon enough mean additional decades of healthy life.

Still, comparatively few lines of research into human aging and longevity have the prospect of leading to rejuvenation. Many are marginal. So effective altruism aimed at bringing aging under medical control and producing very large gains in life span depends upon effective research and development. This means choosing the right strategies to support, those based on repairing the damage that causes aging, rather than those that try to paper over or compensate for the damage in some way. It is very hard to keep a damaged machine running when repair is not on the table, and this has been well demonstrated in medical progress and practice over the second half of the 20th century. Gains were small and hard-won, precisely because the wrong strategies were applied to the treatment of aging. Researchers attempted to treat the end stage symptoms rather than repairing the cell and tissue damage that lies at the root of all age-related disease.

These two articles from groups considering the reinvention of philanthropy are interesting to contrast on this basis. One sees the potential for very large gains in life span, and a control over disease and disability, while the other does not. Evidently, this makes a large difference to the calculus of efficiency when considering whether or not to support research into human aging.

A general framework for evaluating aging research. Part 1: reasoning with Longevity Escape Velocity

Longevity Escape Velocity (LEV) is the minimum rate of medical progress such that individual life expectancy is raised by at least one year per year if medical interventions are used. This does not refer to life expectancy at birth; it refers to life expectancy calculated from a person's statistical risk of dying at any given time. This is equivalent to saying that a person's expected future lifetime remains constant despite the passing years. It's possible, given sufficient ongoing improvement of medicine and its democratisation, that nearly everyone on the planet, at a certain date in the future, will benefit from therapies that allow Longevity Escape Velocity to be attained, at least until aging is eradicated completely.

If a given intervention "saves a life", this usually means that it averts 30 to 80 Disability-Adjusted Life Years (DALYs). This figure comes up from the remaining life expectancy of the recipients of the intervention. In order to evaluate the impact of aging research, one could be tempted to try to estimate how many end-of-life DALYs that a possible intervention resulting from the research could save and adjust the number using the probability of success of the research.

This line of reasoning is part of the impact, and it has to be factored in, but it doesn't consider where the largest impact of aging research is: making the date of Longevity Escape Velocity come closer. This would have the effect of saving many lives from death due to age-related decline and disease, but here, "a life" means, more or less, 1000 Quality-Adjusted Life Years (QALYs). The average lifespan of a person who reached LEV will be around 1000 years, mostly without disability, as 1/1000 is more or less the current risk of death of someone between 20 and 30 years old.

Open Philanthropy: Mechanisms of Aging

We are highly uncertain about, and do not have internal consensus regarding, the potential extension in healthy lifespan that might result if one or two of the present major objectives in anti-aging research were accomplished. Some of us see several years of healthy life extension as the plausible potential upside and others see larger possible gains, but all of us involved in creating this report expect that any increase in healthy lifespan would keep average lifespan within the range of natural lifespans observed in humans today (barring a historically exceptional increase in the rate of scientific progress).

We think the best case for this cause involves the prospect of healthy life extension within the range that some humans currently live. In contrast, some people who are interested in the mechanisms of aging have promoted the idea of "curing" aging entirely. Our default view is that death and impairment from "normal aging" are undesirable. However, we would have some concerns about indefinite life extension, mainly related to entrenchment of power and culture. We don't have internal consensus on whether, and to what extent, such indefinite life extension would be desirable, and don't consider it highly relevant to this write-up. We don't see promising life science research that would result in indefinite life extension in the next few decades, barring a historically exceptional increase in the rate of scientific progress.

Our program officer offers the following forecast to make the above more precise/accountable: By January 1, 2067, there will be no collection of medical interventions for adults that are healthy apart from normal aging, which, according to conventional wisdom in the medical community, have been shown to increase the average lifespan of such adults by at least 25 years, compared with not taking the interventions.