After a short pause, the Foresight Biotech and Health Extension Group sponsored by 100 Plus Capital reconvened on the second Thursday of the month to start this year’s program together, announce the 2021 Foresight Fellows, recap what happened in 2020 and discuss potential high-impact areas, plans and accelerator opportunities in 2021. Another announcement made was that to further improve upon the actionability of the group, this year’s program will be a little bit different. In the first half of the year, we will focus on identifying the biggest opportunities, and bottlenecks in the industry. The second half of 2021 will focus on an accelerator for actual ideas and projects that will try to act on the identified opportunities and goals. Connected to that is the possibility of a grant and a follow-up investment from partners in December 2021.
The 2021 program, mentors, potential focus areas, and application can be found on our keynote program.
Longevity network building and high-level agenda setting
- Picking up the network pace in 2021: The longevity industry saw impressive progress in 2020, bringing together quite a large number of people in science, industry, and policy. In 2021 we could strive to get longevity even more attention from those high up the relevant decision-makers, such as Anthony Fauci or Joe Biden. There have been statements from the Biden admin on wanting to overcome cancer and Alzheimer’s. A good question to ask is: “What coalitions would you call on to advance progress and what would you ask them to do?”
- Devising actionable longevity progress roadmap: Assemble a top 10 list of things that the government, FDA, other crucial actors can do to help longevity science move forward, to be circulated by the group in relevant contexts. This list would specify concrete needs, and for each need propose potential small step but high-impact actions for the relevant actors. For instance, for recognizing aging as a disease, who needs to do what to make it happen.
- Creating a coalition with coherently articulated ends and means: Do for aging what CRA does for computer research. Create a coalition that: 1) continually assesses where we are today with longevity research, 2) where we would like to be in various timeframes, and 3) identify the key public and private members of the community and the actions they need to take in order for the field to get where we want to be.
An example of something we would like to see happen is that the NIA should have a larger budget, that is not specifically allocated to Alzheimer’s but fund both fundamental and translational geroscience research. First, we need to ask: “What has to happen in order for the budget increase to happen?” Based on that we need to figure out who needs to come together, and tell them with some level of specificity what it is that we want those individuals and organizations to do. And make it as easy as possible for them to do it. Example action is telling a specific person: “I want you to send an email saying this and that to this member of that cabinet.”
- Boarding the COVID-19 related longevity advocacy boat: We haven’t missed the boat yet for pointing out the connection between aging and COVID-19. The main challenge will come after the pandemic, when longevity advocates will need to convince policymakers that rejuvenating the immune system is the right prevention for the next pandemic (after the focus shifts to the next pandemic when the current pandemic is under control and waning off). There might also be a second potential boat and communication angle, if we find that the mRNA vaccine immunization works worse in the elderly.
- Working together with partners on issues aligned with the longevity crusade: Figure out how we can align the longevity movement with other interest and philanthropic groups, and work towards the same goal. An example of a problem with many potential synergies is the problem of cutting-edge technologies that are in dire need of FDA regulation streamlining. Example of FDA Reform proposal by Dan Elton.
Issues with clinical trials and data collected
- Pushing for standardization and validation of biomarkers: The regulatory process is still a major bottleneck. While there may be aging reviewers at the FDA that could be interested in healthspan improvement, a clear measurement via biomarkers to get solid clinical data is key. Unfortunately, recent promising aging-relevant projects such as resTORbio’s drug candidate failed FDA review. Finding a common language with the government agencies needs to be an important part of the longevity advocacy strategy.
- Finding novel ways to accelerate trials: Push to get better-targeted studies by creating a prototype of how to share open data in an accessible way, which could serve as a foundation for finding new hypotheses to run more trials on. A few decentralized projects such as Trustee already provide privacy-preserving platforms for aggregating data from personal healthcare records.
- Rethinking use frameworks for patient data: NHS in the UK already has standardized patient records but the problem is accessing them because of different data packages used to collect them, compatibility between systems, and privacy concerns.
General industry opportunities
- Avoiding market failure of low cost measures: Avoid that technology-focus leads to overlooking affordable and available cost-effective interventions that can already have a significant effect on healthpsan.
- Finding a bottom-up way to change the system: Make a solution so valuable and intuitive to understand that the public starts to push for fast-tracking it. Like the COVID-19 detection system utilizing smartphone audio detection used by the NBA. Find something similar for aging – so obviously better than anything else that everyone puts pressure on the system to put it to use as quickly as possible.
- Evaluating systemic versus divide and conquer approach: Are we looking for a health extending technology that’s systemic, or for something that’s repairing things on a piece by piece basis? Systemic promise of senolytics might have been one reason for the current hype, even though we don’t have strong data in humans yet. Need better and standardized biomarkers and measurement methods to compare progress.
In-group community actionables
- Making the community global rather than local: The group shouldn’t focus just on the US and work more internationally, as there are initiatives that can serve as potential role models across countries. Case in point is the UK, where the House of Lords published a report recommending tackling aging as the cause of aging-related diseases rather than individual diseases.
- Nurturing serendipity and silo cross-pollination: It would be great to be able to meet in person again. Before that, expand on virtual membership profiles and collaboration documents.
- Starting a fund or a network of funds targeting more clinical data: Expand the network of funders, perhaps even start a new funding structure in which group members can pool their investments.Potentially focused on supporting clinical trials for new proxy disease for aging, which seems to be one of the main bottlenecks at the moment.