'Longevity' Could Reach Billions In 2019 - And Is No Longer Just The Preserve of Billionaires

At-home DNA testing kits were one of the most fashionable Christmas gifts this year. And with companies like AncestryDNA, MyHeritage, and 23andMe offering kits for as little as £75 - less than the cost of the latest Amazon Echo – it is no wonder they appeal to those with the curiosity to know the most intimate information on themselves and their families.

While DNA testing has reached the mainstream, it is only 15 years since the official completion of the Human Genome Project and the publication of the first genome sequence at a cost of over $3 billion.

But DNA analysis has far more implications for humanity than understanding our genealogical roots or risk of disease. The vast global DNA library resulting from mass genomic profiling is helping us understand how we could extend “longevity”, that is living younger and healthier for longer. It also means the search for the elixir of youth may no longer be the preserve of billionaires but instead be accessible to billions.

There is serious money to be made here. The 50+ market is the third largest after China and the U.S., a key message from advisors at a recent investors event in London hosted by Julius Baer, the Swiss private banking group. Investors may be uninspired by addressing the familiar problems of an aging population like mobility scooters and care homes but are excited by the products and services that people will buy to help keep them young. New areas like “femtech“- technologies to promote vitality in women, especially those in the menopause – will be the next big thing. For example, Nicole Shanahan recently invested in a center for female reproductive longevity and equality at the Buck Institute for Research on Aging.

The stats reinforce this. A recent report by the Milken Institute, Silver to Gold,  states that those 50 and over own nearly three-quarters of all financial assets and  spending by age 60 + adults globally will reach $15 trillion by 2020. In the U.S. alone, the over 50s spend almost half of all vacation dollars, account for 80 percent of luxury travel, and purchase more new cars than other age groups.

But healthier aging will also benefit the younger generations if the dividends of longevity can be shared across all age groups in society. Until now, lofty “moonshot” ideas have propagated a longevity industry dominated by cultish Silicon Valley entrepreneurs like Peter Diamandis. But more recently, dramatic developments in our understanding of genomics and the interplay between genes and the environment (including lifestyle, nutrition, fitness and microbiome) are revealing the truth about aging.

With the cost of genetic sequencing coming down to levels of $100 per person (compared to £10,000 only a few years ago), decoding our DNA to understand aging is not only driving many entrepreneurial ambitions but also big plans in the public sector. In the U.K. for example, the   100,000 Genomes Project was recently expanded to allow 1 million whole genomes to be sequenced by the NHS and UK Biobank in five years, with the ambition to have 5 million people agreeing to have their genomes sequenced in the next 5 years – to help U.K. citizens live longer and better as a result of the insights gained from the data.

And data is king – especially in a world that will be increasingly driven by artificial intelligence that relies on data to develop its algorithms. Each human genome generates 200 gigabytes of data (more than 40,000 times the complete works of Shakespeare), and this data is particularly valuable especially to pharma companies who risk being disrupted by newer, more agile firms like 23andMe, which recently partnered with GSK, and Insilico Medicine, a global  leader in pharmaceutical artificial intelligence. Insilico Medicine has partnered with many pharma companies including  Juvenescence and GSK, and is now breaking new ground to predict biological age using biological markers (“aging clocks”) in a number of areas –  including the microbiological profiles of gut microbiota to elucidate how the microbiome is implicated in the aging process. Their many deep learning aging clocks are already available for public testing at Young.AI and can be used to track the predicted biological age using multiple data types.

The hard science goes like this. Scientists, entrepreneurs and philanthropists are now re-thinking aging and our assumptions that chronic diseases – like arthritis – are the inevitable by-products of aging. The latest research unlocking the cellular basis of aging shows that we can prevent or slow down chronic diseases. Aubrey De Grey, the maverick bio-engineer who pioneered rejuvenation medicine, argues that aging is just a set of accumulated side effects from metabolism that eventually kills us off, and so we need strategies to minimize cellular death, improve the rate of repair and/or stop mutations going awry (as with cancer) to stay younger for longer.

Intriguing possibilities are emerging. Old drugs like rapamycin (used to prevent organ transplant rejection) and metformin (a gold standard in diabetes management to control blood sugar) are finding new uses to delay aging. Over 100 new drugs have also been found to extend lifespans of mice, with specific “senolytic” drug cocktails, for example, combining dasatinib (used to treat leukaemia), and quercetin (a plant chemical often found in red wine and kale), shown to kill off senescent cells. Unity Biotechnology, a company specializing in development of senolytics recently completed a successful IPO and the results of the clinical trials will soon show the effects of this new class of “geroprotectors” in humans.

This quest for drugs to extend longevity is not confined to big companies focused on keeping their shareholders happy. In 2018 several start-ups came out of the stealth mode including the Harvard spin-off Elevian, a company targeting age-related muscle wasting and another company with the ties to Harvard, Life  Biosciences working as an accelerator for multiple longevity-oriented subsidiaries.

A recent call by Y-Combinator focusing on longevity means that we will see a plethora of young start-ups coming through in 2019. Increasing number of venture funds, holding companies and venture funds including Juvenescence, Apollo Ventures, Longevity Vision Fund, Life Biosciences, Deep Knowledge Ventures and Longevity Fund are funding and incubating a large number of promising companies in the longevity space.

But a key trend with these start-ups is that many have literally gone out “to the people”. LunaDNA, for example, is aiming to “democratize genomics” through its community-owned platform and Longenesis is applying artificial intelligence and blockchain technology to help companies and biobanks to enable individuals to store, manage, and control access to the many types of life data in a secure environment. George Church, Harvard geneticist and co-founder of Nebula Genomics, which utilizes the Longenesis platform  to enable customers to profit directly from their own genomes through control of their data, says in a recent interview: “right now, genome sequencing is like the internet back in the late 1980s. It was there, but no one was using it. Then the first browser came and commerce started – it was the tipping point.”

The “people first” approach of these start-ups could disrupt the business models of established industries, especially in pharmaceuticals and financial services. Pharma is not the only industry scrambling to work out what longevity will mean to its business model. While pharma has profited hugely from the chronic disease epidemic, pension funds and institutional investors are equally reliant on a business model based on people dying earlier than later and keeping data within their own four, siloed walls. Insurance companies stand to gain by encouraging people to live healthier for longer and are (very belatedly) starting to enter the longevity debate.

The impact of demographic change is already underway, from the healthcare system to the world of work. There are 10 million people in the U.K. today who will live to be 100 and the Office of National Statistics forecasts that one in four people will be aged 65 years and over by 2037  (compared to 1 in 5 currently). By 2066 there could be an additional 8.6 million people aged 65 years and over in the U.K. – a population roughly the size of present-day London. This would take the U.K.’s 65 years and over age group to 20.4 million people.

The potential problems are obvious – in social care, healthcare, transport, pensions and housing – but if we get it right our longer working lives, coupled with the growing population, could increase the size and productive capacity of the U.K.’s workforce (for example, the government believes that if employment among 50- to 64-year-olds matched that of people aged 35 to 49, GDP would increase by 5%). Macroeconomic studies show that increasing productive longevity will benefit the economy and may lead to the unprecedented increases in economic growth.

Of course there are many issues facing older people – such as isolation and restricted mobility – but there are also many opportunities. For example, the U.K. government’s Industrial Strategy Grand Challenge for the Aging Society is investing £300 million to encourage industry to create a new marketplace for products and services harnessing technology to support us as we live longer.

We have to choose which direction we want to take. In Japan,  which has embraced new technology to help care for its elderly citizens, the potential damage to society when robots become the default carer in the absence of humans is a risk to be avoided. However, there are alternatives in which technology can support families in more positive, community-centered ways, as seen in the press recently with the Albert Scurfield’s family, where 3 generations and 14 family members used technology to care for Albert, 81, who otherwise would have been consigned to a care home at a cost to the state of £50,000.

We need more ethical innovation like this that protects humanity, across science, health and care and financial services – and a blueprint to guide the burgeoning longevity industry, lobbying for large-scale investments and regulatory changes needed to reap the “longevity dividend” for all of society to benefit from. As part of this we need the ingenuity of scientists to continue innovating in aging research but also the imagination of leaders in big industry sectors – and especially pensions and insurance – to develop products and services that incentivize people to live healthier, longer lives too.