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The Yuan: Adding Years to Life and Life to Years

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Calum Chase in "The Yuan" here.

Becoming a workaholic seems to be an occupational hazard among longevity researchers and advocates. A few weeks ago, Eva Bischof was involved in a serious accident, which gave her concussion, and badly injured herarm. Though a highly-qualified doctor, the therapy she prescribed for herself was not bed rest, but work.

You probably have to be a workaholic to secure the qualifications and the professional appointments on Bischof's CV. Especially if you come from humble origins: Bischof is the daughter of a tailor and an accountant's assistant, and spent her summers in a house with no running water in her grandparents' village.

Despite this, she trained as a doctor in Germany, then at Harvard University and Columbia University practicing at top institutions in Zurich, Basel, and Shanghai, where she is an associate professor, lecturing and doing research. She is also a medical adviser at four prominent and intriguing longevity organizations, though she emphasizes she spends less than half her time on these engagements.

"I can't survive without my clinical work," she said.

While working as a physician at the University Hospital in Basel, Bischof, who won a grant to study cancer in China, began to focus on longevity medicine. She is enormously impressed by the appreciation for innovation and progress she experiences in China, and by the country's ambition to lead the world in various categories of technology, including healthcare.

Bischof's first medical adviser role is at Insilico Medicine, a Hong Kong-based company which uses artificial intelligence (AI) to develop drugs. She had known founder and Chief Executive, Alex Zhavoronkov, for several years before he invited her to join the firm. Because both of their schedules were so hectic, their first meeting to discuss the role took place on a Sunday at 11.30pm.

In the early 2000s, Zhavoronkov worked at a company manufacturing Graphics Processing Units (GPUs), the chips that have long powered video games, and which helped enable the deep learning (DL) revolution. This gave him an early start when the AI Big Bang took place in 2012, and DL enabled AI to fulfil its long-awaited promise. Bischof's work at Insilico has given her new insights into the enormous potential of AI in healthcare, and her work there includes improving use of biomarkers to help patients optimize their physical condition. Biomarkers are anything that measures the condition of a living organism, and they are crucial to the emerging science of longevity, because you cannot demonstrate the effectiveness of a therapy if you cannot measure it.

Tremendous progress has come in the field of longevity, but many challenges remain. Two emergent ones are of particular concern.First, the reputation of the field, and hence its progress, is undermined by the proliferation of commercially-driven pseudo-longevity supplements and therapies which are expensive placebos at best and can cause serious harm.

Second, extraordinary claims require extraordinary proof. Plenty of solid and rigorous research is going on, much of it presented at the annual Aging Research and Drug Discovery meeting (ARDD), at which Bischof co-organized the first Longevity Medicine Workshop this year. Randomized controlled trials are the gold standard for research, but are time-intensive and would require aging to be acknowledged as a disease in its own right, not simply an unfortunate part of the human condition. Compounding the problem is that the field is evolving so fast even the most committed clinical practitioner finds it hard to keep up with the basic science progress.

Longevity science can only proceed at the pace which medical practitioners allow it to, Zhavoronkov says. This is why Bischof is working with him and other scientists and physicians to train as many medics as possible, developing a range of free courses accredited for continuing medical education, ranging from a few hours up to degree level.1

Bischof's hopes and ambitions for longevity medicine are more cautious than those of some of its evangelists.

"Maybe it's because I'm German, but I have no unrealistic end goals. I'm primarily a physician, not a transhumanist.2 My ambition is simply for my patients, and indeed everyone, to enjoy a healthy lifespan, maintaining a high quality of life with optimal performance until they die, and detecting risk of diseases decades before they occur," Bischof said.

Bischof's second advisory position is at Maximon, a Swiss company which provides venture capital and other support for a growing number of longevity research startups. The third is Holmusk, a company formed in 2015 to capture, curate, and organize data on mental health, which is the most complex and most difficult aspect of healthcare. They already have the world's largest dataset on neuro-degenerative health and, among other things, are developing algorithms to predict the progression of dementia from mild to acute and the efficacy of new drugs.

The fourth advisory position is at the newest organization, and also the most ambitious. The Longevity Science Foundation launched in Switzerland at last month’s end. Over the next ten years it aims to distribute US$1 billion to groups researching ways to extend healthy lifespans beyond 120. Bischof is chairman of the foundation's advisory board, working with a number of leading figures in the community. The foundation will support fundamental research which will bear no fruit for decades, but its primary aim is to fund work which will extend lives within five years. It will require neither equity nor a share of intellectual property from the groups it supports.

Bischof is also a concierge longevity physician at Human Longevity (HLI), which is based in San Diego and Beijing , and set up by Craig Venter, the first person to sequence the human genome, and wealthy transhumanist, entrepreneur and author Peter Diamandis. HLI offers a precision diagnostic service at the Health Nucleus, which is seen as one of the most comprehensive such services in the world. HLI's progress has not always been smooth, with the Wall Street Journal reporting an 80 percent drop in market value in 2018 that led to half the staff leaving, but that was two years before Bischof signed on. More recently, the company has published peer-reviewed articles demonstrating it has saved the lives of many of its clients by surfacing early-stage cancers and other problems in time to fix them before symptoms emerged.

The really valuable part of the company is its large and expanding AI and scientific expertise, Bischof says, and she expects this to enable the company to fulfil its goal of democratizing the offer of precision diagnostic and concierge healthcare. HLI is opening new centers in San Francisco and Beijing. It aims to swiftly grow to cover every major Chinese city, and gradually roll out globally.

Bischof's forecasts for 2035 and 2050 reflect her cautious pragmatism. Her hope for 2035 is that longevity medicine will have progressed toward use in national health systems in many countries. For 2050, she hopes that a publication in a top peer-reviewed journal - ideally one she co-writes - will provide conclusive evidence most people can live optimally healthy lives up to 100 and maybe a bit beyond. By "optimally healthy," she means, to quote pioneering epidemiologist Prof. Paffenbarger, adding “not years to your life, but life to your years.”


  2. Transhumanists believe that people should be free to augment themselves physically and cognitively with new technologies as they become available, and they are usually optimistic about what will be possible in the coming decades.
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