On policy and government work in aging

In February of 2023, I published a memo with the Day One project suggesting the changes that NIH and NIA should implement to accelerate the progress in biomedical sciences. It focuses on biotech / medical fields in general, which is why I wanted to step out of memo format and discuss more informally why it is critical for these changes to be implemented in order for aging research to stand a chance in its mission. 

Government is still the biggest funder of aging research.

In recent years we all witnessed the Cambrian explosion of new institutes and novel funding models. While I am leading one of such efforts now and it has been fantastic to experiment with what one can do when no institutional templates are given, I still believe that we can not ignore the biggest player in the funding space - the government itself. None of the existing experimental institutes, even when combined together, have a yearly budget that the National Institute of Aging operates with. This is why we should use the successes of experimental meta-science as a way to advocate for bigger governmental changes, not as an end goal in itself. Otherwise, they will just remain as patches on the system that doesn’t globally work well.

Gatekeeping.

It is my personal opinion, but, as it exists right now, the aging field has no chance of competing in the league of big biotech science. If you were to rank all the work that is collectively published in biology yearly by metrics like impact/citations / etc - the top of this list still belongs to people developing tools. CRISPR. Sequencing techniques. Protein design. For life extension to have any chance for success, we should actively encourage those people to apply their knowledge and techniques to aging science. 

Impetus Grants involved 50 (!) new labs with no prior experience in aging to work on aging research. Because we believe that people who propose cool rigorous work can figure things out, even if they haven’t worked on aging before.  Within government, applying for grants “outside of your core expertise” is heavily discouraged right now, especially if one is applying without collaborators. This disproportionally affects small labs. If you are a small lab and you want to work on aging - you have to do some mental gymnastics of connecting aging to your prior work, which is not always possible.

The rate at which we fund research is one of the most obvious variables we can control. 

This would be a very simplistic estimate but bear with me.

If you do a back-of-the-envelope calculation, we get a few big healthspan trials per year. If you measure your remaining life in the number of trials you can run during those years, you get a few hundred trials or way less TOTAL until aging becomes a big concern on a personal level. Now, how many of those clinical trials are actually going to be successful?  Given the success rate of clinical studies, the number of hits in those trials will be low or close to zero. Given this track record, how many successful clinical trials do you expect to happen by the time you are 80?

The numbers are not optimistic. 

There are a few ways to change this grim status quo. I would broadly categorize them into quality and speed. 

Now, the quality of research is not entirely a black box, but serendipity plays a huge role in it. It is something people decide for themselves - that is, whether they want to do high-quality work or not. Whether they publish because they need to publish for their career or they publish to maximize the chances of improving outcomes in aging studies. And even high-quality proposals can fail because that’s how big bets in science work. As such, the quality of research is much harder to control systematically. 

The rate at which research occurs is an entirely observable variable though. And while the research process or clinical trials can not be accelerated simply because they do require time to output a result, we can often accelerate the boring parts - the bureaucracy, the grant-writing, the year-long back-and-forth to publish papers. Reducing the wait time for grants from a year to at least a few months is one of the most painfully obvious tools for speeding up aging research.