Michael Kotlikoff

Transcription

let me just say I am greatly honored to be able to have Alex cover on call on the call today to discuss his work and his recent book. Alex holds several degrees including a PhD and as a director and trustee of the Biogerontology Research Foundation which is a think tank supporting aging research worldwide he has a laboratory of bioinformatics at the clinical research center for pediatric hematology oncology and Immunology and is involved in the World Federation for Regenerative Medicine and the European Federation for regenerative medicine welcome Alex. pleasure to be here Michael and I also read your very relevant blog lots of fresh ideas great to be here again great My focus is more on the personal lifestyle and financial implications your work in this is is very relevant in that it really lays out the background of how anti-aging and healthy life extension can have dramatic impacts on the global economy and society altogether so thanks again for doing this re interview and I let me to say a few more introductory words a I know you've written this book a book called The Ageless Generation: how advances in biomedicine will transform the global economy you know was just published in June 2013 the this a book as I mention is incredibly relevant and that's why I tracked you down to be able to ask you a few more questions and get your perspective but let me read an introduction to your book that I found it was on the the Amazon site a know was that it was an introduction by Aubrey de Grey who I know is your friend and somebody I've written about and talked and met myself that many times and here's what Aubrey says about your book quote "the devastating impact a population aging in the decades to come is becoming like the proverbial weather - everyone is talking about it but no one is doing anything about it Zavoronkov starkly set/sets the nature and trajectory this crisis and then he elaborates what few others have yet described and no one so expertly the unique solution to it namely the development of a comprehensive rejuvenation medicine that will restore and maintain the health of the elderly so that they continue to contribute wealth to society. This book has the potential to define the medium term economic and social policy for the entire industrialized world" unquote. So that is from Aubrey de Grey, the chief science officer at the SENS Foundation - that's an incredible vote of confidence don't you think Alex? Absolutely. Aubrey is one of the very few visionaries in this world who suggested the first comprehensive model to on combat aging and the I respect his opinion greatly. Let's dive into your book and maybe I thought might be helpful would be if I could is read the headlines of the chapters so that people get an idea of the flow of what you've covered and then I'll go back and ask some questions about the various chapters so that's okay Perfect. so the your introduction is phenomenal but but when you get into part 1 which is called the era of longer life spans where you really give us the whole kind of picture of where we're heading I interms of life expectancy I E and you get into that talking about a tipping point and into the demographics of major countries and how each country is a little bit different but essentially we're in a global aging world and then you get into Part 2 where you really dive into I aging itself and the process of aging and what aging really entails looking at the biology of that and basically the looking a lot of the current thinking and theories about aging and then also get into the idea of repairing damage and the whole idea of regenerative medicine and and Biogerontology which really brings up the whole notion of people living longer and healthier lives in-depth in a really excellent I mean I've been reading this topic for a long time but I have to say that was just an excellent overview and in-depth dive into this whole area then Part 3 of the book is called "the need to reform medical research" and I really hope you will talk a bit more about that to me it seems like a real key part to making this really become a real reality to move the actual anti-aging research along we really need to look at reforming how it's done right now and then in your Part 4 you get into the retirement culture in and how this will change as as people live longer and what this means to society and means to people I hope then to ask you particularly what which you people do you know as a result of this kind of vision that you're laying out what does the individual who's thinking about their own retirement and their own financial security are given the world and given the uncertain nature of medical and health costs what should they do now? we'll get to that down the road so so me jump back now into Part 1 which is the Age of Longer Life Spans and there are you you presented the notion that we're approaching a tipping point in in respect actually a couple different tipping points how the aging population will strain the financial system that we have he can you describe this viewpoint a bit further? well I think it's pretty obvious that in many countries me bandow see letters the ratio of fun the retired population to I'll be working population is increasing steadily especially those visible in the west where well first of all its statistics are transparent and but I we have he baby boomer population that's been my tracks I from all angles I and we'll see how or the retirement of that population group is going to affect the economy I'm definitely not the first a on person to raise the leg red flag and there have been not many economists I'll multitude I who are pointing to aging as wanna be major sources of our economic problems down the road are one of the most local and most prominent scientists a in the field of economics are who actually raise this issue on is Laurence Kotlikoff I at fun Harvard I'll and a few others are so basically so what some economists suggested that where going to go into the state of what are basically fiscal collapse I and roadblocks were I exactly her that name in the a word in the title so yeah it's a high note there's no shortage over %uh economists warning against a they're heading for this financial crisis and you know that the only solutions that that people think there is a solution some people don't but some don't think there may be some kind of combination of economic growth in Inca raising income taxes and in various cuts a but it just doesn't say I mean your book really lays out the the economic serve that kind of approach is probably not really adjust dressing the reality of the situation exactly because a on if you look at be progress on biotechnology and Madison I would have for a lot of new procedure is coming on the market and with the current paradigm from health care where we just don't love the patient die I during the last mile so when you get into the hospital doctors will try to do whatever is possible to keep you alive on with more people are heading in there senior year is I am we perfectly understand that but we get more and more diseases and a of medical problems are down the road because most of the diseases out there are age-related I the health their part is going to get more expensive and we can either caught or weekend a do something else i'm almost all economists in our box are proposing well wanna be few alternates so some of them are proposing I have major austerity measures so that's the key word right now in Europe so a star in the authority of 30 what's up tighten their belts and lots of introduce more transparency I collect taxes more efficiently I'll look at but out ways to redistribute well so from the rich to the or so it's becoming more socialized on and as you can see that socialism trend is increasing in even in the US rate though where Sr I return of the previous century a would have been not I consider it to be you know communist ideas on the were also cut at this rural roots I but at the same time are you see the very few solution up solutions that mean a work in this current economic growth a or economic climate because a if you cut are anywhere you quoi either heard be retirees or evil hurt the economy so because are definitely not going to do it because the waves so the waves and waves are retirees are going to be just increasing people are gonna live longer with a current on healthcare fired I'm soul it's very difficult to stop the quayle retirees I so what the solution not I've proposed was too accelerate aging research and I change the retirement culture so the typical yet but I think went back to the question is no very clear I mean it's very simple maths INR varies from country to country because I in some countries the government provides the lines so share of the funds from and health care benefits a later in life after are citizen which is a certain age in some countries the soon is responsible for Iran a kinky are of himself or south for later in life but let's say in the US which is the getting hard to the world economy on and where citizen laws rules cover part of the health care expenses on but I'll on stole a large percentage of the retirement income comes from savings and home equity but even in this country I have the government pay czar if we think about just pure numbers on why my maybe of play 1000 or 2000 a are or category I because numbers change or or Thailand your gonna just that but just on the abstract level in the US approximately on 13,000 a per person per year is spent on social security I have done another level thousand I that's medicare and our 6,000 those for retired Iran first after our reaching the retirement age which is what's a 65 I had another 6,000 us a medicate so we're talking about are gras sets going to you over thirty thousand dollars a year so if the person so %uh Iran life after retirement is significantly longer the are what time it took to I contribute to the economy on run we have and that loss on the Euro wife time basis and of course a the retirees do contribute to the economy about the a whether some not negative contribution if you think about it because they don't want to contribute to the healthcare segment of a circle seidman but the drawer more from the economy than they contribute so it might help me look bother with a GDP side of you concur a call to the GDP but this actually it increases though liabilities going forward and the increases the strain only I younger population indeed I i mean in your in your book you me make a point that while I guess it in my discussion with with the clients and i actually admire retirement advisor that a lot of people dole like the idea of living longer because essentially I think that it is just a matter of Science keeping them alive in ill health and then of course that would also add to the costs kinda already happening now in your book I i think you know that the real key is we're talking not about keeping ill people alive but we're talking about actually preventive medicine as well as regenerative medicine and and and you actually say in your book as the that he said every general medicine is in a so far more advanced 8 than most people realize now can you see a little bit more about this and you know when where are we and how how soon could summer these a a you know breakthroughs actually start to have an impact well general Madison was definitely far more about stalking are most people love realize and the the fact of the matter is that some other procedures are already in the clinic is just a gentle Madison as a term is a very broad area I which is calm which in encompasses many areas of scientific research so for example blood transfusions let's also a form of Regina the protestant Iran which went online in La are nineteen-thirties the late nineteen thirties I went mainstream but the think about from someone up at ext um I'll transplantations a what banks themselves were just categorize the humans and not late 80s and the right now they're all are you saving lives they're not used for perot provincial they're not used for regeneration at the moment but the in pediatric on course mccalla G for example the Sumter were on I have my lab we have for vast number of mathematics stem cell transplantations every year a bone marrow a transplantations are also for most for a chance miss some down but right now there are already advanced procedures were you could transplant but bone marrow from the donor to a recipient and the have very little adverse effects a going forward so were a little non-genetic Iran response there are many procedures there are that are currently in clinical trials were leaving the clinic but a in are probable that already save lives unfortunately we don't use that for of provincial we don't use that for a regenerating organs ought to prevent a 0 or to restore lost function I already there are procedures about restore eyesight using on some other agenda medicine our techniques are some other a generous person techniques are already saving lives of patients that lost their track here so just couple years ago on which he really I transplant at the the first rakia I into a patient a after receive your injury I'll where r CU's the extracellular matrix form from a dubbed or from arts aka belorus are on issue but go or keep the cell arise the matrix then resell rights that using patient's own cells so its own autologous transplantation so the wuv it's not recognized by the Union sistema the form body and does not require much arm immune suppressants during the course of treatment are and those procedures are slowly progressing and so clinic we already see clinical trials in gene therapy on or in the cardiovascular diseases we always see some clinical trials im not us thomas also refuse and cardiovascular disease or so we see you organs arm built de novo are from the based in Seoul in most cells so in the very near future we're probably going to see an explosion in this area and if you think about it be problemo store rapidly advancing field offer jobs must some lies in I in the used to report those some cells so we are on SL can be any so the body can be brought back into a you stem cell-like States well almost any soul and body so are you would not house much lower were a refer sites for some ourselves to loss though who their nucleus on so you would be able to broker bring this all back and the done YouTube were dunno differentiated into another storm cell site state so basically on you do not need embryonic stem cells anymore to produce other cell types you can use a induced pluripotent stem cells in Los techniques are becoming words bounced a war third reliable so I would say with them next few years we're probably going to see you for a pic with viable induced pluripotent stem cells %uh producing both either system so a types a cell types to build new organs or injected unused the and a directly into the patient as a cell therapy so and if you look at Whole fast this industry as progress just in 2007 you will not cut I published his first broke protocol I'll score and use for all for generating newspaper reported some softballs I just last year she gonna Bell price for it so be a technology has proliferated so many labs even our love has a project in IPSC I and everybody in there john thomas was thinking about whoa one or the other technique right and using I induced pluripotent stem cells or generate to pick a viable induced pluripotent stem cells so in the future I would say are within next few years are I have little doubt up by given be number of projects worldwide I am enough funding going your process out into this area I'll I have no doubt that we are going to see you all this industry and bounce and naturally we're gonna see treatments so or are deadly arm world diseases early-stage disease is are book will extend 0 patient lives sponsors marginally and primarily on the belt but but hopefully layer we will see those procedures what translating into the mainstream and acceleration up this translation into mainstream will define I the health of the global economy so thats I was I was a going to comedy in your book you really do spend a fair amount it I'm saying that well this explosion is coming it still needs a change in acceleration interns are the actual process from discovery to clinic can you say what kinds have things might speed that up well there'll also ideas that can be brought forward one idea is currently we see a lot of regulatory barriers especially in the US especially in the European Union we r on where to look really experiment selectively where a some all the advances in regent let us on humans even when there is informed consent and people are willing I have to take risks to get better outcomes I even if there is if the possibility of you know for Tally radovan because the understandably lifeless planet iron so rules we went we really need to see some deregulation a young be you delivery of soul the experimental techniques to the patient and the have more well transfer some all the power back to the patient because right now the industrys to regulate they will if we look at the aspirin example a naturally this drug but I so welcome to mainstream as a the preventative for drug are over the course of one hundred years so it's a very long time a imagine so all the stuff so procedures original muscle procedures going mainstream it will not be possible in the current through or regulatory environment I if we look at Kohls all the drugs progress to market it takes on average six years for a I you know hardcore Johnson drug so yup to the market then we're talking about early-stage a row worry arming aggressive cancer focus for some of those drugs so are you would expect that the for patients that are already on their deathbed that would be easy to get access to some other experimental treatments but it's not but they say you'll or own over six years from what a the lab to the clinic all-round for so all the world for for other diseases of for example for cardiovascular diseases and score on out even diseases for metabolic diseases %uh this cycle is by far while much longer so we really need to figure out a way to speed up and the reviews the burden of the FDA on acceleration are all the progression of medical technologies from the lab to the clinic so face let's go son should be enough in some cases yes I mean that would obviously really speed things up if you have people that were are well informed of the risks but are willing to proceed I i can see how that would be really important I i wonder a in your book you talk about China as really committing a a fair amount of funds and a focus to a medicine and can you talk about how that system differs from the US and and what you expect to see there in the next five to 10 years are well in terms of biomedical research china is the new promised land core many scientists because of b.o vast amount of funding just putting into biomedical research a to put into perspective for in the US the major funding body is the NIH and a spermicide somewhere in the range of our sorry billion dollars well sorry for 33 sorry five billion dollars on on Nov by research and the Elias share all about funding a is going into the on wall extramural funding is basically grunts to other organizations its side fueling our research not only in the US but also worldwide %uh so think about it let's say for you thirty billion dollars and the the figure has been must only increasing so if you look at a I that spending money and buy by the NIH twenty years ago it was probably a third or less Iran so it has been steadily increasing and the in large China China just recently announced a program to spam but I 302 eight billion dollars over the the course of five years on biomedical research in infrastructure so batters significantly more than me and nature over the past are what's a eight years or even ten years are I'm not program one so live am NOT 2011 so it was announced in 2011 it's already ongoing America constantly planning to invest more and that was just the federal level funding I municipal governments are spending a enormous amount of money on Mar biomedical infrastructure is so you something scary so they have things like the China Medical City where your house or are as city you sisal Baltimore Iran I was jus dedicate to medicine or you have ground projects like the Beijing genomics Institute it sa not located in Beijing is located in changing I S currently the large the world's largest sequencing Center so about 30 percent or more should not genetic sequencing is done about particular Center all what's the largest in the world and currently there venturing into other area so areas they're not only the sequencing Center he also venture into diagnostics so is the largest pre-natal diagnostic center in the world I there are are venturing into transgenics so they are already designing new fissures I that will be a resilient to pollution and will grow we were rapidly yes very Iran sorry noble a strain officials they're designing I saw it with my own eyes and I said recently announced a plan to build a Sumter or a genomics research for this actually it's like for biomedical research I does was gonna be fifty square kilometers are north of invention and the in projects like that really blow your mind and think about the sheer number of scientists I yes the quality of the research was worse than the US are couple years ago are but they're catching up really rapidly because the US may be I O largest major altruistic gift to the world the open up or on the fruits of well are biomedical research to the world so there are no more barriers to go to PubMed there it that's the central repository for biomedical texts I run by the National Lab reply to some a and you can PubMed almost any keyword in Burma some and you will be able to juppe will include a journal and there is a high chance that there's going to be I accessible I love with a subscription or without a subscription so you would actually be able to on goal unlearn about the study I just saw China I does not need to I repeat the experiments conducted in the US because now they have for free access to the medical literature I they can re up I so be articles in PubMed so on loan journalist up amid links to on just access to that knowledge I'll start where r their US peers left off I'll or venture into something new direction so this completes part 1 the interview with Alex other on growth in part to will discuss what policies are needed to encourage healthy behavior and also what individuals can do including adopting an attitude of continuous learning