it I’m trying to fix this and I thing to
be doing okay so um I’ve got a question
for you here’s the first question in
fact I’ve got a few questions over the
next few minutes um I decided when I was
really young like eight or nine years
old that I wanted to make a difference
in the world and that eventually led me
into science for several years I worked
in artificial intelligence research and
then when I was in my late 20s I
switched careers and became a biologist
now the reason I did so was because I
found out that hardly anyone was working
on the world’s most important problem
namely the fact that we get sick when we
were born a long time ago and then we
die and that’s kind of like not a good
thing so so I am you know I really want
to know why people don’t get this and at
Ted or TEDx events I have the right kind
of audience for this because these guys
people who can’t you guys people who
come to conferences like this ultimately
you are visionaries or at least you are
one of the visionaries right you you you
would kind of like to UM you know to
make a difference in the world so you
know let’s look at the let’s look at the
kind of things that I don’t think are
very controversial that that you
probably all agree with you know you
care about people
you’re not skating you’re a visionary
right you’re not scared to aim high you
see that there are lots of people out
there who are not visionaries who are
scared to aim high and ultimately it’s
not a crime not to want to aim high you
may not think much of those people but
the fact is you want to help them anyway
so um that’s it right what if I actually
mean well it means making a difference
perhaps making a really I mean really
big difference and the question that is
what is a bigger difference than what
he’s a smaller difference I think there
are two dimensions to that two things
that determine whether you’re how big a
difference you’re going to make number
one how important the thing is that
you’re going to work
to change and number two how easy it is
to change it those two things both have
to be looked at because unimportant
things we can forget about those they’re
definitely not big but important things
actually if they’re easy then they’re
already done or at least a lot of other
people are already trying to do them so
you’re not going to make much of a
difference by being just another person
who’s also trying to do them then again
there’s the other end of the spectrum
things that would be great but
unfortunately they are completely
impossible like perpetual motion okay
now that’s just you know life we know
that perpetual motion is genuinely
unsolvable but the thing is it’s
actually quite hard to tell whether
something is unsolvable by and large
really hard things are actually solvable
but they’re also the most important
things because they’re not easy so the
first step is to distinguish the two and
that’s not trivial most people get it
wrong most people think that hard things
actually are impossible unsolvable
that’s what we need to fix for now what
is the most important hard but not
impossible problem climate change well
it’s pretty hard
it’s probably solvable in the fullness
of time how about these you know I mean
well peace that’d be quite nice you know
prosperity stuff like that disease that
is everybody wants to be healthy being
sick is seriously no fun hand up anyone
who wants to be sick tomorrow right in
particular there are a particular subset
of diseases called the diseases of old
age diseases that people in the twenties
and thirties and forties basically never
get but pretty much everyone gets them
when they get to be seventy or eighty or
ninety what is special about those
what’s special about that means
everybody gets them because everybody
the other disease is so now the topic of
the talk the real topic why is it that
most infectious diseases
you know tuberculosis the theory or
things like that have been prevented now
you may not know this but 200 years ago
in every country even the wealthiest
countries more than one-third of babies
would die before the age of one more
than one-third was around 40% in any
country that tells you how far we have
come against infectious diseases but
age-related diseases ain’t the same
we’ve made almost no progress what’s
going on what’s so different well is it
like you know is it something that we
can solve or is it unsolvable first
thing I want to look at is the question
of what is aging because people think
well there’s aging and there’s the
diseases of old age and the aging is
this kind of natural thing that’s
universal and fixing it is like
perpetual motion and we might as well
just get over it but actually that may
not be true because there’s ‘yes’ of old
age we don’t think about them that way
we think of them as curable you know
things that we can’t cure yet but we’ll
now when you look at the problem of
aging and the ill health of old age most
people will say well actually the thing
is yeah maybe it’s solvable but it’s
just so intractable there’s so many
things that go wrong and they go wrong
almost at the same time and they
interact with each other and make each
other worse you know it’s just so
complicated that’s what’s been holding
us back don’t worry you’re not supposed
to be able to read this slide it’s just
right but actually that’s not the main
thing that’s holding us back so I’m
going to spend the next minute or two
telling you what is holding us back I’m
going to start by giving a definition of
aging that turns out to be necessary
because if you ask 10 people what that
what aging is then you’ll generally get
about 11 different answers the thing is
that people don’t have a good sense of
what aging really is so I’m going to
give you a definition of aging that is
first of all it’s it’s clear it’s
mechanistic it says what happens and you
know cause and effect but also this
definition demystifies aging it tells me
what aging is in a way that helps you
understand that you already do
understand what aging is aging is not a
phenomenon of biology really at all it’s
a phenomenon of physics which is to say
it’s the same process in the human body
or in any other living organism that it
is in a car or an aeroplane or any other
machine with moving parts whether or not
it’s alive
it’s the accumulation of damage that the
machine does to itself throughout its
operation as a side effect of the normal
operation of the machine damage is
simply the changes in the structure of
the body that are not automatically
reversed by machinery that’s built in
and the body like any simple machine can
tolerate some damage but no me some not
too much if you have too much you go
downhill so it’s like this in a living
organism metabolism is the word that
biologists use to denote the all the
entire network of processes that
that the body does to keep us alive from
one day to the next and damage happened
through our life even starting before
we’re born
and eventually that damage causes
pathology I’ve drawn these little arrows
in a strange way to indicate what we
would like to do we would like to slow
down those arrows but actually at this
point we can’t so here’s the problem I
told you earlier that the popular
conception of the problems of ill health
in old age is essentially this aging and
the diseases so we could say it in the
way that I’m describing on this table
there are in most people’s heads there
are three types of disease there are
infections that’s column one then there
are genetic diseases that’s column two
things that are few people inherit from
their parents and then there are the
chronic progressive diseases of old a
and then way out there in the
stratosphere there’s this completely
different thing that isn’t a disease
that the the somewhat like you know
nebulous things that we call aging
itself sarcopenia that’s the loss of
muscle mass as we get older that kind of
thing that’s what most people think but
this is how you ought to think all the
columns are the same as they were on the
previous slide but as you can see the
big black line is in a different place
the point here is that column three is
misinterpreted and misclassified the
disease is the chronic progressive
diseases of old age are not really
disease at all they are not things that
can be cured they are parts of aging the
only difference between column 3 and
column 4 is terminology we have chosen
to give some of the aspects of aging
disease like names and not other ones
and that’s all now once you get that
right a couple of things come into
perspective you get to understand a lot
of things first thing is you can
understand that the way that we’ve tried
to go about keeping people healthy and
old age is obviously never going to work
it’s called geriatric medicine and
geriatric medicine essentially consists
of attacking the things in column 3
as if they were in column one attacking
the diseases of old age as if they were
infections attacking the pathologies the
symptoms directly it’s never going to
work and in from this simple diagram
it’s obvious why it’s never going to
work because the damage that the body
does to itself in the course of life is
continuing to accumulate and so anything
that attacks the consequences of that
damage is going to become progressively
less effective as the person gets older
now I’m not the only person to point
this out this has been realized by a few
people for more than a century now and
that’s why we have a field called
gerontology
but unfortunately gerontologist don’t
get it right either
what John told us to do is they say well
okay some animals live a lot longer than
other animals they age more slowly
maybe if we study that variability and
we try to understand it really well
we might be able to translate that
understanding into actual treatments
it’s not work it’s actually this is wise
my work metabolism is rather complicated
this diagram is a simplified diagram of
a small so I’m sure I’m sorry it is of a
small subset of what we know about how
the body works and you know it’s rather
mess that handle up anyone who writes
software right if you boil it right so
anyway right software will understand
that this is the ultimate nightmare of
uncommented spaghetti code there is no
way there is no way that we’re ever
going to be able to tweak this thing to
stop it doing the thing we don’t want it
to do the creation of damage without at
the same time having unintended
consequences that stop it from doing
things we need to do and that’s actually
an understatement the real problem is
not that this is a simplified diagram of
a small subset of what we know about how
the body works it the real problem is
that it’s a simplified diagram of a
small subset of what we know about how
our body works which is tiny compared to
the astronomical amount that we don’t
know about how the body works even
ignoring all the stuff that we don’t
even know that we don’t know yeah so
ain’t going to happen all right
but luckily there is a common
alternative a third alternative that was
overlooked for a very long time until I
started to point it out about 50 and 15
years ago
rather than trying to slow down those
two arrows the process were metabolism
creates damage or the process where
damage creates pathology instead we can
separate the arrows from each other we
can go in and periodically repair the
damage so that even though it’s being
created at the natural rate nevertheless
it will not actually accumulate to the
point where it’s bad for you and of
course that’s what we already do coming
back to my point that Aging in the
phenomenon of physics it’s what we
already successfully do with simpler
machines with man-made machines this car
of course is more than 100 years old and
it’s was not designed to be that old it
was probably designed to last no more
than 10 years or 15 but because it had
periodic preventative maintenance
throughout its existence it’s doing just
as well now as when it was built so if
it’s so simple if it’s so obvious then
why the hell don’t have to but come and
give these bloody talks I mean I mean
honestly um the answer really is people
are scared of getting their hopes
up of believing that after the entire
history of civilization having failed to
bring the world’s most important problem
under control that finally we might be
in striking distance of doing it nobody
wants to get their hopes up so they like
to make their peace with aging and put
it out of their minds and get up with
them miserably short lives and and make
the best of it well I say that’s
I say that I say that we ought
to fight to actually save some lives and
that’s why I’m saying we need to wake up
and act decisively it turns out that we
can for the past 15 years I’ve been
working on essentially this dissection
of the problem the types of damage that
accumulating the human body can be
classified into only seven major
categories which I’m listening on the
left here of course I don’t have a
chance to go through them today because
I’ve only got another two minutes and 50
seconds but the what you really need to
know is that for each of those seven
types of damage there is a very
plausible and viable approach to fixing
it you’ve heard of stem cell therapy
that’s the way to fix one of those types
of damage the one at the top loss of
cells which is just cells dying and not
being automatically replaced by cell
division it seems very clear now that
this categorization this classification
really is actually exhaustive there’s
not some category number eight lurking
out there waiting to be discovered
furthermore this is getting traction
among very elite and authoritative
scientists this is here it’s just a
picture of our research advisory board
25 extremely prominent and world leading
specialists in their various areas who
are very much signed up for this damage
repair approach furthermore other people
are beginning at this point to actually
reinvent this idea and pretend it’s
original this paper came out three years
ago annex getting cited roughly once
every two days by other papers so it’s
really saying something that people
believe in and it’s identical to what I
just told you this is they divided Aging
into nine categories rather than seven
but it’s essentially the same idea each
of them they have a particular repair
approach so that’s all nice now the
question then is um what progress are we
making well the good news is quite a lot
of course there is progress worldwide by
various scientists and laboratories
around the world there’s also a charity
a foundation called cents Research
Foundation which we created around this
idea and which I’m the chief science
officer this is a selection of the
papers that we’ve published over the
past few years demonstrating our
progress so it’s happening it’s real
we’re really getting there it’s there’s
a long way to go that I mean if you get
this book which I wrote a few years ago
which actually was translated into
German it’s called niemals alt in german
and you can get it but yes it’s it’s
it’s detailed
there’s a lot of material here because
the fact is aging of the human body is
really really complicated and fixing it
is not going to happen overnight but we
are making more and more progress as
time goes on we’re going to get there
but the question is how soon the
question has it we actually
you have to remember how important this
problem is going back to the word I say
at the beginning of the talk this
problem the problem of aging kills
100,000 people every day that’s roughly
two-thirds of all deaths it’s about 70%
of all deaths worldwide in the
industrialized world it’s about 90% of
all deaths are caused by the ill health
of old age that’s quite bad you know and
we’ve got we’ve had a few we were under
lighted to say that we have had a few
wealthy supporters including a guy named
Michael graver from Berlin who started
web de and Flute de and last minute de
so you’ve probably heard of those
website you’ll hear of Michael graver as
well fairly soon because he’s giving us
quite a bit of money to get this done
but he’s not giving us enough we need
your money too we need every we need
everybody’s money so the fact is you
know think about it how much difference
do you want to make look at that bottom
line you can save a life with $1 if you
think about how quickly we’re going to
solve this I reckon that if we could get
maybe 10 20 30 40 million dollars per
year to do this rather than only four
million which is what we have at the
moment we could probably get this done
about 10 years more quickly and that
come at what if you work it out that
comes to about $1 per life so that’s
worth doing thank you very much [Applause]