On policy and government work in aging

In February 2023, I published a memo with the Day One project proposing changes that the NIH and NIA should implement to accelerate progress in biomedical sciences. While it broadly focuses on the biotech and medical fields, I wanted to step out of the formal memo format to discuss, more informally, why implementing these changes is critical for aging research to succeed 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.

In my view, the field of aging research currently lacks the ability to compete at the same level as major biotech sciences. If we were to rank all the work published in biology each year by metrics like impact and citations, the top of this list would still be dominated by those developing tools—CRISPR, sequencing techniques, protein design. For life extension to have any chance of success, we need to actively encourage these innovators to apply their expertise to aging science.

Impetus Grants brought 50 new labs with no prior experience in aging research into the field because we believe that researchers with strong, innovative proposals can succeed even if they haven’t focused on aging before. However, within government funding structures, applying for grants “outside of your core expertise” is heavily discouraged, especially for those applying without collaborators. This disproportionately affects small labs. If a small lab wants to pivot to aging research, it often faces obstacles in trying to connect this new focus to prior work—an often impractical requirement.

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

A rough back-of-the-envelope calculation shows we get only a few major healthspan trials per year at best. If you think of your remaining lifespan in terms of the number of trials that can occur during those years, you might see only a few hundred or fewer total trials before aging becomes a personal concern. How many of these trials are likely to be successful? Considering the success rates of clinical studies, the expected number of breakthroughs is low, maybe even close to zero. So, realistically, how many successful clinical trials can we expect by the time we turn 80?

The outlook is not encouraging.

We have a few ways to shift this bleak status quo, broadly categorized as improvements in quality and speed.

While research quality isn’t a complete mystery, serendipity plays a large role. Researchers must decide for themselves whether to pursue high-quality work or publish simply for career progression. Even high-quality proposals may fail—that’s the nature of high-stakes science. As a result, research quality is more challenging to control for systematically.

The pace of research, however, is a fully observable variable. Though the research process and clinical trials naturally require time to produce results, we can often speed up the administrative side—the bureaucracy, grant writing, and the year-long delays for publication. Reducing the wait time for grants from a year to a few months is one of the most urgently needed tools to accelerate aging research.