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Lifespan inequality: Are we heading toward a dystopia, or does it already exist?

by Peter Moulding Published on 29th Sep 2015

by Peter Moulding Published on 29th September 2015

Concerns about the advance of life extension science research and development frightens many people. Particularly, the level of private investment pouring into the industry. The most extreme of prophecies argue that there will be an absolute divide between the handful of super rich who can afford life extension treatments, and those who can’t. The fear is that this divide will permit a world in which a new social order is established planted in financial wealth, but rooting from access to life-prolonging medicine.

In recent years the scientific community as a whole has seen more private commercial injections, as the figures associated with private and philanthropic contributions grow. Virgin Galactic, for example, led by Sir Richard Branson, is perhaps the most publically recognised commercial injection into science, furthering the scientific research around suborbital space flight, but leaving only the richest to enjoy it.

Virgin Galactic is just one example in a long line of commercial ventures propped up by billionaires and multinational companies with the aim of advancing scientific research. Last year Google launched its subsidiary company, Calico, pumping in millions of dollars to kick start the commercial drive toward establishing an anti-aging industry.

Life extension science is at the forefront of this debate, with critics arguing that scientific research should be led by a social contract, rather than a fiscal objective. However, supporters believe that commercial input, especially in life extension, is accelerating the overall momentum of scientific research.

Ultimately though, life extension science is suffering from a complete lack of federal funding, and so if an anti-aging community is to be created, whether the result will benefit us all or just the richest in society, it must first be born out of big business and philanthropy. So then, if this is the case, how much truth and evidence are there in the claims from either side of the debate, and should we be afraid of private entities taking hold of the anti-aging industry?

At the moment, whether we like it or not, privately funded anti-aging research is all we have.

In April of this year, scientists at the Massachusetts Institute of Technology released a full report outlining in detail the severe decline in US government spending on basic scientific research -from 10% of the total federal budget in 1968 down to below 4% in 2015. The report, called "The Future Postponed", provides a thorough account of each area of scientific research that is suffering as a consequence, and also details the potential short and long term ramifications upon the US economy.

The first chapter of the report focuses on Alzheimer’s disease, specifying that there are over 5 million sufferers in the US alone, which is more than most forms of cancer. The prevalence of this is projected to double in the coming decades. Despite these figures, Alzheimer’s is greatly misunderstood, and research is relatively non-existent. According to the report: “Under current funding constraints, the National Institute of Aging can fund only 6 percent of the research ideas it receives.”

However, this decline in federal scientific research funding has seen private backing soar, filling the void left behind. Science philanthropy is rife, and anti-aging research has been elected as the next major investment obstacle, with many wealthy individuals taking up the challenge, including Larry Ellison, Peter Thiel, Sergey Brin and Larry Page.

Does privately funded science result only in a private beneficiary?

Answering this question is important when looking at the reality of the potential that anti-aging research has. Historic and current trends within the broader picture of science must be considered, so to determine whether the result of private funding in anti-aging will produce a world of haves and have-nots, as many on the opposition bench are claiming. It would be easy to focus on the channeled privately funded companies such as Virgin Galactic, with ticket prices for a flight of up to $250,000, as an example of clear private beneficiary. But, privately funded scientific research is now a huge slice of the industry, and following the crumb trail of a single company does not really prove that the same would happen with anti-aging advancements.

Regarding the US alone, the portion of biomedical research funded by private backers and companies within the industry has almost doubled since 1980, with it presently at around 60%. The American health care system has, rightfully, many critics, as statistics are constantly circulated of its all too apparent lack of scope. Included in the statistics are the most visible problems, that almost 33 million people are without health insurance, and of those who are insured, millions are considered underinsured, often forgoing care. In 2013, 1.7 million Americans living in households declared bankruptcy due to healthcare issues, and over 25 million adults did not receive necessary medical attention due to cost. With this real crisis in the healthcare system it is true that, in terms of health in general, the US is already a nation of haves and have-nots.

However, these clear disparities, although shocking, do not reveal any tangible link between privately funded science and private beneficiaries. What they do reveal though is a much greater issue, of the decrepit state of current health care systems and the resulting beneficiaries of both privately and publically funded research. There is a clear case to argue that anti-aging advancements would systematically follow the trends of any other scientific advancement, and be exposed to the inequality of health care systems around the world.

Predictions of wealth, poverty and life extension in the US

In the US, the cost of healthcare is not regulated by the government, and so it is probable that the initial prices of any anti-aging treatment, or treatment for specific diseases, will be astronomically high, leading to the probable scenario of a significant hike in the very wealthy purchasing them. Furthermore, because life extension science is so controversial and the benefits so huge, any significant advances leading to either a longer life, or a significantly healthier life, will likely cause an enormous media frenzy. In turn, this may create an initial surge of people taking out loans, or declaring bankruptcy, as they race to acquire treatment. However, this would probably soon curb as prices decrease, while a large proportion of the population catches up. Anticipating this decrease, the wealthier middle classes in the US would then look toward treatment.

However, with the healthcare system as it is, millions of people are not likely to have access to any form of treatment, and depending on the variety of cures and the cost of treating each specific disease and condition, the distribution of medicine is likely to be irregular and will result in an inconsistency amongst the population.

Inequality in America is currently at a desperately high level, with the top 3 percent now holding over double the wealth of the poorest 90 percent of families. Critics and naysayers believe that advances in life extension science will widen the gap to a point we could hardly conceive now. The problem with these opinions is that they regard life extension as a non-medical subject outside of the current economic situation, ignoring the real problem within healthcare and economic inequality at the moment.

The problem isn’t the rich taking hold of life extension, the problem is within the grossly unequal society we live in today. The fact of the matter is that advances within this research, and further access to treatments, would not likely widen the gap so much as access to new treatments for cancer or heart disease might. The advances within this area of medical research would more or less play by the rules of the economy, and follow the trends of other areas of research, leaving millions of people out of the game.

The question that we must ask ourselves then, is how can we justify only extending  the lives of those who have more already? Disparity in life expectancy and access to health care is already a problem in the US, as those who are lucky enough to be born into stable environments with financially stable parents are more likely to have access to health insurance, hospitals, nutrition, and greater social care. While those who aren’t are more likely to fall ill to preventable diseases, and die from those that are treatable. Last year, Michael Reisch, a professor of social justice at the University of Maryland, stated that, “Poverty not only diminishes a person’s life chances, it steals years from one’s life.” For any health care system to truly serve properly, it must serve everyone equally.

Unequal attention across racial and economic lines

As the New York Times article by William J. Broad makes clear, historically, disease research is ‘prone to unequal attention along racial and economic lines.’ And so, when looking at the leading research campaigns from those companies which are funded privately by rich philanthropists, the initiatives are evidently driven by personal adversity, and conditions that affect those who are funding them.

This theory is likely to see a stark absence of research and thus treatment or prevention for diseases more widespread in low income nations, such as malaria, AIDS, and tuberculosis. 95% of the global AIDS prevalence and 98% of active tuberculosis infections are accounted for in low income nations. The 2014 United Nations Human Development Index (UNHDI) compiles tables of statistics related to human development. Table 1 includes life expectancy, presenting some particularly shocking results from nations, the majority from sub-saharan Africa, whose inhabitants live to a mere average of around 46 years old, due partly because of the prevalence of these diseases.

These issues are likely to remain, as life extension research drives forward in different directions. As the years are added to people's lives in countries such as the US, life expectancy in countries such as Sierra Leone, Chad, Congo, and Mozambique would remain low.

This inequality in the research approach would coincide with the economic and access to healthcare trends within these areas of the world. In terms of medicinal and biological scientific advancements, in the majority of low income nations, it is only the minority of their populations who can afford treatment that receive it. The UNHDI reveals the very low levels of adult health, health expenditures, population in or near severe poverty within the bottom 40-50 nations classified with the ‘Low Human Development category’. If following this trend, it is thus clear that life extension advances would more than likely not reach the majority of people within these countries.

Private funding, will likely partially contribute to a resulting severe inequality, but it is not the problem.

It is not fair to assume that life extension research is being taken over, or overrun, by the rich just because the rich and other private backers are its only major supporters. Indeed, it is being driven by private beneficiaries, but it is not absolutely being diverted by them. Radical or indefinite life extension, as a hypothesised science fiction entity could result in a terrible dystopia, but as a vast area of research, with multiple and various objectives, motives, and directions, will more than likely follow the currents of today’s world.

This though, could be just as worrying. Following the trends of other such recent advances in treatments for cancer, HIV, coronary heart disease, and malaria, in high and low income nations, one can see that the possible social ramifications are both huge and considerably less clear-cut than those predictions made by naysayers, with the result likely to produce a more disheveled world map.

If life extension science continues to advance, it may taint our already vastly unequal economic landscape with a slightly darker shade of disparity. Millions of people could be denied access to medicine that could grant them a healthier and longer life, leaving entire communities and great proportions of populations dieing decades younger according to their place of birth. Nonetheless, life extension research is following the course of research in any other field, and so cannot be at fault for the inequality that it would inevitably produce.

The problem is with healthcare, in the lack of government action toward alleviating inequality and taking steps toward advancing access to medicine. In this regard, if there really is no difference between the social ramifications of life extension research and research within any other area, then what is the problem with it progressing?