Future generations and historians may look back at the first part of the 21st century as the emerging Age of AI — but also maybe the Age of Gene Editing. Thanks to the revolutionary molecular scissors of CRISPR, humanity can now go into its cells and stitch in a gene sequence to create new therapies to fight cancer, design disease-resistant crops, and perhaps end hereditary disease in humans, including cystic fibrosis, muscular dystrophy, and Huntington’s Disease. (That is, so long as geneticists can fix recently discovered issues in the embryo-editing process.)

We focus so much on the financial costs of healthcare that perhaps we underfocus on the benefits of health innovation, everything from public sanitation to drugs. As Kevin M. Murphy and Robert H. Topel calculate in a 2005 paper:

Over the 20th century, cumulative gains in life expectancy were worth over $1.2 million per person for both men and women. Between 1970 and 2000 increased longevity added about $3.2 trillion per year to national wealth, an uncounted value equal to about half of average annual GDP over the period. Reduced mortality from heart disease alone has increased the value of life by about $1.5 trillion per year since 1970. The potential gains from future innovations in health care are also extremely large. Even a modest 1 percent reduction in cancer mortality would be worth nearly $500 billion.

Again, while we often discuss the effect of income and wealth on healthcare, it also works the other way around. In 2004, Merck pulled Vioxx — one of the mostly widely prescribed painkillers known as Cox-2 inhibitors — after it was revealed that the drug increased the risk of heart attacks and strokes. But there was a trade-off for that action, one that shows how medical innovation can affect our living standards and economic outcomes. The Vioxx removal, along with the subsequent reduction in the use of all Cox-2 inhibitors, decreased the probability of working for an affected individual by 22 percentage points, according to the 2012 paper “The Economic Benefits of Pharmaceutical Innovations: The Case of Cox-2 Inhibitors” by Craig L. Garthwaite. Moreover, these estimates suggest that $19 billion in wages were lost in the year following the removal of Cox-2. Garthwait: “Inhibitors had an economically and statistically significant impact on labor supply in the United States. These medications are only one example of a medical advancement that has a demonstrable economic impact.”

Of course, costs matter. And innovation can help there, as well. That is why I found so interesting this recent Financial Times interview with CRISPR pioneer Jennifer Doudna, the American biochemist who, along with French microbiologist and research partner Emmanuelle Charpentier, was awarded the 2020 Nobel Prize for chemistry. From the FT:

How can [Doudna] make sure Crispr is not prohibitively expensive? Her answer is simple: with more innovation. “The more efficiently you can do the editing, the more effectively you can deliver editors into cells, whether plant cells or the human brain or anything else, the better it will work, and the more you can control cost,” she says. “I guess I’ve grown up in a capitalist society where you believe that as technologies become more capable, that it enables more companies to do interesting things and then it drives down cost and we’ve seen this over and over.” She points to the iPhone as an example of a technology that was once the stuff of sci-fi and is now widely available.

And, of course, innovation might move beyond the gene editing techniques of CRISPR to even more revolutionary results. This from my podcast chat with Kevin Davies, executive editor of The CRISPR Journal and the founding editor of Nature Genetics. He is also the author of Editing Humanity: The CRISPR Revolution and the New Era of Genome Editing.

Pethokoukis: Could CRISPR extend lifespans, in some fashion, so that we’re all living to be 150?

Davies: At the moment, I would say no. Still, I am aware that many companies and many philanthropists are very interested in understanding and exploring the genetics of extended lifespan. I’m not aware of any magic gene that would allow this. That said, if you want to extend lifespan, one thing you want to do is to remove the risks of falling off the wagon and succumbing to Alzheimer’s disease or heart disease or cancer. 

One way to answer your question is if gene-editing — not just editing embryos, but the whole repertoire of gene-editing — can provide us ways where that we can tackle genetic diseases, certain types of cancer, and perhaps eventually things like Alzheimer’s disease. In that case, then yes, genome-editing will absolutely help us extend the lifespan.

To add to that, we want not just to live to 150 (and have that last 60 years be racked with illness), but also to make the current lifespan healthier and then add on more healthy years. So I certainly can imagine there being plenty of 60-something billionaires right now thinking about projects they could fund.

We already see that, to some degree, with stem cells. Do you remember, maybe 20 years ago, when scientists made big discoveries in stem cells? And we had the whole debate when George W. Bush took office about whether federal funds should be used to engineer new stem cells, because of the fear that it promoted the destruction of embryos. A lot of stem cell clinics and offshore clinics were set up. I know some philanthropists who’ve funded some of these themselves because, pretty much as you suggested, they want to give themselves the secret of near-everlasting life — and live to 120 playing a couple of sets of tennis every day.

I’m as skeptical about that as I am about genome-editing, providing these sort of magical and fantastical theories. Then again, this book is about a revolution in science technology, and the amazing thing about our field is that you can never predict where the technology is going to go. So I can wax and wane about how this is the greatest technology since sliced bread, and five years from now, somebody may well come up with something that makes CRISPR look quaint and outdated.

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