A Pioneer of Human Longevity Research

“I always grew suspicious of people who explained to me that things had to be done a certain way because, for a long time, they had been done that way.”

Dr. Michael Fossel, PhD, MD.

In 1996, Dr. Michael Fossel published a daring book, titled Reversing Human Aging. Now President and Founder of Telocyte—a company devoted to curing Alzheimer’s disease, to prove that aging is reversible in humans—Fossel didn’t immediately receive praise for his work. He recalls presenting the book’s findings to the NIH, in an auditorium shaped in such a way that “physically, people looked down on you.” He pauses, adding that “conceptually, they did too.” 

Twenty-four years later, the longevity industry is booming, with companies like Google and Amazon CEO Jeff Bazos investing billions of US dollars in the field, alongside hundreds of emerging startups. For the first time in history, the possibility of reversing human aging is perceived—by a large portion of scientists and bioethicists in the field—as not only eventually feasible, but perhaps ethically necessary.

By 2035, the U.S. Census Bureau estimates that there will be more people in the world aged sixty-five and older than people aged eighteen or younger. Silver Tsunamis are no longer exclusive to developed nations, and national health services across the planet—absent any recognized pandemic—are overwhelmed.

According to the Federal Reserve Economic Research, a mere forty-five percent of the total American population is currently employed, while the U.S. spends roughly one trillion taxpayer USD yearly on the research and maintenance of the “diseases of aging.” The Alzheimer’s Association estimates that, in 2020, Alzheimer’s disease alone will generate a staggering $305 billion USD bill to US taxpayers.

Perhaps a tribute to his medical training, Dr. Fossel veers from the impersonal lenses of academia, fueled by the prospect of improving and/or saving lives. Beyond his several degrees, one encounters the sentiment that to design cures for the root-source of all leading causes of death in the world is a humanitarian pursuit: one of compassion toward the one-hundred percent of the global population bound, sooner or later, to suffer the devastating effects of aging. 

In the midst of a global pandemic, Fossel’s work is a reminder that even those not yet physically undergoing the decay of their own bodily or mental functions, may be put under great socio-economic stress due to the short healthspan of unprecedentedly long-lived populations. The graph on the right demonstrates his calculations on the correlation between aging and mortality rates by COVID-19.

Highly attentive to the ethical underpinnings of his now well-received—and funded—research, in an article on the ethics behind embryonic stem cell use, Dr. Fossel weighs the practical corollaries of techno-optimism against those of bioconservatism, pointing—as a clinician must—to conclusions which ethically, cannot be overlooked:

“If any individual would intentionally restrict the development of a life-saving therapy, then he/she must be willing to shoulder responsibility for the consequent deaths.”

Dr. Michael Fossel, “The ethics of Embryonic stem cells—Now and Forever, Cells Without End,” JAMA, 2014.

Such consequences, Dr. Fossel argues, are to be perceived as the “costs of omission” of any given scientific advancement.

My interview with Dr. Fossel begins here.

RR: If we disregard deaths indirectly caused by aging (such as the majority of those by COVID-19), we still have some 120,000 people dying every day by the so-called “diseases of aging”—in what people consider to be a “natural,” non-pandemic scenario. What would you say the “costs of omission” are in stifling longevity research due to ethical concerns, such as about overpopulation?

MF: Great question. First, it’s important to make note of the fact that the global population is expected to be in decline toward the end of the century, simply because people have fewer children. It’s just a fact—even though yes, we will eventually face overpopulation, and we’ll eventually need to solve it. But my own stance is, if you are that concerned about overpopulation [so as to restrict the development of life-saving therapies], are you willing to remove yourself from the planet? 

RR: Right. The death of which people seem to be in favor seems to be, almost as a rule, that of hypothetical Others. People don’t seem to extend the consequences of their own ethical approach to their own family or themselves, which is problematic. I often ask my interviewees if they would stop, or have their children stop, taking antibiotics, under the premise that if they live on, we may soon have to find solutions for overpopulation.

“We tend to be very compassionate about the young, and less so about the elderly.”

MF: Exactly. We tend to be very compassionate about the young, and less so about the elderly. This is, in part, because we expect the elderly to die, and in part because most of us haven’t been old. We’ve all been children. It’s time that people realize that if you’re going to treat an age-related disease, it’s not a matter of cholesterol, or high blood pressure, or diabetes. Or in regard to Covid-19 [the patients at highest risk] give us a passing nod to aging—their health is already compromised by diabetes, high blood pressure or cholesterol or cancer. But aging is what underlies the vast majority of those conditions, and unless we focus on the cellular and genetic components of aging, we will not make headway on these death rates, nor will we lower exponential curves such as the one we see with Covid-19 deaths today.

RR: From an ethical standpoint, do you think our concerns about overpopulation should be linked to the status of human healthspan, as opposed to that of human lifespan? In other words, if we have a population of sixteen billion whose healthspan is nearly as high as its lifespan, do we have a problem?

MF: We need to concentrate not on longer lives, but better lives. At some point we will face overpopulation, though not so soon as people might expect. And I anticipate that it will not be as unresolvable a problem as we may think. This is not at all to take the approach that these issues will simply resolve themselves, but if we think of the measures taken against climate change in the 1960’s, and if we compare them to the measures we’re seriously taking today: it’s a whole different world. Climate change is far from being solved, but there are certainly a lot of fruitful efforts in the space. It’s great to be preventive, and foresee problems we are likely to face, and to prepare for them, as we finally have been, for the serious threats of climate change. But if you think of New York City a little over a century ago, there was a serious and legitimate concern that horse manure could ultimately lead to the city’s decay. We now look back at this as a quaint problem. I think and hope that a few decades from now, we might look at carbon like this: a quaint problem.

RR: Fascinating.

“The majority of people, when asked if they would like to live an extra thirty years, replied ‘no.’”

MF: There was a project done in the US a few years ago—and I think this stands true still—wherein the majority of people, when asked if they would like to live an extra thirty years, replied “No.” This is because people construe the question as “Would you like to live in a nursing home for an extra thirty years?” But if you rephrase that question as “Would you like an extra thirty years where you can play with your grandchildren, go canoeing, garden, do interesting work?”—then we’d be getting very different answers. This happens, then, in part, due to people misconstruing the question, but in part also due to the fact that human beings are basically an irrational species.

RR: So overpopulation is a legitimate, but not insurmountable concern. If we focus on preventive measures, and produce technologies, as we have been, which circumvent the misdistribution of resources; and if we have larger portions of the global population working, we could have better, as opposed to simply longer lives. What do you think is hype in the field of healthy longevity, and what reality?

MF: What we’re about to see is a conceptual revolution of microbial theory, and it will start in these next couple of years. It will have a bigger impact on us culturally than anything we’ve ever done before. And, it will lower the costs of healthcare. There were predictions in the US, and across the world, that we’d be bankrupt by now because of the costs of nursing care. This hasn’t happened yet, but [if we maintain our traditional approach to aging] it will. The goal needs to be to extend healthy human lifespan, while lowering the costs of medical care. Most nations right now are concerned that with the costs of Alzheimer’s alone, if unchanged over the next fifty years, they’ll be medically bankrupted. Without change, countries will be bankrupted—they are concerned about this, and they should be. Polio, for example, could have bankrupted us, if we didn’t find ways not just to treat its symptoms, but to treat it.

RR: When it comes to aging, where should we be focusing? 

“If you’re a parent in 1954, and you know that your kid has polio, and you’re offered a dozen conferences on the hallmarks of polio—would it be actually good news that you can get better and better at diagnosing polio?”

MF: The whole idea of focusing on the hallmarks of aging is a misconstruction of what is important: we’re focusing on biomarkers and interventions, rather than on understanding how the disease actually works. Hallmarks are important, but the result is you might end up focusing only on downstream symptoms, in a sense, rather than on the overall process of how the disease works and might be treated. There are billions of dollars being invested—and Bill Gates is following this trend—into better diagnosis of Alzheimer’s. Now I submit this to you: If you’re a parent in 1954, and you know that your kid has polio, and you’re offered a dozen conferences on the hallmarks of polio—would it be actually good news that you can get better and better at diagnosing polio? 

RR: Especially given the fact that every single human being, at present, is sure to develop aging—unless they die young—a diagnosis seems far from reassuring, albeit important for the discovery of potential treatments (which must, after all, address a specific hallmark). How has the field evolved since you first published Reversing Human Aging, in 1996?

MF: The issues in 1996 were actually not too different from the ones we face now. There was a biphasic curve: some people were flakes and believed that aging could be reversed with small molecular compounds (e.g., vitamins) and some people were serious scientists who did not want to be taken for flakes. The result was a lack of serious science “in the middle,” that involved serious consideration of how aging really worked and what might be the optimal point of intervention.

RR: Scientific breakthroughs often outpace ethical dialogue. Do you think that, as a field, we should be focusing on developing communication strategies to explore the corollaries of each ethical approach to longevity research, or do you think rather that scientific data, if sufficient to prove that human aging is reversible, would in itself produce more positive views on the field?

MF: We certainly need the ethics. Scientific data is great and reliable, but with that data, you can still go left or right, and the ethical dialogue, as you say, is important to ensure the capacity in which the data will be applied, for many of the reasons we alluded to. 

RR: I’ve noticed that a lot of longevity enthusiasts—such as myself—began growing interested in the potential malleability of aging at a young age, sort of as a hallmark which separated us from the rest of living humans. When did you first realize that you were not OK with aging being addressed, simply, as a fixed process? 

MF: 

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By the end of the 20th century, a handful of scientists believed that cell aging could be malleable. The notion, however, that this could translate into the reversibility of human aging, was reserved for ingenious pioneers.

Similarly, today, the prevailing notion in the field of Alzheimer’s research is that it cannot be cured.

Previous therapies have focused on the symptoms of Alzheimer’s: Dr. Fossel is determined to tackle its underlying causes.

Telocyte is currently preparing to move toward human trials, to prove that aging can be reversed at the cellular level, in humans.

“The cause of aging is ignored by the same people who argue that aging is the greatest risk factor for their favorite disease.”*

Leonard Hayflick, 2019

*Quote cited by Dr. Fossel during interview.