Fighting Aging as an Effective Altruism Cause: A Model of the Impact of the Clinical Trials of Simple Interventions
Abstract: The effective altruism movement aims to save lives in the most cost-effective ways. In the future, technology will allow radical life extension, and anyone who survives until that time will gain potentially indefinite life extension. Fighting aging now increases the number of people who will survive until radical life extension becomes possible. We suggest a simple model, where radical life extension is achieved in 2100, the human population is 10 billion, and life expectancy is increased by simple geroprotectors like metformin by three more years on average, so an additional 250 million people survive until “immortality”. The cost of clinical trials to prove that metformin is a real geroprotector is $60 million. In this simplified case, the price of a life saved is around 24 cents, 10 000 times cheaper than saving a life from malaria by providing bed nets. However, fighting aging should not be done in place of fighting existential risks, as they are complementary causes.
Highlights:
● Aging and death are the main causes of human suffering now.
● Simple interventions could extend human lives until aging is defeated.
● These interventions need to be clinically tested before FDA approval.
● A trial of the life extension drug metformin is delayed by lack of funds.
● Starting trials now will save 250 million people from death, at a cost of $0.24 for each life saved.
Please comment on the preprint of the article here: https://goo.gl/WaEYt5
The argument that aging is the world's greatest cause of suffering relies heavily on prax. Do older people report lower levels of day-to-day happiness or overall life satisfaction? I recall reading that they do not. If we are to believe that they are wrong, then a direct explanation for it is in order.
The death of investor paradox doesn't work under basic utilitarian math, since it neglects the opportunity costs of fewer new people being born and having utility of their own.
For 3.4:
Death is the end of everything, but again this neglects the opportunity cost of allowing new people to be raised with the same resources.
Baillie 2013 doesn't seem to indicate that there is a loss of well-being from knowledge of death. It's an analytic philosophy paper divorced from human experience.
Not certain or substantiated, but highly plausible. Ok.
Again, opportunity costs. Though this response is substantially mitigated by the time required to train a new person to be productive (20-25 years).
I don't believe there is any direct moral reason to value the information in a human mind. Sure there is some pragmatic value, but again there is the problem of opportunity cost, since new minds will have unique memories and information of their own.
That's a good point. But you really should be integrating these straightforward considerations into a single quantitative model that aggregates the costs and benefits.
Yes.
Only if we care little for the utility of yet-to-be-born people.
Yes, though this is a counterargument to arguments which I wouldn't make. Actually there is a good Pascallian Wager argument to be made here about minimizing the number of potential bad afterlives.
Regarding opportunity costs, you write "The idea of an infinite universe where everything is possible kills the objection." What? I just have no idea what this argument is. Like, it makes no sense. Do all possible universes exist, so that it doesn't matter what we do entirely? Then why talk about fighting aging? I don't get it.
For the $0.24 figure, your calculation for 250 million people being saved doesn't make sense to me. As someone without prior background on the Gomopertz-Makeham law, it just isn't clear. Also, it's not clear what part of gwern's post supports the claim that life expectancy would be extended by one year. And there are explicit quantitative problems.
First, 90% of drugs that reach Phase I trials are not approved (https://www.bio.org/sites/default/files/Clinical%20Development%20Success%20Rates%202006-2015%20-%20BIO,%20Biomedtracker,%20Amplion%202016.pdf), so you should increase the expected cost by a factor of ten.
Second, the drug may not be approved for Phase I trials even if we fund the study.
(The possibility that it is nonetheless approved outside of the US is counterbalanced by the possibility that it is approved within the US but not elsewhere.)
Third, just because a drug is approved does not mean everyone will be able to afford it. This is especially true in poorer countries outside the West, where most of the world population is located. 84% of the world lives on under $20 a day, and gwern says that this drug costs $8 a day in the US. So it looks like most people in the world won't be able to afford it anytime soon.
Fourth, just because someone can afford it does not mean they are open to the concept. Western medicine is not embraced by everyone in the West, and it is often rejected in many other parts of the world. This study found that 27% of Chinese did not consult a Western doctor for their most recent illness.
Fifth, even if someone is okay with Western medicine, they may not want to take an anti-aging pill. 40% of Americans drink practically nothing despite the purported anti-aging benefits of red wine, the remaining 60% don't all drink red wine, and the ones who do presumably don't all do so for anti-aging reasons. Very few people, a tiny minority, take resveratrol. Only a small minority takes Vitamin D, despite its anti-aging benefits. Only a small minority are vegetarian, despite evidence of vegetarian longevity. Anti-aging blood transfer and cryonics are both commonly regarded as creepy jokes in popular culture. And no one seems to be attempting to illegally take metformin. Given all these examples, only a minority can be expected to take metformin prior to the longevity horizon.
Sixth, just because someone is willing and able to take it doesn't mean it's the most effective way to increase their lifespan with their limited excess money. If you are very poor, spending the same money on meat, vitamin fortification, or conventional healthcare may have a greater impact on your longevity. Gwern's calculations on metformin seem to support this.
Seventh, even if metformin is optimal for a poor person, it will still have a nontrivial opportunity cost in the form of foregone health and nutritional expenses.
Eighth, this is still a rough and simple argument which must be adjusted for the Optimizer's Curse when compared against something like anti-malarial bed nets.
Estimating these numbers in my head, it seems like you are overestimating the cost-effectiveness by an order of perhaps several thousand. That is a massive error. Imagine if Givewell had started out by saying that bed nets save lives for $1 each and then revised it up to the current $2,000.
Metformin is not 8 dollars a day, but 2 cents a day in Indian pharmacies. As TAME study and adoption will take at least a decade, people will be in general even reacher and can take the drug.
Metformin has already passed Phaze 1,2 and 3 for many other conditions so its safety profile is well known. It is even known to extend the life of diabetics so they live longer than healthy people.
I explored the problem that not everybody will take it in the article. First, I assume that only half people will take it for whatever reason. Secondary, I explore the ways s... (read more)