Home / Health / A cure for no cures – the next generation of medicine | Ashkan Fardost | TEDxBerlin

A cure for no cures – the next generation of medicine | Ashkan Fardost | TEDxBerlin

[youtube https://www.youtube.com/watch?v=W3C23m71Yws&w=560&h=315]

Translator: Leonardo Silva Reviewer: Denise RQ In the 1920s, a state-of-the-art airplane looked like this, a Nieuport 17, topping a speed of 200 kilometers per hour, one of the most powerful airplanes of World War I Drugs, in the 1920s, looked like this

This is aspirin, a champion drug of the 20s, relieving pain for millions And aspirin came in the form of a pill Moving to the 60s, airplanes became even more powerful Here, a Tupolev 134, now traveling at a speed of 1,000 kilometers per hour Drugs, in the 1960s, looked like this

And they came in the form of a pill Fast-forward to the 21st century: an F-22 Raptor, one of the most advanced fighter jets of all time, now traveling at a whopping speed of 2,400 kilometers per hour And drugs, in the 21st century, looked like this And they came in the form of a pill And today, aircraft can look like this, SpaceShipTwo, by Virgin Galactic

It goes to freaking space And drugs today still come in the form of a pill I know what you're thinking, "The content that's inside the pills must have changed," right? Haven't modern medicine and state-of-the-art chemistry brought advances to this stuff that's inside the pills? I spent ten years studying pharmaceuticals, researching pharmaceuticals, and obtaining a PhD degree in the pharmaceutical sciences And like every PhD student on the planet, I had an existential crises every week in my lab And one day, I asked myself, "Where the hell are we going with all of this research? Why is progress in pharmaceuticals feeling so damn slow?" Because progress felt slow to me, because I've been a computer and tech geek since age ten, and for the last 20 years, I've been obsessively following the progress, the exponential progress of computing and technology

And as many of you know, computing is an exponential technology, which means it advances really, really fast So, why aren't pharmaceuticals advancing as fast? Or maybe they are, but I just couldn't see it back then So I decided to find out But first, to make my point clear, let me take you to a small journey through the world of computing and technology The story starts with Moore's Law, first described by Gordon Moore, cofounder of Intel

And in the mid 60s, he discovered that computers became twice as powerful roughly every second year And the data behind this phenomenon looks like this, and it's an exponential curve An exponential curve can also be viewed on a logarithmic scale, which means that the exact same data will, instead, look like this And now, we can see a smooth and clear trend, which allows us to predict the power of computing in the future And the same goes for the cost of computing

The price of computing power is decreasing exponentially And thanks to these trends, we can predict the price of computing in the future These trends have been going steady for many decades now, and we can see them in other technologies, such as megapixels in cameras, the cost of genetic sequencing, the performance of LED lights, and so on And today, many industries rely on these trends to continue, because if they don't, the survival of their industry will be at stake But looking at data like this can be quite deceptive sometimes

There's a more truthful way to look at exponential progress, and from a broader perspective, it really looks like this It's a series of overlapping S curves, and in this example, we have the history of computing power, and it began with the old electromechanical computers that used punch cards And zooming in on their S curve, we will see three phases The first phase is the experimental phase, the exploration phase This is where experiments are happening with brand new technologies

And things are often risky, there might be ethical concerns, and new technologies are usually opposed by skeptics and critics, but eventually comes a breakthrough, and the technology gets adopted and rapidly developed as new competitors in the field arise And now, we have reached mastery, technology is progressing exponentially, but eventually, all technologies will reach a limit This is the limit where progress, beyond this point, will give little returns anymore And the electromechanical computers were replaced by the relay computers, when they got to a breakthrough And the story continued with the vacuum tube computers, and then the transistor-based one, and then finally came the integrated circuit: the microchip, the computing technology that's been with us for over four decades now

And this technology will too reach its limit one day, and then, we will be in a dire need of a replacement So, in a hundred years time, computing has been revolutionized over and over, several times So, almost in the same period of time, what has happened in the field of pharmaceuticals? Did the content inside the pills actually become better? Rest assured: they did No doubt about it But I think there's an even more important question here

I think the question is: are new and groundbreaking discoveries in pharmaceuticals coming fast enough? I think that's the billion-dollar question So, after digging through FDA's publicly available database, this is what I found So, the number of new pharmaceutical inventions available on the market is growing, and it's growing fast And it's looking good: we can see the first half of the S curve, and we've passed the breakthrough point, and the curve is just soaring, right? So, according to this data, if we're looking to the future, well, by the year 2050, we will have 30,000 new pharmaceutical inventions on the market And that seems great at a first glance

But the thing with S curves is that it's really hard to predict when a technology is going to reach its limit, and when the curve starts to dip Because how can we be sure that this trend is going to continue? So, we need to dig deeper into the data to find out So, instead of market growth, let's look at how many new inventions from the pharmaceutical industry see the light of day on a yearly basis In other words, what's the speed of inventiveness of the pharmaceutical industry? Now, that's a totally different picture The peek of pharma inventions was in year 2010

That year, 100 new pharmaceutical inventions were released to the market, but after that, it's starting to dip And to add to the bad news, the number of new discovered drugs per dollars spent on research is actually decreasing, exponentially fast So, the data, so far, is not in favor of pharmaceutical progress But here's the most shocking fact: of all the pharmaceutical inventions since 1945, only 3% are actual cures And these cures are mostly antibiotics and antifungals

As it turns out, pharmaceuticals are excellent at killing germs, but for the majority of diseases that are due to malfunctions in our own bodies, what do pharmaceuticals do? They can only treat the symptoms That's what 97% of all pharmaceuticals do They treat symptoms We have no cures And I believe the ultimate goal of health science should be to deliver cures

And pharmaceutical technology has utterly failed to do so So, number one: pharma's speed of inventiveness is slowing down Two: research of pharmaceuticals is becoming more and more expensive – so this is the opposite of Moore's Law; this is the opposite of exponential progress And three, and most importantly: pharmaceutical technology seems incapable of actually producing cures So, if cures are what we're looking for, I believe pharmaceutical therapy has reached its technological limit

And to find cures, we're in a dire need of a replacement But here's the good news: there is actually a new S curve in town, and it's called genetics And it's been just 60 years since Watson and Crick discovered the structure of the DNA molecule, and that changed our understanding of life forever And our understanding of genetics is advancing exponentially fast "Scientists identify schizophrenia's 'Rosetta Stone' gene," from Cardiff University

"Gene therapy restores auditory function in deaf mice," from Harvard Medical School "How to reprogram cancer cells back to normal," from Mayo Clinic And "Scientists successfully edit human immune cells," from UCSF And these headlines are just a tiny pick from the last 60 days That's how fast genetic research is advancing

And for the first time, we're actually closing in on real cures, real fixes to the defects of the human body, because the power of genetics allows us to do so Pharmaceutical technology does not But here's the best news of all: this is a revolution that all of us can partake in, thanks to the rise of the biohacker movement For example, like Kay Aull, who built her own genetic testing kit, in her closet, for small-time money, after her father got diagnosed with a hereditary disease, as written in Discovery magazine And just like many other technologies, genetics is progressing exponentially, and the price of doing genetics is dropping in the same fashion

For example, you can now order an open-source DNA copying machine, for 600 bucks, online This is something that would cost tens of thousands of dollars just a decade ago And as forward-thinking teachers are bringing programming and hacking into their classroom, the hacker movement will grow even faster every generation These efforts, together with the forward thinkers of academia and industry, will help to hypercharge the science of genetics And for the first time, the art of actually finding cures is finding its way into the hands of us, ordinary citizens

But, of course, there is a lot of room for concern This is a new technology, and the ethical dilemmas of genetics are just as mind-boggling as genetics itself And I don't think anyone has the answers to these ethical dilemmas yet, because we are, after all, playing with the code of life But this is how its supposed to be Genetics will be fought by skeptics

Genetics will be fought by critics And we should welcome it, or else it wouldn't be new and exciting groundbreaking science, because that's what genetics is So, don't forget: we're at the beginning of a new S curve; the next generation of health, the generation of genetics Let's climb it together Thank you very much


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