2023 FUTURE OBSERVATORY

5140 LONGEVITY AND HEALTH

The World Health Organisation may believe, we suspect somewhat quixotically, that the world's population is not getting any healthier, but perhaps the most direct evidence of the medical advances will now be seen in the increased life expectancy to be experienced by almost all populations not facing an AIDS crisis. This will be seen in terms of the absolute length (not just a reduction in infant mortality), especially in the developed countries; as doctors come - for the first time - to understand the mechanisms which lie behind the various disease, and behind the ageing process itself. Two thirds of research groups were expecting significant increases in longevity; and a quarter suggested that this would reach a hundred years or more on average. Thus, Dr Michael Jazwinski - of Louisiana State University Medical Centre - suggests that in the next decade we could add 30 healthy years to human life.

The earlier stages of this process can be largely explained by improvements in the individual's environment. It is only in recent decades - and then typically in developed countries - that improvements in heath care have significantly entered into the equation. Even then it has probably been the breadth (the quantity) of its provision rather than the individual offerings (the quality) which has counted most.

In fact, despite the public's belief in the rationality of medical science, most of the discoveries - especially in the field of pharmaceuticals - have so far come from trial and error - albeit on a grand scale, costing hundreds of millions of dollars. Thus, the greatest invention of Edison has turned out not to be the electric light but the modern process of research and development (R&D), which he invented in order to find the best filament material for the lamp.

It is the pharmaceutical industry, above all, which takes this to the limit; deploying it on the grandest scale imaginable. It takes the widest possible range of (organic) chemicals - which is why it is so interested in keeping Amazonia untouched, since it contains many millions of such compounds. It then tests them on as many patients as possible - where the companies have entered into an alliance with teaching hospitals around the world.

Decoding the human genome now offers a more direct route for some inherited diseases, but trial and error will still have a major role to play, and in the near future we may see average life expectancy moving steadily beyond a hundred years or more. 

The major outstanding problem, though, is represented by the needs of the poorer nations. Diseases, such as malaria, which are controlled in the rich nations still kill millions in the Third World simply because they do not have the resources to treat patients; while the rich worry about a few hundred exposed to SARS or Bird Flu! 

7 May 2003 

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