The document discusses effective altruism's approach to combating aging, identifying it as a significant cause of suffering and death. It highlights the economic and social impacts of an aging population and presents various interventions to slow aging, including lifestyle changes and potential treatments like metformin. Additionally, it emphasizes the need for increased research funding and collective action to advance anti-aging therapies and improve overall life expectancy.

1. Fighting aging as
effective altruism
Alexey Turchin

2. 1. What is effective
altruism
• Doing good better
• Cost-effectiveness
• Act remotely, not locally
• Malaria bed-nets case

3. 2. Aging is the main cause of suffering
• Social problems
• Physical sufferings
• Death

4. 2.1.Social impact of aging
• Old population is growing
• Economic burden of ALZ
• Over-stretched pension funds
• Increase in the old-age dependency ratio

5. 2.2. Aging as a major
cause of human suffering
• There are more old people than
poor people now
• Aging is associated with illness
• Peak of quality of life at 18,
followed by decline (Easterlin,
2006).

6. 2.3. Aging is the main
cause of death in the world
• If there will be no age-related
diseases, humans will live
thousands years.
• Gompertz curve of mortality
is hyper-exponential (for
total death probability).
• Cancer, ALZ, heart diseases
grow with age.

7. 3. The badness of death

8. 3.1. Negative utility of death
in preference utilitarianism
• How to calculate good? Pain or values.
• Humans prefer not to die.
• Non-exsitence as sufferings.

9. 3.2. Death of investor paradox
• If we calculate utility as “money x time”, death should be
taken into account
• Better to live longer than to be reacher
• Discount rate should be taken into account

10. 3.3. Willingness to pay as
a measure of the preference not to die
• The willingness of people not to die could be indirectly estimated by their willingness to
pay for expensive cures or risk reduction.
• It was estimated that humans are ready to pay between $100K-400K for QALY, that is only
for one year while the median household income only $37,000
• US citizens in 1997 valued one year of their life 3–10 times more than the wellbeing of the
whole family for the same period.
• it equates to 9–30 years of economic wellbeing being equal to one additional year of life.

11. 3.4. Reasons why death is bad
• Death is the end of everything.
• Non-existence itself is known to create existential fear.
• The moments before death are often the most emotionally and
physically painful.
• Death means that a person can't finish his projects.
• Death is the loss of the information.
• Death is unpredictable in both time and form.
• Deaths of relatives create intense, long-term emotional suffering.
• Death in the 21st century is an enormous opportunity cost.

12. 3.5. False arguments against
badness of death
• “Bad immortality”.
• Overpopulation.
• Stagnation, infinite totalitarianism, or other bad social outcomes.
• Stopping death takes opportunity from non-born people, who would be born if resources were
freed up by death of aging humans.
• Death can’t be experienced, so it can’t be bad. This is so-called Epicurean conjecture.
• Death is needed to bring “meaning” to human lives.
• Torture is worse than death.
• Most people believe, or at least hope, that there is some form of afterlife.

13. 3.6. Life expectancy is the best measure
of cost-effectiveness, not QALY
• “Healthy aging” doesn’t take into account “longevity
escape velocity”
• We could survive until immortality, if we survive until
superintelligent AI.
• It could appear in the 21 century.

14. 4. Aging could be slowed
down by simple
interventions

15. 4.1. Aging could be slowed down
by simple interventions
• Aging has been slowed down on animals by simple interventions
• Negligibly senescent animals exist, like the naked mole rat
• But we can’t know how the geroprotector experimental data would
transfer to humans, without experiments with human
participants
• There are around 1000s potential geroprotectors

16. 4.2. Problems with clinical trials
of antiaging therapies on humans
• Such tests will take a very long time, because humans have long life spans.
• Research on the aging of humans is difficult because aging is not
considered a disease under WHO classification.
• Many promising geroprotector candidates (drugs slowing aging) can’t be
patented
• There was an idea that extending human life is immoral even among
gerontologists
• The field is a case of market failure: despite large demand, only a small
percentage of money is going into actual research.
• Problem of will: Many interventions, which are known to slow down aging,
and generally improve health, are not implemented by the majority of the
population.
• Need for highest safety, as antiaging treatment will be applied to healthy
middle-aged people before the onset of age-related diseases

17. 4.3. Total research budgets on the
fundamental problem of aging are small• The biggest player here is the National Institute of Aging in the
US, with a budget of 1.2 billion USD annually
• The next-largest player is Google’s Calico, with (not annual)
funding of 500 million USD total.
• All other players combined have smaller budgets, including the
famous SENS by Grey, which in 2015, had a budget of around
4 million USD per year
• If we exclude age-related diseases, the total budget on
fundamental research on aging could be estimated at an order
of magnitude of 100 million USD in 2015.
• $25 billions for chewing gum

18. 4.4. Simple interventions
criteria
We could identify criteria of simple cost-effective interventions
for life extension:
1) They are already implemented by large group of healthy
adults on non-prescription basis, and cohort studies
support their effects on life extension.
2) They are cheap enough to be bought by almost everyone.
3) They are easy to implement, without requirement of
enormous will.
4) They could be quickly implemented globally without
overstretching limited supplies of some types of resources,
so billions of people could have access to it.

19. 4.5. Simple interventions types
• Limiting smoking.
• Mediterranean diet with large amount of fish and olive oil.
• Physical activity.
• Limiting sugar consumption.
• Vitamin D.
• Ten cups a day of green tea.
• Red hot chili pepper lower mortality to 0.87 of control
• Metformin
• Enalapril reduce all-cause mortality to 0.87
• Aspirin addition after 50 could add 0.28 years of life
expectancy

20. 5.1. TAME study of
metformin is example of
icebreaker study
• Based on crowdfunding
• Needs 65 mln USD
• Double Blind Randomized Placebo Controlled Trial
• 18 Month Recruitment
• Range of Follow-up Times: 37-54 months

21. 5.2. TAME expected effects
• Lower mortality to 0.9 which translates into 1 year of life expectancy
• 10 per cent more people will survive until 2100 from old cohort who take
the drug
• If the size of the old cohort who take the drug is 2.5 billion, 250 millions
more people will survive until 2100.
• Each year of the delay of implementation means around 3 million less
people will survive until 2100.
• If TAME successful, spending 60 mln USD will save 250 mln people, which
price for saved live = 0.24USD
• The nearest competitor is malaria bed nets with 1500 USD for 1 saved live.

22. 5.3. TAME as
icebraker
• TAME study could fail
• Biggest impact is the precedent
• However, for 2 years they can’t start
• Crowdfunding failed

23. lifespan.io
• Crowdfunding platform for cheap tests on mice
• Medium costs is 20-50.000 USD
• Several successful trials

24. Open Longevity
Clinical trials funded by patients
• Openness of the research: the results belong to society, so there is no file drawer effect
• Non-commercial approach: the measure of the result is life extension and the improvement of the
biomarkers of aging, rather than commercial benefits.
• Cost reduction due to the fact that experiments are conducted at the expense of the volunteers
themselves.
• Testing of simple interventions which are proven to have low level of side effects makes it possible to
simplify experiments and remove the very expensive part: payments to clinics which organize clinical
trials.
• Collective activity increases motivation for some interventions, like sport
• Acceleration of studies due to the world's first diagnostic panel of aging, which allows to shorten the time
of the experiments
• Potential exponential scalability of the project, which will lead to an increase in the number of
experiments, improving their quality and attracting large donations.
• Experiment participants benefit from the tests and enjoy the experiments, thus getting positive utility
• The personal data collection system motivates the competition for rejuvenation, and also leads to the
integration of experiments with future AI systems
• Easiness to participate. People can join Open Longevity remotely by providing their data online.
• A group of patients can promote needed regulations, like gay community did in 1980s for acceleration of
research in AIDS.

25. Open Longevity
The “Longevity School” in Montenegro organized by
Open Longevity in 2017 was the first viable test of this
approach.