The Global Healthspan Report A New Agenda For Global Health - January 2024

THE GLOBAL
HEALTHSPAN
REPORT
A New Agenda
for Global Health
Hevolution.com
Foreword Acknowledgements
The reality of ageing today is an unforgiving one: Since our launch two years ago, Hevolution has The Hevolution Foundation wishes to thank the following
people are living longer yet are spending more been on an impressive trajectory, committing over experts, listed in alphabetical order, for kindly sharing their
years in poor health than ever before. This paradox $200 million in global funding to help reshape and time and expertise in the development of this report.
is a testament to both the successes and the severe accelerate discoveries and tangible contributions
limitations of our current healthcare paradigm. We to healthy ageing research and development. We
believe this can and must change. Everyone has the have also established a fast-moving investment
right to age well. Every person should live better – team based in Boston, Massachusetts, extending Dr. Jan Adams
not just longer. Hevolution's operational footprint globally and Partner, Apollo Health Ventures
Launched in 2021, Hevolution Foundation is a first amplifying its engagement with the broader life
of its kind global non-profit organization that provides sciences ecosystem that now includes a short list of Dr. Salman AlAsiry
grants and early-stage investments to incentivize companies that are potential investment candidates Vice President of Law, Ethics, & Compliance, Hevolution
independent research and entrepreneurship in the this year. We are proud to work with leading Foundation
emerging field of healthspan science. scientific institutions around the world to expand the
Our mission is to extend healthy lifespan for emerging field of healthspan science such as the U.S. H.R.H. Princess Dr. Haya Bint Khaled Bin Bandar Al Saud
the benefit of all humanity by driving efforts to National Academy of Medicine, the Buck Institute, Vice President of Organisational Strategy and Development,
understand the processes of ageing. We want to the American Federation for Aging Research, and Hevolution Foundation
increase the number of safe and effective treatments multiple universities worldwide, including nine across
entering the market, compress the timeline of drug The Kingdom of Saudi Arabia, in addition to The
Dr. Nir Barzilai
Founding Director, Institute for Aging Research, Albert Einstein
development using the latest tools and technologies, United States of America, The Netherlands, Austria,
College of Medicine
and increase accessibility to therapeutics that extend and Australia.
healthy lifespan. Our success is inseparable from our partnerships,
Stephen Berenson
because humanity achieves its greatest potential Managing Partner, Flagship Pioneering
through collaboration. Indeed, engagement is a
critical part of our work. It helps us to identify gaps, Dr. Victor J. Dzau
share valuable insights, unite diverse perspectives, President, National Academy of Medicine, United States
and offer practical recommendations to help guide
our collaborative efforts to deliver healthspan for all. Dr James Kirkland
To that end, we are delighted to share our first President, American Federation for Ageing Research
Global Healthspan Report: A New Agenda for Global
Health. This report synthesizes the findings of our Dr. Andrew Levin
global survey of 4,000 citizens and domain specialists Partner & Managing Director, RA Capital Management
from over 20 countries, two workshops with experts
in London and Boston, and a series of in-depth Rt. Hon. Lord David Prior of Brampton
interviews with scientists, investors, practitioners Former Chairman of NHS, United Kingdom
and policy experts. We are so pleased to bring
Professor Andrew J. Scott
together this group of experts to share their views
Professor of Economics, London Business School
and perspectives. We hope this report, published at
our Global Healthspan Summit in Riyadh, serves as a
Michael Torres
clarion call for advancing the healthspan agenda for all. Chief Communications Officer, Hevolution Foundation
DR. MEHMOOD KHAN

Chief Executive Officer, Hevolution Foundation
Table of Contents Abbreviations & Acronyms
Executive Summary 06 Aged society GDP
An aged society is one where 14% of the gross domestic product
About the Surveys 08
population will be over 65.
MENA
Introduction: Igniting the Healthspan Revolution 10
BMI Middle East and North Africa
The Healthspan Imperative 11
body mass index
mRNA
Chapter 1: From Reaction to Prevention 13
CAGR messenger ribonucleic acid
Chapter 2: The Healthspan Science Frontier 16 compound annual growth rate
NAM
Stem Cells: Fountain of Youth? 18
CRISPR National Academy of Medicine
Tackling Cellular Senescence 19
clustered regularly interspaced short (United States)
Genetic and Epigenetic Innovation 19
palindromic repeats
Drug Repurposing 20 NCD
The AI Enabler 20 DALYs noncommunicable disease
Chapter 3: Investing in Healthspan 21 disability adjusted life years
NHS
Chapter 4: The Healthspan Society 25 FDA National Health Service
The Healthspan Economy 28 Food and Drug Administration (United Kingdom)
Putting Healthspan to Work 29 (United States)
Intergenerational Relations 31
NIH
G20 National Institute of Health
Chapter 5: A Leapfrog Opportunity? 32 Group of 20 (United States)
R&D Challengers
GCC WHO
Chapter 6: Policy Leadership 36 Gulf Cooperation Council World Health Organisation
Conclusion: An Action Agenda for Healthy Longevity 40 IMF

International Monetary Fund
Healthspan science is flourishing, thanks to innovations in medical
research and new ways of understanding human biology.
The evidence base is building for novel approaches to tackling the diseases of ageing.
Early diagnostic innovations, such as AI-powered liquid biopsies, promise to catch
killer diseases before they take hold. Senolytics can target damaged cells before they
wreak havoc on the body. mRNA vaccines and cell and gene therapy hold promise for
stopping diseases from emerging in the first place. Leading the research agenda are
a growing pool of investors and scientists who are boldly questioning the common
assumption of chronic disease as an inevitable consequence of ageing. Their efforts
are essential; nearly two in three health professionals we surveyed (63%) believe health
systems will not be financially viable by 2030 without a breakthrough in healthy longevity
science.
To capitalise on progress, scientific research into expanding healthspan needs

enabling reforms on how therapies are tested, approved, and reimbursed.
Our survey found scientists were most optimistic about the impact of stem cells on
longevity (63%), but large shares also marked AI, next-generation vaccines, genomic
editing, advanced biomarker detection and therapies targeting senescence. The business
case is compelling; 97% of financial professionals believe healthy longevity investments
can yield greater financial returns than traditional healthcare investments. But as a highly
regulated sector, pharmaceutical research and investment is heavily influenced by the
Executive
incentives laid out by regulators. To encourage bold R&D, medical agencies and payers
(insurance companies or governments) need to craft a pro-innovation regulatory and
approval environment that rewards innovations that prevent, rather than treat, disease,
Summary
and that recognise the clinical validity of ‘pre-disease’ states and new biomarkers.
Emerging economies face a worrying rise in unhealthy ageing; with

the right actions now, they can learn lessons from the mistakes of the
developed economies – and be innovation leaders in their own right.
Antibiotics, vaccines, agricultural productivity, digital technologies, and radical new approaches
and public health policies all helped significantly to how we organise work, pensions, and education, Our survey found that citizens in emerging markets are strongly in favour of innovation
increase human lifespan in developed economies countries can finally make healthspan achievable and reforms to enable healthy longevity, from willingness to use longevity therapies
and services to rethinking policy areas like pension age. As their health systems are
over the 20th century. These hard-won additional for all citizens.
less entrenched, these countries, home to most of the world’s population, can build
years are frequently blighted with chronic disease But the shift is systemic and complex, the infrastructure required for a ‘healthspan society’ including a greater role for digital
and morbidity. In both developed and emerging requiring new ways of thinking and breaking away technology and preventive approaches. Their regulatory approaches could also challenge
economies, ‘unhealthy longevity’ is weighing from conventions and the status quo, stretching conventions and norms, fostering responsible innovation in the healthspan field.
heavily on the individual, as well as health systems, from how medical research is conducted to health
economies, and societies at large. service design. This Hevolution Foundation report,
The ’healthspan’ agenda – which emphasises drawing from a global survey of citizens and experts,
the extension of healthy life years, not simply two expert workshops and an interview program Health system reform is often glacial; ambition and policy leadership
lifespan – is moving from the field of geroscience with leading thinkers in science, investment, and will now be key to tackle the crisis of unhealthy ageing.
into the spheres of public health, policy, and policy, outlines the key calls to action for enabling Most policy professionals in our survey believe that healthy longevity requires a new
economics. Thanks to breakthroughs in science and the healthspan transition. approach, but a similar majority (75%) would prefer to be a “fast follower” rather than a
leader when it comes to approving longevity therapies. This shows the need for policy
leadership for countries to show vision and provide the path for others to advance.
Globally, coordination and collaboration on best practices to support preventative health
is essential; international organisations and standards-setting bodies can aid in this and
leverage networks like the G20.
6 The Global Healthspan Report A New Agenda For Global Health 7

About the Surveys 4,000 Citizens Regional Distribution
(Percentages may not total 100 due to rounding.)
To inform the report and complement its research, interview program and
workshops, Hevolution Foundation commissioned two global surveys, the findings
of which are described in this report.
Industry
University degree 38%
Post-graduate 25%
Secondary (high) school 20%
Vocational qualification 11%
Other 6%
0% 12% 24% 36%
Data for the citizen survey was collected

1,000 Healthcare Regional Distribution
(Percentages may not total 100 due to rounding.)
20 Countries
between June 16, 2023 and July 27, 2023
via online surveys.
Professionals
Were Covered
Data for the healthcare professionals
survey was collected June 15, 2023 and
Africa Middle East July 14, 2023 using computer assisted
Nigeria Bahrain telephone interviews methodology
South Africa Egypt
Kuwait
Asia-Pacific Oman Industry
Australia Qatar
China Saudi Arabia
India United Arab
Japan Emirates
Singapore
North America
Europe Canada
France United States
Germany
United Kingdom
Latin America
Brazil

Igniting the
Healthspan Revolution “OF ALL THE ISSUES
THAT FACE THE WORLD
AND HUMANITY, THE
AGEING POPULATION
Antibiotics, vaccines, improved food production are falling too, a demographic time bomb as Gulf countries, meanwhile, have a median
technologies and investments in sanitation and tomorrow’s workforce shrinks ever further (7). population that is relatively young, and yet there AND HEALTHY
public health all helped dramatically lengthen The outlook for emerging economies is more is evidence of an increased incidence of diseases LONGEVITY IS VERY
IMPORTANT”
human lifespan in Western countries over the 20th dire. Falling fertility in emerging economies is traditionally associated with ageing (10). In
century, and promise to lift the six billion inhabitants doubly significant because the family network Oman, for instance, almost 20% of all colorectal
cancer patients were diagnosed under the age of
of developing countries to look forward to the same (1). shoulders a considerable share of the care burden
− DR. VICTOR J. DZAU
These hard-won additional years are frequently for older people, and it is shrinking. The number 40, partly attributed to changes to lifestyle and President, National Academy of Medicine,
blighted with chronic disease and morbidity from of people aged 60 and over in China will rise from adoption of Western diets (11).“The primary health United States
what longevity thought leader Peter Attia has 254 million in 2019 to 402 million by 2040, making care challenge in [Saudi Arabia] is cardiovascular
dubbed the ‘four horsemen’ – atherosclerotic up 28% of the population. An estimated 14 million diseases,” says Salman AlAsiry, Vice President of Law,
disease, cancer, neurodegenerative disease and of them will need long-term care by 2030, and Ethics, & Compliance at Hevolution Foundation.
foundational disease, a spectrum ranging from there will not be enough young people to shoulder
insulin resistance to fatty liver disease. These the informal support that the country has implicitly THE HEALTHSPAN IMPERATIVE
together account for 80% of deaths of those relied on (8). Several Asian economies are also Healthspan – a concept referring to years of life
over 50 who do not smoke (2). “Through most of 'prematurely aging', meaning their population lived in good health, rather than simply being
human evolution, lifespan has been between 20 is growing old in ways that typify demographic alive – is a concept that is moving from the field of
and 30 years,” says Dr Nir Barzilai, director of the trends in much higher income countries. Thailand, geroscience (12) to wider public health, biotech and
Institute for Aging Research at the Albert Einstein for instance, reached the threshold for an aged policy circles, as the unsustainable trajectory of this
College of Medicine. “In the last 150 years, we did society in 2021 (14% of the population aged 65 or every-growing number chronically ill older people
something incredible: we tripled our lifespan. In over) yet unlike aged societies like Japan and South becomes evident everywhere. As a testament to
doing this, we got diseases that haven't been part Korea, Thailand is not yet a developed country (9). its importance, the National Academy of Medicine
of the previous 100,000 years of human evolution.” in the US has selected healthy longevity one of
The burden of ‘unhealthy longevity’ on the grand challenges. “Of all the issues that face
individuals, their families and health systems is the world and humanity, population ageing and
immense – and set to worsen. Globally, disability
“IN THE LAST 150 YEARS, WE healthy longevity are especially important,” says
adjusted life years, a metric that includes years Dr Victor Dzau, president of the National Academy
DID SOMETHING INCREDIBLE:
of life lost to time lived in a state of ill health, of Medicine.
increased by 32% between 1990 and 2019, and is
WE TRIPLED OUR LIFESPAN.
expected to have increased by 55% between 2004 IN DOING THIS, WE GOT
and 2030 (3,4). DISEASES THAT HAVEN’T BEEN
An estimated 20% of healthcare spending PART OF THE 100,000 YEARS
growth will be attributed to ageing by 2025 (5). OF HUMAN EVOLUTION”
Rising costs coincide with economic stagnation
common to ageing economies, including slower − DR NIR BARZILAI
GDP growth, smaller working age populations Founding Director, Institute for Aging Research,
Albert Einstein College of Medicine
and tighter government budgets (6). Fertility rates

Current healthcare systems are poorly set up healthcare costs (15). Advances in technology and
01
From Reaction to Prevention
Health systems of the developed world were
designed for a far-gone age, focused on acute care,
consumption of healthcare resources and facilities,”
says Dr Dzau at the National Academies of
to respond to this new paradigm. In 1948 when the preventative healthcare can postpone the onset of infectious disease and hospital-based interventions. Medicine. “A population health approach is key.
NHS was founded, a baby boy had a life expectancy ill health before death, with periods of morbidity Combined with the power of vaccines, antibiotics Prevention needs to happen further upstream.”
of 65.86 years and that of a baby girl was 70.29 (13). becoming ‘compressed’ into shorter periods (16). and sanitation, they were successful in lengthening Primary and secondary care spending
Now, the average across both males and females “Healthspan has been the objective of medicine life expectancy in the 19th and 20th century. “The constitute the majority of health spending with
is 81.77 years (14). According to Lord David Prior since Greek times, and suddenly we have new traditional health system, based upon disease- just 2 to 3% on average directed at prevention,
of Brampton, a member of the UK House of tools and new understanding at our disposal,” says based interventions, has got us living to 70 or according to Professor Scott. The focus is
Lords and former chairman of England’s National Lord Prior of the UK House of Lords. 80,” says Andrew Scott, Professor of Economics intervening on the consequences of ageing. Yet,
Health Service (NHS), developed economy health By expanding healthspan, older citizens can at London Business School. “But a system by a large majority, prevention is seen as the most
systems are skewed towards acute and ‘sick-care’, be productive, active, and contributing members designed around the model for infectious disease effective lever to achieve healthy longevity. Nearly
rather than prevention and supporting elderly of societies. But achieving healthspan requires interventions can't cope with the second longevity two thirds of citizens (64%) in our survey agree that
people with chronic disease. “We’ve got a massive ambition and innovation, from challenging norms revolution, which is about changing how we age.” influencing lifestyle and diet was the strategy that
investment in legacy institutions of a late stage sick and assumptions about biological ageing to ‘Healthspan’ marks a paradigm shift in would help most to rapidly extend healthy human
care system,” says Lord Prior. “We have invested revising medical curricula to emphasize preventive medicine and policy that targets both adding lifespan. Indeed, under a healthspan paradigm,
in hospitals at the expense of primary care, social health insights which today’s medics are barely more years to life and more active life into those the citizen becomes a central actor at the heart
care and public health.” taught. It requires harnessing the latest advances years. Ambitious but essential, the healthspan of the prevention system, with the majority of
Emerging economies, meanwhile, face a twin in wearable technology, artificial intelligence, early vision requires far-reaching changes to health medical experts (52%) believing that the main
challenge of supporting growing numbers of older diagnostics, drug repurposing, and exploring systems, from drug development to the structure consequence of a healthspan system would be to
people with chronic disease, while still battling a frontier ideas like stem cell therapy, mRNA vaccines and distribution of health services. One such pivot empower individuals to manage their own health.
high infectious disease burden with conditions like for chronic disease and drug development areas is towards prevention. “The older population has This means designing a health system that puts the
tuberculosis, HIV/AIDS and malaria, all in a context like senolytics, which can tackle the process of 2-4 times more chronic disease that is responsible individual in command.
of lower incomes and smaller public budgets. cell ageing itself. It will be a society-wide reform, for increased disease burden and significant
The outlook might seem gloomy, but going far beyond biotechnology and healthcare
projections are not laws. The decisions we take now actors, to include labour markets, advertising and
will impact how our societies adapt to demographic branding, and education. If achieved, expanding
change. Growing older need not mean growing human healthspan will also raise new questions “A SYSTEM DESIGNED AROUND THE MODEL FOR INFECTIOUS
sicker, as evidenced by how the health of about everything from intergenerational equity DISEASE INTERVENTIONS CAN'T COPE WITH THE SECOND LONGEVITY
centenarians varies across countries, especially to reforms to the retirement age, while at the REVOLUTION, WHICH IS ABOUT CHANGING HOW WE AGE”
in the so-called 'blue zones', defined as regions same time accommodating cultural and religious
of the world with higher than usual numbers of differences on the scope of medical research into − PROFESSOR ANDREW J. SCOTT
healthy older people. Demographic ageing ageing and longevity. Professor of Economics, London Business School
does not inevitably cause an exponential rise in

Figure 2
Figure 1
“What do you think would be the main consequences of healthy longevity for healthcare systems?”
"Which of the following strategies do you think will help most rapidly extend healthy human lifespan?”
(Medical experts responses)
(Citizen responses)
80%
Individuals would be more empowered 56%
to manage their own health
It would accelerate the transition to 49%

64% precision public health
60% It would align healthcare payments with positive 44%

health outcomes instead of negative ones
It would switch the paradigm from 43%

disease-focused care to preventive care
40%
40%
It would reduce the cost of public healthcare 43%
33%
27% 26% Other (specify) <1%
0% 20% 40% 60% 80%

20%
10% 10%
7%
6%
0% pressure, and improved psychosocial outcomes a combination of inertia and regulatory obstacles
Promote healthy Adapt the social Increase Train doctors Increase Increase the Repurpose Compress the Other (specify)
lifestyles
and diets
and economic
environment to
awareness on
healthspan
in healthspan
practices
accessibility to
therapeutics that
number of
healthspan
existing drugs for timeline for drug such as depression and anxiety (20, 21). prevented adoption. That changed under necessity
healthy lifespan development
accommodate
healthier older
benefits to trigger
a mindset shift
extend healthy
lifespan
drugs in the
marketplace (e.g.
applications using the latest A study on the long-term benefits of using during lockdowns, and digital consultation has
technologies
people among the
population
geroprotective
drugs)
trackers such as continuous blood glucose now become more accepted. In the first months
monitors indicates beneficial effects on parameters of the COVID-19 pandemic, the number of
like blood sugar levels (22) while online health teleconsultations skyrocketed to as high as 50%
communities have improved patient outcomes of all doctor consultations in Denmark and Spain,
Delivering this change will require a shift in outlook Medicine and passed in 2017 by the American and increased empowerment (23). But such tools for example (24). Nine countries (Estonia, Hungary,
and training, such as moving more nurses and Medical Association House of Delegates, is a are often confined to the already healthy, better Iceland, Ireland, Korea, Luxembourg, Mexico,
doctors to local community bases so it’s “easier to commitment to support policies that incentivise or off citizens in society, and need to be made more Turkey and the United States) which previously
just pop in and talk to people,” says Professor Scott. fund the inclusion of lifestyle medicine education in commonly available. only allowed in-person medical consultations also
Upskilling will also be needed. As explored in the undergraduate, graduate and continuing medical As clinical evidence grows, those who adapted their policies.
London Hevolution Foundation workshop, medical education (19). regulate, approve and reimburse digital health Though triggered by a crisis, the changes
education needs to incorporate preventive and Professional incentives are also often geared technologies will likely see value in shrinking the look set to remain. Some 40% of patients now
lifestyle education, which has played a minor role towards acute care and surgical specialty - thus ‘ill’ years of life, which currently weigh heavily on prefer telemedicine to in-person consultations (24).
in conventional curricula. towards promoting the status quo. To enable a health systems and the public purse. “Healthcare England’s NHS is increasingly rolling out ‘virtual
Medics are not taught enough about shift towards preventative care, medical curricula providers will be happy to pay once they see how wards’ that can monitor patients at home or in care
preventive approaches and the role of nutrition, must evolve to bring areas like nutrition and healthspan is extended,” predicts Dr Barzilai of the homes, greatly reducing pressure on overstretched
sleep, and stress during their training. A Lancet lifestyle to the fore, so that prospects for a career Albert Einstein College of Medicine. hospitals (25). This shows change is possible, and
analysis showed that nutrition is insufficiently in that space become more attractive. Health system reform is a challenging reforms that facilitate the uptake of preventive and
incorporated into medical curricula across countries, Technology will be a powerful ally in achieving endeavour akin to changing an engine while a health management technologies, from consumers
settings and years of study (17). A 2021 survey of a prevention-focused health system. For consumers, vehicle is moving. But there are signs that, with to clinical actors, could play a major role in bringing
US and UK medical schools found that students there are now a range of affordable, effective political will and given pressing needs, legacy greater agility to the current system.
received an average of 11 hours of nutrition training, wearables that track activity, diet and sleep, while institutions can shake out of their inertia and make
part of which is typically student-run (18). This social networks incentivise and reward healthy greater use of technology. Telemedicine and
shows there is significant need for more policies to decisions by making them more fun and social, such virtual consultations are a case in point. These were
embed preventative care in the healthcare system as sharing of runs and ‘personal bests’ on Strava. technically possible for years prior to the outbreak
if we are to move towards a prevention-focused These promote self-monitoring and goal-setting, of COVID-19, offering more convenience and
approach to health. For instance, Resolution 959, and are associated with improved physiological service efficiency for patients and medical staff, but
introduced by the American College of Preventive outcomes such as a reduced BMI, reduced blood

02
‘Pills for living longer’ are no longer the stuff A Breakthrough is
of science fiction: the humble statin has saved
thousands of lives including in those who lead Expected this Decade
healthy lifestyles overall but are at risk with the
passing of time. Lord Prior of the UK House Half of healthy longevity professionals
of Lords says the pharmaceutical and biotech expect a breakthrough in longevity
industry should not be underestimated as an research within the next 5 years (most
engine of change in bringing new therapies to healthy longevity professionals expect it
market. “If you look at who rose to the challenge within the next decade)
of COVID, it wasn't primarily the traditional
The Healthspan Science Frontier

healthcare service,” he says. “They treated people Big Pharma is believed to be the number
who got the symptoms of the disease, but it was one driver in all regions, but the belief is
the pharma industry – it was BionTech, Moderna, significantly greater in Brazil, the Middle
Pfizer, AstraZeneca – who came up with a vaccine East and Europe
in under a year and now these new mRNA vaccines
Prevention can delay the onset of noncommunicable disease, but cannot entirely eradicate it. Genetic can be produced in under 60 days.” Improving social benefits is believed
and environmental stresses, and the march of time, statistically increase risk. Even those sceptical that the The healthspan science field is now advancing to be the most important objective of
overall lifespan of humans can be expanded recognize the possibility of 'compressing' the period of life in across several fronts, from stem cells and gene longevity research for both citizens and
ill-health to the final months or years. editing to repurposing mainstream drugs which healthy longevity professionals
Optimists believe biotech and pharmaceutical innovation, from stem cells and breakthroughs in early confer surprising healthspan benefits. Our survey
diagnostics to mRNA-based vaccines for chronic disease, could bring curative breakthroughs for conditions found scientists were most optimistic about the
that have so far eluded a cure, like dementia and cancer. Indeed, most professionals in the healthy longevity impact of stem cells on longevity (63%), but large
field expect a breakthrough in longevity research within the next 5 years. They also see those breakthroughs shares also marked AI, next-generation vaccines,
as necessary: nearly two in three health professionals we surveyed (63%) believe health systems will not be genomic editing, advanced biomarker detection
financially viable by 2030 without a breakthrough in healthy longevity science. and therapies targeting cellular senescence.
Figure 3 Figure 4
“To what extent do you agree with the following: without breakthrough in healthy longevity, our “When do you believe that breakthroughs in longevity research will significantly impact society?"
healthcare systems will not be financially viable by 2030." (Medical experts responses) (Expert and citizen reponses)
Total 63%
North America 57%
Brazil 64%
Middle East 47%
Europe 74%
Asia-Pacific 68%
Africa 74%
0% 25% 50% 75% 100%

Figure 5 TACKLING CELLULAR SENESCENCE GENETIC AND EPIGENETIC
“Which scientific breakthroughs do you believe will have the most significant impact on the longevi-
Senolytics and senomorphics are drugs that kill MODIFICATION
or modify the behaviour of senescent cells, which Epigenetic mechanisms – cellular processes that
ty field in the next 10 years?” (Scientists responses)
have stopped replicating (33) and which contribute regulate and change gene expression without directly
to ageing by secreting bioactive molecules with bringing about gene mutations – are a second target
mostly deleterious functions. Senolytics have in healthspan research (34). Certain practices that
Stem cell research 60% shown promise in treating age-related diseases influence ageing, such as dietary restriction, work
such as diabetic kidney disease and idiopathic in part by causing epigenetic modifications. (35). A
Artificial intelligence pulmonary fibrosis. “It may take only one dose of number of pharmaceutical companies are currently
and machine learning 47% senolytics to get rid of those senescent cancer- working on reproducing genetic processes that
harboring cells that are susceptible to senolytics, slow ageing. Merck is developing a CETP inhibitor
Next-generation because senescent cells generally do not divide,” for cardiovascular disease. Ionis is developing an
vaccines e.g. mRNA 43% says Dr James Kirkland, President of the American APOC3 inhibitor. A third project is an IGF1 receptor
Federation for Ageing Research. antibody, developed by several pharmaceuticals to
Genomic editing
“There are at least 40 conditions that fight cancer; in preclinical studies on animals, they
41%
(e.g. CRISPR) senolytics appear to delay, prevent, alleviate lived 10% longer and were much healthier.
or treat in preclinical models. These are things For Dr Barzilai at the Albert Einstein College
like osteoporosis, osteoarthritis, diabetes, of Medicine, this sector is poised for growth as the
Advanced biomarker 34%
identification complications of obesity, complications of global health data ecosystem expands. “Two-thirds of
chemotherapy, cancer development and cancer the drugs approved by the FDA last year were based
recurrence. There are several hundred senolytic on genetic findings in humans,” says Dr. Barzilai. “If
Senescence-targeting 31%
therapies candidates discovered now since we discovered we had the genome sequencing and electronic
the first ones.” According to Dr Kirkland, the study medical records of all 8 billion people in the world,
of senescent cells is relevant across various ageing we’d be able to treat every disease in the world.”
Microbiome therapies 27% treatments, including metformin, a diabetes drug. Gene editing is another way of exploring the
“Metformin works in part by inhibiting production role of genetics in the ageing process. CRISPR-
0% 20% 40% 60% 80%
of the things that senescent cells use to damage based gene editing can be used to promote
those around them,” he says. healthspan by identifying and silencing genes that
affect ageing (36). Studies in mice with a mutation
that causes progeria – a rare, fatal, genetic disease
that causes symptoms of early ageing – have
STEM CELLS concerns. However, regulatory reforms are starting shown that a CRISPR-like technique corrected the
Stem cell research is by far the most impactful to emerge, with the potential to facilitate new mutation and prevented the heart damage typical
field, our survey found. Stem cells are found in the avenues and therapeutic uses. Japan has adopted of the disease. Treated mice lived more than twice
developing fetus and are undifferentiated cells a policy of regulatory reform, aiming to stimulate as long as untreated animals (37). Gene editing has
from which cells with specialised functions are business and speed up the approval process for “THERE ARE AT LEAST been a particularly fast-changing area of research.
generated, such as brain cells, blood cells, muscle stem cell therapies (29). Businesses 40 CONDITIONS THAT “From an investment point of view, we see medical
cells or bone cells (26). Many adult tissues also and patient groups in the US and UK have SENOLYTICS APPEAR progress as a slow process of chipping away,” says
contain stem cells with the ability to differentiate advocated for similar approaches (30). TO DELAY, PREVENT, Dr Andrew Levin, Partner & Managing Director at
The Middle East is an emerging hub for stem
into tissue-specific cell types. These lose their
cell research. Jordan has been leading the way for
ALLEVIATE OR TREAT IN RA Capital Management. “But mRNA and editing
potential for self-renewal and tissue generation systems have changed a fair bit, at a steeper curve
(27). Clinical trial results from studies of stem cell the regulation of stem cell research, passing laws PRECLINICAL MODELS" than you’d normally expect.”
in 2014 that allow the use of human embryonic
transplantations on frailty and facial skin ageing − DR. JAMES KIRKLAND
have been positive (27). Stem cells in conjunction stem cells from permissible sources - including
President, American Federation
with genetic functions create a shield of protection excess eggs from in vitro fertilisation, which are for Ageing Research
to withstand erosion by ageing and may result in banned from use in many other countries - by
longevity (28). government organisations and publicly funded
Preserving the functions of stem cells for academic institutions (31). Other countries in the
longer could have significant impacts on slowing region have since moved in the same direction,
the ageing process. Currently, stem cell research is with a centre established in the UAE developing
strictly regulated in many countries due to ethical COVID-19 treatments using stem cells (32).

03
DRUG REPURPOSING THE AI ENABLER
If the allure of breakthrough novel therapies is Cutting across each healthspan field is the capability
understandable, there is also a surprising level of contemporary artificial intelligence, which was
of optimism that existing drugs could deliver the second most-cited breakthrough innovation
healthspan benefits. Our survey found that 86% of opportunity in our survey. AI can identify patterns
medical professionals believe repurposing existing within complex data sets including genomic,
drugs for healthy longevity applications is a viable proteomic, metabolic and physiological ageing-
approach to enhancing the field. related data and unveil mechanistic relationships.
Among top candidates are rapamycin and It can identify biomarkers of age which would allow
metformin, with about one third of respondents targeted treatment, optimises the development
being highly optimistic that they can be of new compounds and improves selection of
repurposed for healthspan benefits. The former appropriate treatments by predicting treatment
Investing In Healthspan
is an FDA-approved drug used to prevent organ outcomes (44).
transplant rejection and in cystic lung disease (38), AI offers significant positive implications for
and has been found to slow ageing in worms, flies, drug development. “This is the most exciting time
and mice, by inhibiting the activity of TORC1, a in medical science in a generation,” says Lord Prior
protein complex that senses nutrients inside every of the UK House of Lords. “The understanding of
cell (39). The same type of drug was found to how molecular biology works at a cell and gene The task of backing scientific research into healthspan medicine is falling to a large extent on biotech
improve immune function in elderly patients (40). level, and the application of generative AI to investors as public funding options, like those of the National Institutes of Health (NIH), tend to focus on
It is currently in veterinary clinical trials to assess its simulate the behaviour of human cells, opens up specific disease verticals, rather than targeting ageing biology per say. Dr. Jan Adams, partner at Apollo
ability to slow ageing in dogs (41). Metformin is a the field of regenerative medicine in a way that Health Ventures views the strategy of targeting the so-called ‘hallmarks of ageing’ as “a vertical in its own
FDA-approved drug that has been used successfully would have been inconceivable three, four or five right”, distinguishing it from traditional approaches to healthcare investment.
to treat diabetes and occasionally helps to treat years ago. Cancer vaccines, cell therapies where
symptoms of polycystic ovary syndrome (42). It you can, for example, reprogram cells to produce
has been shown to delay ageing in animals and dopamine, these are extraordinary potential
influence fundamental ageing factors that underlie breakthroughs.”
Figure 6
age-related conditions in humans. Scaling up AI in healthcare will require
“Two studies, one in the New England Journal regulatory frameworks - of which there are few The Hallmarks of Ageing
of Medicine and one in the Lancet, showed that at the moment worldwide, though this is starting
giving a COVID patient metformin within three to change. In October 2023, the WHO released
days of infection prevented hospitalisation, death, a series of considerations for regulation of AI for
and long COVID by over 40%,” says Dr Barzilai. health, aiming to provide a framework for countries.
“Metformin changes immunity and cell formation, The WHO report emphasises transparency and
and that’s why it has the potential to prevent age documentation, risk management, clarity of
related disease.” The American Federation for intended use, a commitment to data quality and
Ageing Research is conducting an ongoing clinical protection, and fostering collaboration between
trial called TAME (43). Dr Barzilai believes that regulatory bodies, research bodies, medical
once metformin is approved for ageing by the practitioners and patients (45). This will support
FDA, “the acceleration of what biotechs will be countries in establishing safe and effective AI
able to do will be amazing.” regulations for healthcare.
"THIS IS THE MOST EXCITING TIME IN

MEDICAL SCIENCE IN A GENERATION”
− RT. HON. LORD DAVID PRIOR OF BRAMPTON
Former Chairman of NHS, United Kingdom

The investment case for A growing pool of investors is spotting (52). The suite of wearable technologies is now
healthy longevity is clear opportunities to build businesses in the healthy expanding to those which can monitor deeper
ageing space. The economic opportunity is vast. indicators like heart rate, blood pressure and blood
to finance professionals The economic value of slowing down biological glucose with increasing precision, often based
ageing and improving health alongside a 1-year on subscription fee models. The supplements
97% of finance professionals believe that healthy increase in life expectancy is $37 trillion (46). opportunity is a draw for some investors and
longevity investments can yield greater financial One estimate puts the commercial market for startups, especially given the reported evidence
returns than traditional healthcare investments ‘delaying human death’ at $610 billion by 2025 of repurposed drugs like metformin (53), although
(47). A recent and prominent sign of growing care is needed to ensure proper governance,
Artificial intelligence (44%) is the most invested awareness came with the $3 billion financing of regulations and safety.
field, followed by stem cells (25%) and Altos Labs, a company with a stellar scientific team “Improving overall wellness rather than
immunotherapy (23%) (48). Our survey confirms that investors see long- increasing the length of life is a relatively new
term commercial potential with 97% of financial concept,” says Dr Levin of RA Capital. “As an
Corporate partnerships (53%) are the most professionals believing healthy ageing investments investor, my theory is that we'll see a shift to more
popular source of funding for longevity research can yield greater financial returns than traditional of a commercial based model in terms of quality
followed by PE (46%), VC (39%) and internal R&D healthcare investments. of life. People pay for the gym and cosmetic
(39%) Major new markets can open quickly, as procedures and other things to make their body
evidenced by recent and mental health feel
The fear of missing out on the next wave of breakthroughs in a class better and look better,
healthcare innovation is strongest in the Middle of appetite-suppressing "WE'RE OBSERVING and that’s how I see the
East (39% vs 26% average) GLP-1 agonist class of A GROWING INTEREST healthy longevity field
drugs, which mimic the
GLP-1 hormone produced
ON THE PART OF going.”
The early, even pre-
by the body to indicate INVESTORS TO FIND symptomatic diagnostics
satiety. Sales of GLP-1
A WAY TO PARTICIPATE space is another domain
drugs are expected to top attracting biotech
Figure 7 $18 billion this year (49). IN ADDRESSING LARGE investors, as product
“The biotech industry MARKETS: DISEASES innovations show potential
What are your company’s motivations for investing in healthy longevity? has been reluctant to go to catch killer diseases
(Finance professionals response) after large population- WITH MILLIONS OF at a far earlier stage.
wide diseases, not PATIENTS” Harbinger Health, a liquid
because of the lack of biopsy and AI startup, has
business opportunity − STEPHEN BERENSON developed an algorithm
but the intractability of Managing Partner, Flagship Pioneering that can detect cancer
the clinical development with 82% sensitivity (54).
programme without surrogate biomarkers and the “One Flagship company currently in stealth mode
capital required to do it right,” says Mr Berenson, is trying to come up with a scientifically rigorous
Managing Partner at Flagship Pioneering. “But way of identifying pre-disease states and then
now that [Eli Lilly and Novo Nordisk] have shown identifying therapies, treatments, vaccinations
extraordinary success, we're observing a growing that can catch something in a pre-disease state
interest on the part of investors to find a way to and at least delay the onset,” says investor
participate in addressing large markets: diseases Stephen Berenson, Managing Partner at Flagship
with millions of patients.” Pioneering, a fund which also backed Harbinger
For some investors, the healthy ageing Health. The company has identified early
opportunity is also the next chapter in the consumer biomarkers for disease states like nonalcoholic
wellness market, a segment which reached $1.5 liver disease. “I think early diagnosis is one of the
trillion in 2021 according to McKinsey (50). About stronger themes in terms of impacting longevity
492 million “smart wearable” units were shipped and wellness,” says Dr Levin of RA Capital.
in 2022 (51). The fitness trackers market size was Investors call for enabling reforms to unlock
valued at $7.5 billion US in 2022 and will reach more capital and support startups. An important
$16.91 billion US in 2028, with a CAGR of 14.32% area for innovation is for regulators and payors to

recognise and reimburse innovations that target In the US, the FDA has set premarket
prevention or pre-disease states, which today requirements for AI or machine learning-enabled
is not common outside of certain well-studied medical devices, expanding the current regulatory
preventatives such as vaccines. This could include framework to ensure the safety and effectiveness
expanding the definitions of medical devices to of AI products on the market. Approved devices
include devices that assist preventative care, for include wearable seizure monitors, glucose
instance, and developing metrics to approve monitors, and a mobile application to detect heart
and fund companies developing therapies that rhythms (56).
spot the earliest signs of conditions like cancer, The regulatory landscape is evolving for AI
dementia and diabetes, when outcomes could be that uses adaptive algorithms, which learn from
04
modified, delayed or even eradicated. In addition real time data, rather than “locked” algorithms.
to regulatory and payor innovation, these types of The FDA is now considering a new product
interventions will require clinical demonstration of lifestyle-based regulatory framework in order to
benefit, with innovative clinical trial designs and allow for modifications from real-world learning
endpoints. and adaptation, while still ensuring that the
“There needs to be an evolution of the way product’s safety and effectiveness are maintained
these treatments would be paid for,” says Mr throughout its lifecycle (57). This expansion of
Berenson of Flagship Pioneering. “Today, at least medical device regulation, once adopted, could
in the US environment, it’s hard for somebody expand the capacity for innovation from medical
to get paid for supplying a treatment to a pre- device manufacturers.
disease state. We have to create a framework for With 52% of investors expecting a
qualifying pre-disease states as being eligible breakthrough in healthy longevity research in the
for reimbursement.” Jan Adams agrees that near future and 97% of investors expecting better
facilitating investment in pre-disease identification financial return from healthy longevity investments,
and prevention should be a priority. “We need to
find early symptoms and get approvals based on
it is easy to see why there is a tremendous interest
from the investment community. The Healthspan Society
biomarkers,” he says. “Neurodegeneration might One driver to be careful about will be hubris,
be where this starts as a template, in areas like especially among tech investors or founders not
Alzheimer’s or ALS, and this could be a sandbox.” familiar with the highly regulated healthcare field.
Regulatory frameworks for AI are also The ghost of Theranos looms as a warning of the Achieving a longer and healthier life for all citizens to emerging science; ignoring public opinion was
evolving, as it can be classified as a medical device dangers of over-hyping. “Tech investors have a would be a triumph of medicine, technology and a key reason for the controversies and pushback
with important implications for allowing individuals very different cultural mindset,” says Dr Levin of health policy. The implications this would have on related to genetically modified food.
to access and pay for AI health services. Used for RA Capital. “The tech mindset is that tech can do society are profound. Demographic transition is an One important finding from the survey is that
diagnosis, prognosis, screening, and supporting anything, we can solve any problem.” Dr Levin engine of wrenching social and economic change, demand for longevity products and service was the
treatment, AI medical devices can relieve pressure cites the example of a company that had built an bringing both opportunities and challenges. highest in emerging markets, with 52% of Brazilian
on the health system (55). impressive diagnostic tool for Alzheimer’s disease, The pursuit of longevity science specifically and 45% of African citizens expressing interest
but that was impractical to roll out at scale – and raises questions about ethics, values and principles (vs. 32% globally). Another is that concerns over
which offered limited impact given there is no cure that will vary across cultures and contexts. For the ethics of longevity research, though real, are
for the condition. example, around 70% of participants - both not necessarily a barrier to demand. While Middle
Still, it is important to encourage a wider citizens and healthcare professionals- express Eastern citizens are more likely to question the
pool of investors into the space. Boston workshop concerns about the ethical implications of longevity pursuit of longevity medicine because it goes
"IMPROVING OVERALL participants proposed a strategic multidisciplinary science, while two thirds of citizens believe that against their beliefs (25% vs 12% average) and
WELLNESS RATHER THAN alliance to showcase investor interest in the longevity research would increase socio economic because we should not tinker with nature (40% vs
INCREASING THE LENGTH healthspan domain to provide the patient capital inequalities. 34% average), their interest in longevity products
needed to support investment. For if startups are
OF LIFE IS A RELATIVELY The Hevolution Foundation survey also found is nevertheless in line with global averages while
hard and risky, biology is harder.
NEW CONCEPT” regional differences on nearly every aspect of it their willingness to pay for it is higher (28% would
- from willingness to buy products or services to be willing to spend 4-6 months of income on
− DR. ANDREW LEVIN attitudes about whether it would require reforms longevity therapies vs. 23% average)
Partner & Managing Director, to retirement age. Health regulators, investors and
RA Capital Management companies must be attuned to citizen attitudes

Tackling existing diseases is seen as a Figure 9 Interest in healthy longevity across regions (Citizen responses)
prerequisite to longevity science. But the

space is creating major unease too.
75% of citizens and 69% of healthy longevity professionals agree

or somewhat agree with the statement: "I am concerned with the
ethical issues associated with longevity science"
In fact, 96% of policy experts believe we need an international

agreement on the ethics and practice of healthy longevity research
Distributive impacts are also a concern — half of all healthy

longevity professionals and citizens believe longevity research will
solely benefit the wealthiest individuals in society
Figure 8 Concerns about longevity science
To what extent do you agree/disagree with the following statements:
Healthy Longevity Professionals Citizens
Longevity science is only

worth pursuing if it helps
address current diseases
Asia-Pacific citizens show one

I am concerned by the of the highest levels of interest
ethical issues associated
with longevity science
Asia-Pacific citizens match Brazilian citizens for previous
consumption of longevity treatments and have a similar level
We should fundamentally of familiarity with longevity as a concept
avoid tinkering with nature's
boundaries for humans
Asia-Pacific medical professionals encounter patients interested
in longevity treatments more often than peers in other regions
There aren't enough (36% on weekly basis vs 19% average / 19% on daily basis
workers to support
vs 10% average)
an aging population
42% of them are also very likely to prescribe a proven

Longevity research will widen
anti-ageing therapeutic (if available) within 5 years, compared
socioeconomic inequality to 23% on average
Governments should actively

fund longevity research
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Figure 11
As for Europe, it is by far and large the THE HEALTHSPAN ECONOMY Preferred retirement age across regions (Citizen responses)
toughest market from a perception and consumer A longer-living, healthier population would require
perspective. Consumers have the lowest interest social and economic changes which many citizens
in and willingness to pay for longevity-related believe their countries are ill-prepared for. More
products. 59% are ‘probably not’ or ‘definitely not’ than 70% of those polled in our survey believe
interested in longevity services/products versus their country is not yet ready to support a longer-
a global average of 38% and two thirds don’t living healthier population, when considering the
want to pay for it (vs. 45% average). The notion full spectrum of implications from pensions to age-
of 10 additional healthy years also fails to intrigue friendly employment. The finding shows that living
Europeans: 41% of European consumers are not better for longer is not an unalloyed good without
interested in such a therapy versus a 25% global reforms to public finances, employment norms,
average. This may be due to cultural values around and equal opportunity.
work in Europe that have led to resistance such as Indeed, many countries are already
the multiple demonstrations against raising the experiencing a top-heavy age distribution with
pension age. Ironically, though, Europe, thanks fewer and fewer workers supporting more older
to its world-leading biotech and pharmaceutical people, an unsustainable trajectory. Our survey
ecosystem, is likely to play a key role in longevity reveals pockets of strong resistance to retirement
science, with 27% of scientists expecting the age reforms, although views vary across contexts.
continent to be a ‘very developed’ research hub Over half (55%) of respondents from North America
by 2030, second only to North America. This is and Europe believe that the retirement age
not necessarily bad news: a combination of low should not change even if the person's average
demand and expected high supply is an export healthspan is extended by 10 years, while only 27%
opportunity for the old continent. of Africans believe so, compared to an average of 40% across regions. African respondents were responsibilities across the overall workforce. “The
also the most likely to say that the retirement age good news is that the labour market is shifting that
should be raised by 5 (30%) or even 10 (14%) years, way for all sorts of reasons,” says Professor Scott.
followed by those in Asia-Pacific and the Middle “We’re seeing a decline in manufacturing, new
East. Respondents in Brazil were far more likely to technologies, and flexible working. Age-friendly
think retirement age should be tied to the average jobs have grown very rapidly, and everyone likes
lifespan for the country (31% vs. 21% global these jobs, not just older people.”
Figure 10 Readiness for longer-living, healthy population average).
To avoid politically contentious retirement PUTTING HEALTHSPAN TO WORK
age reforms, it is crucial to encourage and People spend most of their waking hours working,
Do you think your country is ready to support a longer-living healthier reward people for staying in the workforce for which makes employers an influential societal force
population in the following categories? (Citizen responses)
longer – which their better health should make – for good or ill. Unhealthy working environments,
possible. Encouraging healthy older people to whether psychological issues like high stress
work beyond the current pension age would and burnout or physical factors such as lack of
both support wellbeing and purpose, and allow convenient access to healthy food and physical
societies to sidestep the tough choice between an activity facilities, can over time lead to health
unsustainable share of non-working people, which issues including obesity, diabetes, some cancers
is unfair to younger generations, or politically and musculoskeletal issues. The mental health
divisive reforms to pension age which would be impacts of work are now receiving greater attention
unfair to the older ones - although the pursuit both due to rising levels of anxiety and stress and
of full employment of people above the current the consensus over the impact of mental health
state pension age could maintain the current age- on physical wellbeing, such as the relationship
dependency ratio (58). between stress and cardiovascular disease. Work-
To achieve this intergenerational balancing related stress, depression, and anxiety have been
act, Professor Scott at London Business School steadily increasing since 2018, even before the
emphasises the importance of ‘age-friendly jobs’ COVID-19 pandemic (59). Over 80% of US workers
defined as those that people can perform without have reported experiencing workplace stress (60).
excessive physical effort, and which offer greater Employers can support workforce health in
autonomy and flexibility to balance work and caring many ways. Inactivity, including sitting at work, is

in order to challenge the association between isolation and, as seen during the pandemic, the
incontinence and old age. This maintains dignity potential for the spreading of infections. He
for elderly customers and reduces shame for believes multigenerational homes offer a smarter
younger customers. Nike embraced a new approach, citing the case of Singaporean housing,
marketing strategy for its CruzrOne sneaker, a where older people often live in units within
“shoe for the slower runner”, in a video featuring multigenerational housing, combining privacy and
Nike co-founder Phil Knight, who talks about sociality, autonomy with support.
his enjoyment of running at a slow pace without In countries where these living arrangements
explicitly mentioning that he is in his 80s. This are less common, there are initiatives to encourage
focus on running speed rather than age is inclusive intergenerational connectivity through other
and appealing to all customers (67). means. Programme-based intergenerational
Joseph Coughlin, founder and director of interactions show positive associations with older
the AgeLab at the Massachusetts Institute of adults’ physical health, cognitive function, and well-
Technology, has argued that a marketing tactic being. Engagement in intergenerational activities
emphasizing old age is unlikely to attract either is linked with increased physical and social well-
young or old consumers, and a neutral strategy being. (72). One of these programmes, Humanitas
linked to obesity, diabetes, and cardiovascular pool (65). Hiring more workers over 50 and retaining
inclusive of all ages - for an “ageless lifestyle” - is Deventer, an intergenerational care home in the
disease. Employers can encourage physical them for longer will provide models of opportunity
best. In other words, focusing on customers’ actual Netherlands, offers affordable housing to students
activity programmes in the workplace, like offering for other older people and younger generations,
needs rather than their assumed age is not just in exchange for contributing to the social care of
open floor plans, treadmills, or standing desks or helping more people envision themselves working
inclusive, it's also good business (67). elderly neighbours. Students’ attitudes towards
encouraging ‘standing meetings’, provided they for longer and improving the mental and social
ageing have shifted and older individuals felt as if
cater for those with any disabilities (61). Our London enrichment of older workers. Conversely, there
INTERGENERATIONAL RELATIONS they exited the “sick role” traditionally experienced
workshop participants proposed that corporations could be an opposite problem of older people
Changes to lifespan have already had ripple in care homes (73).
could commit to specific healthspan targets. staying in post for longer, limiting the churn and
effects on younger cohorts. Longer life expectancy Supporting intergenerational connectivity
An Economist Impact study found that to turnover that otherwise allows younger workers to
combined with more years of ill health places a at scale might require policy and infrastructure
contribute to reducing stress, workplaces can ascend the ranks. The key will be to redesign the
heavy burden on middle aged children, who find changes, however. In the UK, for example, it
support workers having a social life at work, improve workforce and organisational hierarchies to allow
themselves ‘trapped’ between caring for parents can be difficult to find affordable housing that
work-life balance and offer flexible working; they people to work for longer without suppressing the
and young children at the same time as they enter can accommodate a large household. Potential
should also take regular surveys and ask questions careers of those below them.
their prime earning years leading to the so-called solutions include connectable flats with shared
to know what their employees need and identify Beyond their role as employers, the private
‘sandwich’ generation (68). Lengthening healthspan kitchens (74). “We've really got to design things
those who may be in ‘silent’ suffering. Workplace sector writ large can play a constructive role in the
could flip the script by allowing older people to intergenerationally, so old and young people
mental health training can lead to a significant healthspan society through means like advertising
continue to support themselves and even make a are living in cities close together and cities
reduction in work-related sickness absence and and product development. Participants at the
fuller contribution to caring for grandchildren. don’t become financially prohibitive for younger
might even be a magnet for talent; 59% of workers Hevolution workshop in London emphasised
Multigenerational households are already people,” says Professor Scott. One idea proposed
in one survey said they would consider taking a the key role that brands and advertisers have in
common in many Asian countries. In 2020, around by participants to the Hevolution Foundation
job with a company that offered better wellbeing tackling ageist bias and stigma and in supporting
80% of elderly widows and widowers in India lived workshop in Boston revolved around the
benefits than their current employer (62). an age-inclusive society. Multiple industries, from
with their children, while 45% of elderly couples encouragement of volunteerism as a mechanism
Managers are in a position to provide support ‘athleisure’ and consumer technology to cosmetics,
lived with their children (69). These households are to promote healthy ageing and combat ageism
and encouragement to employees. A study by have already evolved their advertising to be more
mutually beneficial for older and younger people. in communities. Participants also put forward an
The Lancet of an Australian workplace found that inclusive of diverse populations, including older
In countries where multigenerational living is idea for the creation of a national service program
implementing a 4-hour mental health training consumers. In 2015, for instance, Apple announced
common, older people in such environments have connecting the aged population and youth to
programme for managers improved confidence a new iPad in Japan specifically marketed to the
demonstrated lower risks of acute and chronic improve intergenerational connectivity.
in interactions between managers and employees elderly, with simplified interfaces and larger text.
illness (70). Two thirds of older people in South
about mental illness and reduced rates of sick leave At the launch, CEO Tim Cook spoke about the
Korea, and a third in India and the Philippines,
(63). 52% of US workplaces now offer corporate growing elderly population worldwide and the
regularly support or care for a member of their
wellness programs, which can include meditation, importance of maintaining a culture of respect for
family, while in Latin America, older people in
mindfulness training, counselling, and resting the elderly, and stated that Apple would eventually
multigenerational households share retirement
rooms; these companies report a 67% increase in explore similar initiatives in the US and other
benefits with other family members (71).
employee satisfaction (64). countries (66).
In the West, people are typically placed
Employers can also drive a shift in culture, More recently, absorbent underwear brand
in care facilities in their advanced age, but Dr
combating ageism and hiring bias, for example, by Depend made ads featuring young-looking
Dzau believes this can bring risks including social
looking at older workers as a key part of the talent models using their product in everyday situations,

05
Emerging economies have another advantage:
access to technologies that were not available at
a corresponding point in developed economies’
earlier phases. Take diagnostics as one example. Brazilian citizens have more
Digital and virtual tools like symptom checkers and
appetite for longevity therapies
imaging are bringing advanced healthcare services
to remote areas (82). Drone technology is helping
than citizens in other regions.
deliver medical supplies to marginalised regions.
Rwanda, for instance, has pioneered the adoption
A Leapfrog Opportunity? of drones for health, through a partnership with

American drone startup Zipline to deliver blood
Most Brazilians (52%) are at least probably
interested in using longevity related products
and medical supplies such as vaccines to remote
versus 13% of Europeans and 17% of North
villages (83). Rwanda’s three-year contract with
Americans
On current trends, the health outlook is intervention-minded healthcare model to a more Zipline, which grants them provisions to deliver
worrying as low- and middle-income countries face proactive, prevention-oriented approach.” vaccines and medicine, will help make new
They also show above average familiarity
a double burden. Rising consumption of Western Participants to the Hevolution Foundation medicines accessible to all and could overcome
with healthy longevity, willingness to pay
diets and processed foods, and a reduction in workshop in London identified several key the access inequality challenge that leads to rural
for treatments and previous consumption of
physical activity due to urbanisation and the advantages for emerging market healthcare health outcomes being significantly worse (84).
treatments not available over the counter
migration away from physical agricultural activities, systems in the healthspan transition. An important Digital infrastructure and electronic health
have contributed to rising obesity, diabetes and one is time: many emerging markets have yet to data could help emerging economies leapfrog the
Compared to other regions, Brazilians (and
heart diseases. Diabetes in Africa is projected to fully engage in their demographic shift, many clunky, silo-riven health data system that bedevils
North Americans) would use healthy life years
increase as populations become more urban (75). have a decade to go, which is enough time to developed economies. India, for instance, began
gained to retire earlier (27% vs 21% average)
Obesity rates in Latin America are among the institute system change. Emerging economies also transitioning to an open digital health ecosystem
highest in the world, reaching 28.9% in Mexico have fewer investments in physical infrastructure, with the launch of the National Digital Health Mission
in 2021, and are increasing faster than any other which means lower sunk costs and weaker vested
region (76, 77). Dementia will devastate millions of interests in the status quo health system. This puts Figure 12
lives in the years ahead; by 2050, prevalence will them in an ideal situation to innovate, becoming
increase nearly 300%, mostly driven by low and sources of ‘reverse innovation’. London workshop “Are you interested in using longevity-enhancing products or services?”
middle-income countries (78). participants noted the analogy of M-PESA, the (Citizen responses)
Some emerging economies are also acutely mobile banking platform that emerged in Kenya
vulnerable to the health threats of climate change and spread to other countries across Africa and
and the worsening environment. In Southeast the developed world (81). “There’s a willingness
Asia, air pollution is the main cause of NCDs (79). to explore innovative approaches in emerging
The Middle East and North Africa (MENA) region markets,” says Dr Al Saud, Vice President of
is vulnerable to rising temperatures, with Oman, Organisational Strategy and Development at
Qatar, Saudi Arabia, and UAE projected to have Hevolution Foundation. “Not just customers, but
high future heat mortality burdens. In such a also governments need to be willing to carry out
context, healthy ageing will be key to successful these potentially high-risk challenges. Compared
adaptation (80). to developed countries, emerging markets are
While these trajectories are a source of more open to innovation.”
concern, emerging markets do have opportunities A more pro-innovation attitude was evident
to ‘leapfrog’ the kinds of legacy challenges that in our survey, which found stronger interest
impinge reforms in developed markets. “The among emerging market respondents in areas like
potential for developing nations lies in their willingness to pay for longevity therapies. When
freedom from the constraints of entrenched asked the question “Are you interested in using
legacy healthcare systems,” says Michael Torres, longevity-enhancing products or services?” 52% of
Chief Communications Officer at the Hevolution Brazilian consumers and 45% of Africans responded
Foundation. “These established healthcare systems “definitely/probably”, compared to only 13% of
are massive and often slow to adapt. Emerging Europeans. African and Brazilian consumers also
and developing countries can learn from this rank significantly higher in willingness to pay up to
established model to forge innovative and agile 1 month of income for a therapy that could extend
healthcare ecosystems. Conversely, the challenge healthspan by 10 years.
Definitely not
for developed nations lies in transitioning from an

Figure 13 route for progress in Saudi Arabia. “Under the
"IN THE NEXT TEN TO TWENTY
current regulations, a great deal of time and
“How much would you be willing to pay for a therapy that could potentially extend your health YEARS, THE OPPORTUNITIES IN requirements are needed before approval, for
span by 10 years?” (Citizen responses) SCIENCE AND TECHNOLOGY multiple reasons,” he says. “I think there is an
ARE GOING TO BE IN EMERGING opportunity for [Saudi Arabia] to learn from global
MARKETS” best practices and develop a progressive drug
approval policy that does not compromise safety
− H.R.H. PRINCESS DR. HAYA BINT and risk.” Streamlining the framework for drug
KHALED BIN BANDAR AL SAUD trials will also allow Saudi Arabia to tap into its
Vice President of Organisational Strategy vast network of hospitals and research centres
and Development, Hevolution Foundation to find potential trial participants and attract
pharmaceutical companies by facilitating clinical
research (93).
Jan Adams agrees that emerging markets
more companies headquartered in China and could become global players, but argues that
South Korea and biopharma drug development is they need to differentiate themselves to become
rising rapidly in China-headquartered companies, real innovation hubs. “Money is a commodity, it’s
whose share now exceeds that of Europe (89). not enough to find an edge. Can you create an
Meanwhile, India’s ‘generics’ industry has earned it ecosystem that delivers specific tools or population-
the title of ‘pharmacy of the world’ (90). wide data sets that you can tap into that others
"In the next ten to twenty years, the don’t have, like a biobank and longitudinal data?
opportunities in science and technology are going In addition to money, talent and infrastructure, you
to be in emerging markets,” says Dr. Al Saud, who need to add something that facilitates innovation
believes Saudi Arabia could be among the leading and product development.”
players. “I believe Saudi Arabia’s contribution He believes Saudi Arabia has the potential
is going to be both on the scientific research to be an innovation sandbox, especially in terms
front and on regulatory frameworks. You need of disease burden of the population. Adams also
to be bold when investing in research. Usually, believes funders in Western countries as of lately
(NDHM) in 2020. Similar digital public infrastructure universities, research institutions, venture capital government funding focuses on basic research in are mostly focused on specific diseases, especially
has revolutionised financial systems in the past, and large pharmaceutical companies able to universities, but we need governmental institutions cancer. New entrants like KSA could spot the “blue
like India’s Unified Payments Interface (UPI). This take ideas through the long, costly and risky drug to actually focus on translational science, on how ocean areas, and channel the money into emerging
has the potential to lead to an unprecedented development process. That is changing as a subset to move science off the bench and on to human areas like ageing which established players are not
change in products and delivery models in Indian of emerging economies with the requisite capital, applications.” geared to”.
healthcare (85). This initiative aims to give Indians research and innovation capabilities start pushing Innovations from the Kingdom could
digital health IDs that will store their medical the frontiers of medicine. include R&D investment and modernised drug
records and streamline healthcare by making it “When I first joined this industry, one of the development and clinical trial approaches.
easier for doctors to access patients’ records (86). things I found very intriguing was how global Regulatory innovations have enabled countries
Dr Dzau also urges societies and communities the industry was,” notes Mr. Berenson, whose "MONEY IS A COMMODITY,
outside of Europe and North America to become
to take advantage of the opportunities presented company Flagship Pioneering is beginning to hubs for healthspan science; for example, IT’S NOT ENOUGH TO FIND
by digital technology. Increasing Internet and establish its Asia Pacific presence through an office Australia enacted reforms to the clinical trial AN EDGE [...] IN ADDITION
broadband access among low-income and other in Singapore, a country which is “making a single, process that supported expedited trial processes TO MONEY, TALENT AND
marginalized populations, for example by utilizing serious run at this…the field will become more and streamlined trial standards (91). During the
community health workers, could help reduce the global and societies with the wherewithal will want INFRASTRUCTURE, YOU
pandemic, Australia was able to fast-track funding,
digital divide by ensuring broad and equitable to be masters of their own destiny.” ethical approvals, trial registration and publication
NEED TO ADD SOMETHING
benefits of such tools. The likes of Singapore, Taiwan, and Korea, as (92).“I believe that Saudi Arabia will go in that THAT FACILITATES
well as developed economies from outside North direction and adopt similar regulations, so that we INNOVATION AND PRODUCT
R&D CHALLENGERS America and Europe like Australia, have all become can support innovation through taking risks and DEVELOPMENT”
Emerging markets could also power new advances challengers in innovation capacity and production, investing in science and implementing regulatory
in medical research. To date, pharmaceutical including in digital health (87) and pharmaceutical reform to support drug development,” says Dr Al Saud. − DR. JAN ADAMS
innovation has been centered in Europe and manufacturing (88). Over the past five years, life Mr AlAsiry of Hevolution Foundation agrees Partner, Apollo Health Ventures
North America, built on established ecosystems of sciences deal activity has expanded to include that regulatory reforms to drug approval is one

06
Policy Leadership
Ensuring emerging market perspectives are part access to HIV treatment, forcing pharmaceutical
of the healthspan agenda – and supporting their companies to radically reform drug pricing (96).
research and innovation ecosystems – can help International organisations play a lead role
deliver a truly global movement, rather than in influencing government policy to lead on the
the developed economies-dominated norms of healthspan agenda. One idea at the London
the past. Participants at both the London and workshop, for instance, was to have the IMF include
Boston workshops stressed the need for global longevity considerations into Article 4 country GOVERNING FOR CHANGE
coordination and collaboration. reviews to create incentives for governments to Central governments will be indispensable to can deliver transformational outcomes at speed
Global coalitions are networks for lesson track and report progress on the issue. achieving healthspan. As research funders, they without compromising human health. The majority
sharing, agenda-setting and resourcing to support There are pre-existing international alliances can catalyse R&D. Public funding has already driven of policy professionals in our survey agree that
healthspan policies and programmes – as well as to tackle diseases of ageing too, although advances in basic and applied science in areas healthy longevity requires such a new approach,
fora for agreeing on new international norms. The these remain focused on conventional disease like cancer and dementia, conditions which are yet few are willing to lead: 75% would prefer to be
scandal of the gene-edited twins in China shows categories. The Global Group of Heads of State draining billions of dollars from health systems (78). a “fast follower” rather than a leader when it comes
how important global coordination is for ensuring and Government for the prevention and control of As regulators, central governments can to approving longevity therapies. This points to
responsible medical innovation (94). According noncommunicable diseases (NCDs), established in nurture innovation by reforming procurement, an important gap in leadership - and to a major
to our survey, 96% of policy experts believe we 2022, is aiming to invest resources and prioritising approval and reimbursement policies. The US opportunity for those who decide to fill this gap.
need an international agreement on the ethics and noncommunicable diseases in healthcare systems Orphan Drug Act in the 1980s was one such Governments can also influence healthspan
practice of healthy longevity. across the world, for example. Norway has been a transformation, offering grants, tax credits and through nudges and incentives on citizens.
International coordination will also be frontrunner in investing in the fight against NCDs marketing exclusivity for R&D in rare diseases, Tobacco control policies prove that government
necessary to mainstream the concept of healthspan as part of its aid, as the first WHO donor country incentivising R&D by the pharmaceutical sector steps can impact consumer choices and directly
into the policy agenda. At the Boston workshop, to include NCDs in its international development and changing lives for patients (98). The pandemic improve health outcomes. The evidence for
participants proposed that putting this issue on strategy. Ghana, which has taken on an important put regulatory innovation in the front seat on a new smokefree legislation impacting cardiovascular
the agenda of finance ministers of the G20 would role in the group, has implemented tobacco scale. In the US, Operation Warp Speed invested health, in particular admissions for heart attacks,
help accelerate global awareness and action, demand-reduction measures and introduced $18 billion and guaranteed purchase of nearly 500 is positive. Ten studies, from countries including
given the looming fiscal disaster of a ‘business as guidelines for NCD management (97). million doses, helping pull vaccine candidates the US, Italy, and Canada, found a significant drop
usual’ scenario. A precedent exists, as shown by But new alliances and actors will be key to through the development process through more in hospital admissions for heart attacks following
the introduction of sustainable finance into the drive progress and tackle neglected areas. “I am flexible approval and data requirements (99). The the introduction of smokefree legislation (101).
G20 finance targets and through the Sustainable very grateful to the Hevolution Foundation for UK’s Vaccine Task Force won plaudits for its venture In the UK, the 2007 ban on indoor smoking in
Finance Working Group (95). London workshop having identified Healthy Longevity as the area capital-style approach to procurement, placing public places was linked to a 2.4% drop in hospital
participants agreed with the importance of the that needs much more support and investment, big bets on unproven approaches. This required admissions for heart attacks in the following year,
G20 as a platform, noting that this could also be says Dr Dzau at NAM. Its focused and pioneering busting through bureaucracy and institutional and the drop since then could be as high as 40%
an opportunity for emerging markets to lead as the investment in the field is having a signature impact. resistance and backing approaches like mRNA (102). New Zealand recently introduced a steadily-
next two years will see a G20 presidency from Brazil We need many more philanthropic entrants and vaccines, which had faced years of scepticism from rising smoking age law ensuring tobacco cannot
(2024) and South Africa (2025). Indeed, Brazil has investors to join Hevolution in this space to bring the medical mainstream (100). be sold to anyone born in 2009 or after (103).
already proven itself a major player in reshaping their expertise and resources to work towards Of course, the pandemic was a unique Andrew Scott at London Business School
global health policy, having passed legislation healthy longevity equity worldwide.” window of time that cannot be replicated easily. expects governments to build on the precedent of
in the 1990s giving citizens the right to universal But it shows that policy leadership and ambition tobacco control in other areas. Sugar taxes have

The WHO also recommends policies for Education is a critical intervention to lower
improving physical education in schools to geographic disparities given the close linkages
improve metabolic and musculoskeletal health in between education level and health overall.
children, including training teachers in physical Universal pre-kindergarten education, improving
activity promotion, creation of appropriate graduation rates, and tax benefits for keeping
spaces, materials and resources, encouragement children in school, have all been shown to have
of innovation, and partnerships with community positive health impacts for communities. Blitzer
organisations (110). Yet physical education classes and Johnson (116) emphasise the link between
have been in decline, and twenty percent of education and preventative healthcare in the US
adolescents across 54 countries have reported and the need for partnerships between health and
never attending physical education classes (111). education policy experts.
Rates of physical inactivity are higher in high- and There is also a role for education about
middle-income countries, suggesting that more preventative health for people of all ages,
people may become inactive as more countries continuing public education initiatives into
transition from lower to higher income (111). adulthood. The Japanese government launched
Social determinants – from income and the National Health Promotion Movement known
become more common globally, for example, and for lifelong metabolic and cardiovascular health. education levels to housing – influence both as Health Japan 21 in 2000, aimed at preventing
evidence suggests they have been effective in In children, poor diet quality raises the risks lifespan and healthspan, with studies showing and controlling lifestyle-related NCDs through
reducing demand through higher prices (104). The of non-communicable diseases in adulthood, they affect more than 50% of health outcomes intervention in workplaces and local communities
WHO has promoted a sugary drinks tax for disease making healthy food for children in low-income (112). This has been vividly illustrated in so-called as well as schools (117). The initiative’s midterm
prevention, with the aim of reducing diabetes, communities an essential area of focus (108). ‘ZIP code’ studies that reveal how individual life evaluation in 2018 found that healthy life expectancy
obesity, heart disease, stroke, and cancer, and 85 Universal free school meals programmes have expectancy or likelihood of disease can differ by had increased (118). In Saudi Arabia, ministries
countries currently implement some form of this tax improved food security in the US and the UK. In years within a single country, even in the wealthiest coordinate across government to emphasise the
(105). Researchers at the University of Cambridge a study of two schools in London, staff observed countries. Studies in England conducted between importance of a healthy lifestyle, ensuring that the
found that the UK’s sugary drinks tax led to an 8% that students who had changed from packed or 2017 and 2019 found a 10.5 year gap in male life design of living spaces takes into consideration the
drop in obesity among girls in Year 6. Funds raised bought-offsite lunches to universal free school expectancy at birth within the country, with the population’s need for sports, exercise, clean air, and
by the tax have been allocated to child health meals were more likely to be eating healthier highest in Westminster at 84.9 years and the lowest more. “I think we’ve made a great deal of progress
measures such as breakfast clubs, sports, and PE and more nutritious food (109). In Latin America, in Blackpool at 74.4 years (113). In the US, there by making sure that the overall environment is
in schools. (106). Doctors have recommended obesity prevention strategies that have shown are similar gaps: in 2020, average life expectancy conducive to a healthier lifestyle,” says Mr AlAsiry
extending the sugary drink tax to other foods high some positive results include front-of-package at birth in California was 79 while in Mississippi it of Hevolution Foundation.
in sugar and salt (107). labelling, school environment/meal regulations/ was 71.9 (114). There is an even starker gap when
Government impact on lifestyle can also programmes, food marketing regulation, beverage compared to Native American communities, with
be facilitative; in particular, investing in optimal tax and programmes to improve the level of the lowest life expectancy in the country found in
nutrition for children to provide the best foundation physical activity (76). Lakota County, South Dakota at 66.8 years (118).

Conclusion
An Action Agenda for Healthspan
Over the last century, breakthroughs in medical the common assumption of chronic disease as an bias against older populations. If people are living Young people also need to be engaged early in
science, and the fruits of economic growth, have inevitable consequence of ageing. longer and healthier lives, the traditional phases of their own lifestyle choices. Preventative healthcare
combined to triple life expectancy relative to To capitalise on progress, healthspan science the working life must be reimagined. The survey means that people will be living healthier
human evolutionary norms. But these hard-won needs enabling reforms to how medical therapies shows many people are willing to retire later if lifestyles throughout their whole lives, which will
additional years of life are frequently marred by are tested, approved, and reimbursed. As a highly their healthy lifespan is extended. This requires reduce NCDs like diabetes and obesity that have
chronic diseases which are taking a heavy and regulated sector, medical research and investment more dynamic, flexible work environments and significant impacts on the young. These benefits
unsustainable toll on both rich and emerging is heavily influenced by the incentives of regulators. 'age-friendly' jobs, defined as those that people must be emphasised early, through the education
economies alike. The global survey found over To encourage bold R&D, medical agencies, and can perform without excessive physical effort and system.
half of healthcare professionals simply do not payers (insurance companies or governments) offering the flexibility to take time off to care for or Governments must show policy leadership
believe health systems will be financially viable by need to craft a pro-innovation regulatory and spend time with familities, learn new skills, retrain to advance the healthspan agenda. The majority
2030 without a breakthrough in longevity science approval environment that rewards innovations that for new roles for take breaks between phases of of policy professionals in the survey believe that
and over 80% of citizens do not believe their prevent, rather than treat, disease, and recognise work. Employers must also challenge ageism in healthy longevity requires a new approach, but a
country is ready to support a longer-living, health the clinical validity of ‘pre-disease’ states and new hiring and consider ways to make the workplace similar majority (75%) would prefer to be a “fast
population. Tackling diseases of ageing requires biomarkers. a healthier and more appealing place for older follower” rather than a leader when it comes
a new paradigm, from medical research and drug Emerging markets face a worrying rise in people. These changes will help older people to approving longevity therapies. This shows
development to employment and welfare. unhealthy ageing; with the right actions now, they maintain purpose and social connection and help the need for policy leadership for countries to
While there is no magic bullet solution, and can learn lessons from the mistakes of developed countries avoid the politically contentious choice show vision and provide the path for others to
contexts vary, the international workshops, global economies – and be innovation leaders. Citizens between raising retirement ages to cope with more advance. Globally, coordination and collaboration
survey and expert interview programme point to in emerging markets are strongly in favour of older people. or placing more financial burden on on best practices to support preventative health
several calls to action for a new, bold agenda for innovation and reform to enable healthy longevity, young people to support older citizens. is essential; international organisations and
achieiving healthspan for all in our lifetime. from willingness to use longevity therapies and Young people must not be forgotten in the standards-setting bodies can aid in this and
Healthspan science is flourishing, thanks to services to their appetite to reform policy areas healthspan economy - building flexible workplaces leverage networks like the G20. To incentivise
innovations in medical research and new ways of like pension age. As their health systems are and preventative health will benefit people of all better choices, governments can build on the
understanding human biology. The evidence base less entrenched, these economies can build the ages. A society with longer lives may mean more success of policies like tobacco control, and invest
is building for novel approaches to tackling the infrastructure required for a ‘healthspan society’ young people are living in multigenerational resources and attention to nutrition and physical
diseases of ageing. Early diagnostic innovations, with a greater role for digital technology, data households or caring for family members; this is activity in the education system.
such as liquid biopsies, powered by AI, promise and preventive approaches. Additionally, their already a norm in many emerging economies - in
to catch killer diseases before they take hold regulations are evolving, with fewer vested interests developed economies, policies may be needed
while senolytics can target damaged cells before and legacy norms, providing more emerging to foster intergenerational relations which have
they wreak havoc on the body. mRNA vaccines economies the opportunity to become hubs for new psychological and social benefits for young people,
and cell and gene therapy may hold promise for approaches to drug and technology development. and widen their horizons and social circles. More
stopping diseases from emerging in the first place. Employers must play an active role in flexible jobs will make it easier for working-age Disclaimer: The views expressed in this report
Leading the research agenda are a growing pool of encouraging healthspan, investing in workforce people to balance work and family responsibilities do not necessarily express the views of the
investors and scientists who are boldly questioning health and challenging labour market norms that as well as leisure time and continuing education. Hevolution Foundation.

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Life expectancy (LE) at birth Secondary care
The World Health Organization’s Global Care provided by a specialist provider or
Health Observatory defines life expectancy at specialist facility to whom a patient has been
birth as “the average number of years that a referred by their primary health provider.
newborn is expected to live, if he or she were
to pass through life exposed to the sex- and Senescence
age-specific death rates prevailing at the A state in which cells have stopped
time of his or her birth, for a specific year, in a replicating and contribute to ageing by
given country, territory, or geographic area.” prohibiting tissue repair.
Liquid biopsy Senolytics

According to the NIH, “Liquid biopsy Drugs or therapies that work to remove
provides the opportunity of detecting, senescent cells from the body.
analyzing and monitoring cancer in various
body effluents such as blood or urine instead
Stem cells
of a fragment of cancer tissue.” Cells with unique abilities to self-renew,
and can be found in embryos and various
Morbidity adult organs. They have great potential
Morbidity is the state of being symptomatic for replacing defective or damaged cells
or unhealthy for a disease or condition. resulting from various disorders and injuries.
M-PESA
A mobile phone-based money transfer, Vertical
payments, and micro-financing service, A group of companies that focus on a shared
launched in Kenya in 2007. niche or specialized market spanning multiple
industries.
mRNA
A form of nucleic acid, which helps the Virtual wards
human genome which is coded in DNA to be Also known as hospitals at home, they allow
read by the cellular machinery. It has been patients to get the care they need at home
used in innovative vaccines and medicines to safely and conveniently, rather than being in
generate an immune response. hospital.”
Neurodegeneration Wearable technologies

Degeneration of the nervous system caused Any technology that is designed to be used
by the loss of function of neurons in the brain. while worn, such as smart watches and smart
Neurodegenerative diseases include multiple glasses.
sclerosis, Alzheimer’s, and Parkinson’s. Western diet
Noncommunicable diseases (NCDs) The NIH defines the Western diet as low
Also known as chronic diseases, they are in fruits and vegetables, high in fat and
diseases that tend to be of long duration and sodium, and consisting of large portions, high
are the result of a combination of genetic, calories, and excess sugar.
physiological, environmental and behavioural
factors rather than transmissible factors like
viruses.
Primary care
The day-to-day healthcare given by a health
provider.
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THE GLOBAL

DR. MEHMOOD KHAN

Conclusion: An Action Agenda for Healthy Longevity 40 IMF

To capitalise on progress, scientific research into expanding healthspan needs

Emerging economies face a worrying rise in unhealthy ageing; with

6 The Global Healthspan Report A New Agenda For Global Health 7

University degree 38%

Secondary (high) school 20%

Vocational qualification 11%

0% 12% 24% 36%

Data for the citizen survey was collected

8 The Global Healthspan Report A New Agenda For Global Health 9

10 The Global Healthspan Report A New Agenda For Global Health 11

12 The Global Healthspan Report A New Agenda For Global Health 13

It would accelerate the transition to 49%

60% It would align healthcare payments with positive 44%

It would switch the paradigm from 43%

27% 26% Other (specify) <1%

0% 20% 40% 60% 80%

14 The Global Healthspan Report A New Agenda For Global Health 15

The Healthspan Science Frontier

North America 57%

Middle East 47%

0% 25% 50% 75% 100%

16 The Global Healthspan Report A New Agenda For Global Health 17

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"THIS IS THE MOST EXCITING TIME IN

20 The Global Healthspan Report A New Agenda For Global Health 21

22 The Global Healthspan Report A New Agenda For Global Health 23

24 The Global Healthspan Report A New Agenda For Global Health 25

prerequisite to longevity science. But the

75% of citizens and 69% of healthy longevity professionals agree

In fact, 96% of policy experts believe we need an international

Distributive impacts are also a concern — half of all healthy

Figure 8 Concerns about longevity science

To what extent do you agree/disagree with the following statements:

Healthy Longevity Professionals Citizens

Longevity science is only

Asia-Pacific citizens show one

42% of them are also very likely to prescribe a proven

Governments should actively

26 The Global Healthspan Report A New Agenda For Global Health 27

28 The Global Healthspan Report A New Agenda For Global Health 29

30 The Global Healthspan Report A New Agenda For Global Health 31

A Leapfrog Opportunity? of drones for health, through a partnership with

32 The Global Healthspan Report A New Agenda For Global Health 33

34 The Global Healthspan Report A New Agenda For Global Health 35

36 The Global Healthspan Report A New Agenda For Global Health 37

38 The Global Healthspan Report A New Agenda For Global Health 39

40 The Global Healthspan Report A New Agenda For Global Health 41

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44 The Global Healthspan Report A New Agenda For Global Health 45

46 The Global Healthspan Report A New Agenda For Global Health 47

48 The Global Healthspan Report A New Agenda For Global Health 49

Liquid biopsy Senolytics

Neurodegeneration Wearable technologies

50 The Global Healthspan Report A New Agenda For Global Health 51

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