John Donvan
This is Open to Debate. I’m John Donvan, your moderator-in-chief, hi everybody. Our debate in this episode takes on a couple of pretty easy to understand questions, at least conceptually. Could longevity science extend your healthspan by decades? Should the government fund it? That is fund the research. And how promising it is or is not? Just to be clear, we are not talking about ex- extending lifespans themselves per se, we’re talking about extending healthspans. As you know, there’s a gap between lifespan and healthspan, and sometimes it’s decades of difference, depending on the individual. But can research close that gap? And should tax money go toward it? That’s what we’re gonna address in this one.

Again, the questions before us, could longevity science extend your healthspan by decades? Should the government fund it? So let’s meet our debaters, answering yes to both questions, we have Peter Diamandis. Peter is founder and chairman of the XPRIZE Foundation, which leads the world in health-span competition. He announced the XPRIZE Healthspan competition, and his newest book is called The Longevity Guidebook, How to Slow, Stop and Reverse Aging and Not Die From Something Stupid. Peter, welcome to the program into the debate.

Peter Diamandis
Pleasure, John.

John Donvan
And here to argue no to these questions, I wanna welcome back to our program Zeke Emanuel. Zeke is an oncologist and author, a bioethicist and Vice Provost for Global Initiatives at the University of Pennsylvania, as well as the founding chair of the Department of Bioethics at the National Institute for Health. Zeke, welcome back to our program. It’s great to have you.

Zeke Emanuel
Great to be here, thank you.

John Donvan
So let’s get onto our opening statements, we want to give each of you a few minutes to explain your position. Peter, you’re up first. You are arguing, yes, longevity science could extend your healthspan by decades, and the government should fund it. Here’s your chance, please, to tell us why, Peter.

Peter Diamandis
Fantastic, let’s jump in. Uh, so first of all, I wanna define, you know, healthspan and lifespan. Lifespan is how long your heart’s ticking, healthspan is how long you’ve got vitality, that you’re enjoying life, that you can move, look good, mem- remember who you’re speaking to. Uh, my argument is gonna focus on the notion of adding 20 healthy years, two decades of healthspan, uh, for Americans today. So, uh, you know, the average life expectancy for Americans today is about 79, but the average health expectancy only takes them to 60 or 63, the last 16 to 20 years they’re in ill health. So the question is, can we match lifespan and healthspan? Can we give Americans an extra 20 healthy years? And should the government fund it?

So, let’s talk about, can we. From a evolutionary standpoint, humans never lived past age 30, 100,000 years ago, you were pregnant by age 12 or 13. By the time you were 26, 27, 28, you were a grandparent. When food was not abundant, the best thing you could do to perpetuate the species was to die. And it truly was a notion that a number of scientific breakthroughs and processes, right? Clean water, sanitation, antibiotics, vaccines, modern medical care, surgery, improved nutrition, all these things have gotten us from 30 up towards of 79, we’ll call it 80 in terms of life expectancy. So the question is, can we do better than that? Can we move life and health expectancy? So what’s causing people to lose their last 20 years of health? Uh, is it genetics? Or is it lifestyle? And the point I wanna make here is that we now have the ability to modify both, right? Turns out that from a genetic standpoint, your lifespan is only a- uh, about 30% attributable to your genetics. 70% or more is attributable to your lifestyle of what you’re doing.

I think the answer is definitively yes that we can. Today, there are 12 million Americans that make it to age 80, 10% of those 1.2 million Americans are healthy at that point. And so what can we do to support others getting healthy? Uh, I think there are breakthroughs, we can talk about these on multimodal diagnostics, our ability to catch disease at the inception, uh, and prevent seven out of the top 10 causes of death today. There are breakthroughs, and the major breakthrough coming this decade, which makes this decade very different than past decades, is AI, single cell sequencing, epigenetic reprogramming, CRISPR, gene therapies. These are technologies that are, are going to impact our health directly. And there were technologies never available before.

Should the government fund it? Well, listen, here’s the problem, if the government doesn’t make this change, we are about to have a bankrupt healthcare system. 63% of healthcare professionals believe that without a breakthrough in longevity science, we’re not gonna have a financially viable healthcare system by 2030. Uh, other points here, we are on a massive drop-off in our population. We need people to be living longer, to be healthy, to be engaged in the economy. The US total fertility has dropped into 1.65 births, uh, per family, 2.1 is the replacement. You know, places like South Korea and China have dropped to 0.8, eventually to 0.5, we’re about to peak in total population and then fall off. Uh, other arguments, in 2020, we are spending $1.8 trillion per year, right? That’s $36 trillion over 20 years fighting the four horsemen of disease, you know, cardiovascular, cancer, neurodegenerative, diabetes. If we can prevent those costs, $36 trillion, um, it’s very much worth it for the government to be making those investments.

And of course, there was a paper written out of MIT, Harvard, and Oxford, uh, by, uh, Andrew Scott, uh, Martin Ellison and David Sinclair, saying that the estimated economic benefit for the US over 20 years of reversing a- uh, 20 years of health is a hundred to $200 trillion. We’re talking about 10s to 100s-

John Donvan
Peter, I’m sure… I’ve gotta jump in because you’ve hit time, but you can continue those thoughts in our conversation.

Peter Diamandis
Thank you.

John Donvan
Zeke, uh, you’re up next, you disagree. Um, you’re arguing that longevity science could not extend your healthspan and that the government should not be funding it. Here’s your chance to tell us why.

Zeke Emanuel
Well, I don’t think we need longevity science to ex- extend our lifespan, that’s really, uh, what I believe. It’s really important to try to understand what we are aiming for. And it does seem to me when we talk about longevity, Peter is on record as saying he wants people to routinely live to 122 or 200 years, uh, or maybe forever, that doesn’t seem to me to be our goal. The other possibility is to ensure that people who now die young, die before they’re 75, that… Which is about a third of Americans, actually can live a full life. Uh, the first, trying to extend life beyond 100 and, uh, years to 122, uh, 200 is foolhardy. And I think a big mistake. Trying to get everyone to live a full life at 75 is a worthy goal, and trying to get them to live a, uh, disability free life to 75 is a worthy goal, and we don’t need longevity science. We know what to do.

Our problem is not, we need some breakthrough like AI or epigenetics or something else that Peter is pushing, but we knew… Need to do is implement the six behaviors of wellness and longevity, which not only do we know, but they’ve been known for 2,500, maybe 3000 years. Now, let’s remember that we’re all gonna inevitably decline, we’re all… We’re w- have a natural limit to our lifespan. And Jay Olshansky, who will be on here a little later, has recently shown that the increases in lifespan are actually slowing down even in long-live populations that are way healthier than the United States like Japan. There is a biological limit, um, and a biological process to deterioration that’s inherent in people. Um, we have been promised we’re gonna have more… The longer we live, we’re gonna have less morbidity, we’re gonna have what’s called the compression of aging. We’ll get more healthspan. We’ve been sold this idea since 1980, consistently.

Unfortunately, the last 45 years have not shown that to be true. We’ve saved more people from dying who had disease, that’s an accomplishment. I’m an oncologist, I wanna save people from cancer. But we have to be realistic. They end up with disabilities. So we save people from strokes, but they have, uh, paralysis on one side or they can’t speak. Plus, we have to also be quite clear when people retire, one of the consequences is that they become more passive, they end up sitting in front of the TV for 40 additional hours that they were working. Um, and there are lots of social consequences of having people live longer, who’s gonna pay for social security? Who are gonna… Caregivers gonna be? Um, and what happens to innovation? Because older people are less innovative than younger people.

So what do we need to do to increase healthy lifespan? Do we need a potion, a pill, uh, Peter’s, uh, fountain of youth and, uh, water? No. We already know the six interventions. The first thing is don’t do stupid stuff, don’t smoke, don’t drive without a seatbelt, uh, don’t take hard drugs. We know this. Second, most important thing is to have a robust social life, family and friends.,Get together and have people you are close to. Third, uh, stay mentally engaged. Postpone retirement if you can, although many, many people do not want to postpone retirement. Um, and do things that are valuable to others, that’s important. Three, eat well, not just at the end of life, but you gotta eat well throughout your life. Uh, exercise, cardiovascular exercise, strength training and balance and flexibility. And finally, sleep, get eight hours a day.

Those are the six wellness interventions. We’ve known them for 2,500 years, and we don’t need any new science, what we need to do is deploy them at scale, and the United States has been singularly bad at deploying them at scale. Doesn’t require federal investment in research. It requires federal investment in getting people to do the wellness behaviors.

John Donvan
Thanks very much, Zeke. Thanks to both of you. We’re gonna come up to a break, but before we do, I- I’m just curious about in a sense where your passion for this comes from. Because Peter, what made you turn to this issue of healthspan?

Peter Diamandis
I love life. And I think this is the most exciting time ever to be alive, and I wanna see as much of it as I can. I think we’re on the brink of making humanity a multi-planetary species. Uh, and I think people need to have a really strong why to want to do the things that will give them the added decades of healthspan. And see my kids, I had kids at 50, I’m 63 now, and I wanna see their, their kids and their grandkids.

John Donvan
And Zeke, you’ve done a lot of writing, Zeke, but your most famous piece of writing without question, 10 years ago you wrote an article in the Atlantic called, uh, why I Hope To Die at 75. You’re now, I think, 67. Um, have you changed your mind as you’ve approached 75?

Zeke Emanuel
No, I haven’t. And by the way, let’s get clear, the author never picks the title and I fought with the Atlantic over that title because I think it distorted my message. My message wasn’t I wanna die at 75, my message is that, um, I don’t want life-saving medical interventions.

John Donvan
We’re gonna take a quick break and when we come back, we will continue our conversation. This is Open to Debate, I’m John Donvan and we’ll be right back.

Welcome back to Open To Debate. I’m John Donvan, your moderator, and we are taking on the questions, could longevity science extend your healthspan by decades? Should the government fund it? I’m here with debaters Peter Diamandis, who’s co-founder of BOLD Capital Partners a venture fund that is investing in biotech and longevity. And Zeke Emanuel, the most widely bioethicist in history. But Peter, I wanna take it back to you. Talk a little bit about what the science is doing and really how will we know that the investment that is being made now, w- is worth it without having to wait 20 years to see what the outcome would be?

Peter Diamandis
Today, the conversation is, can we get… Match lifespan and healthspan, get the average American to an healthy 80? And can we do that just with, um, you know, without any new science, any new technology? Uh, and we’ve known these things, as you’ve said, for, for decades, centuries, millennia, but it’s not happening. You know, it is way too easy to just lie in bed and not go and work out or to eat that last donut on the plate in the morning. So what’s gonna change people in doing that? It’s not gonna be wishful thinking. It’s gonna be new methodologies, it’s going to be AI in our life, you can turn on your AI health coach that’s gonna say, “Hey, listen, here’s an alternative, take the stairs, don’t take the elevator.” It’s gonna be technologies which are transforming our genes, because some people don’t spike their glucose when they’re eating a donut, other people do.

It is, we’re genetically different. And our ability to, if you would change the deck of cards that we’ve been dealt, is now possible for the very first time, you don’t need to live with what you’ve had. Now, it… Is it available today? No. Is it it possible to see where we’re going in the next decade? 100%. Um, you know, we have a genome and an epigenome, right? You have the same 3.2 billion letters from your mom and your dad when you’re born, when you’re 50, when you’re 80, hopefully when you’re 100, and so why do we look different? Why don’t we… We’re running the same software throughout life. It is our epigenome that control of which genes are on and which genes are off. And that is modifiable by many different factors. And our ability to restore an earlier epigenome has the potential for us to change our metabolics. There’re incredible companies on… And I know this because I scanned 500 of them, and the technology they’re gonna bring to bear over the decade ahead is going to make this automatic and some ways magical.

Zeke Emanuel
Yeah, it sounds more like hucksterism, we don’t need that CRISPR uh, the AI to get this solution. The problem as I think, uh, you said is not much of this is genetics. Uh, some of it is, but most of it is about lifestyle. The six wellness interventions I mentioned, uh, don’t be a jerk, uh, uh, have social, good social relationships, uh, stay mentally engaged, eat well, exercise, and, um, sleep well, uh, is very important. And getting people to do those things, uh, is also important, and you don’t need any additional CRISPR of this or epigenetics of that to get those things, it’s an adoption problem, it’s a behavior problem. And constantly selling people that it’s a technology problem means that they can be passive about it. And that I think is the problem. Today, our big problem is we’ve postponed mortality, but we haven’t solved the morbidity problem. And the morbidity problem is not gonna be solved by doing something to someone in their 50s or 60s. It’s about getting people in their teens, twenties, and 30s to live more healthily. And that, again, is a behavior, not a technology problem.

Peter Diamandis
Yeah. So first of all, the new book that I wrote, Longevity guidebook talks about the fundamentals of diet, exercise, sleep, and mindset, right? Mindset is one of the most important things. Uh, I think mind over body is a fundamental thing. So I completely agree that those things, uh, sleep, diet, exercise and mindset, uh, and what I call not dying from something stupid, understanding what’s going on inside your body, uh, are fundamentals, and they will get you so far. Now the question is, do we have additional tools? If we wanna try and, and, uh, extend healthspan with what we’ve always had, fine, you can choose that. For me, I want to use the best of science available. And can we in fact, generate the technologies that are required to support people to make it easier for them to live those additional healthy decades, and I think that we can.

Zeke Emanuel
Look, but there’s a, there’s a serious contradiction here in what Peter is saying. He, in his opening statement, he says, you know, 70% of healthspan is about lifestyle, and then he proceeds to sell you all this stuff about altering your genes and altering this and that. The problem is, it’s the 70%, that’s what we should be focusing on. We know what those interventions are. And the issue is about having a society that encourages the adoption of those interventions early in life so that, uh, you can, uh, establish healthy habits and you can have your body programmed in the right way. The problem in our society, just take one example, school lunches, 70%… 60 or 70% is ultra processed foods, okay? We’re poisoning our kids, um, instead of giving them a way to live a healthy lifespan, uh.

John Donvan
I, I wanna jump in, in the interest of time and I wanna move on to the second piece of this, which is the question of government funding science. And you both have addressed this in your opening, but Peter, to take it back to you, what are you arguing would be the dividend?

Peter Diamandis
So-

John Donvan
And, and what would be the case to the taxpayer?

Peter Diamandis
So it is over a 20 year… We’re talking about a 20-year increase in healthspan, and it is worth 100s of trillions of dollars in the US alone, right? And it’s not just that, it’s the fact that we’re gonna break our healthcare system where it’s fundamentally going to go bankrupt. So bankruptcy on one side, the saving of, let’s call it 100 trillion other side, take 1% of that and invest it in the technologies and methodologies, it’s not just better education, but can we provide mechanisms that make it easier for people to make the right choices?

Zeke Emanuel
We’ve had this promise many times before and it never seems to pan out, and I don’t think this is gonna pan out either. The federal government’s investment in tech through the NIH, which is what Peter’s advocating is not it, maybe we need a federal investment in better habit formation early on, we need to change our… What we’ve done, our taxing policy, so buying ultra processed food is not the cheapest alternative, but fruits and vegetables and eggs and dairy are more… Are better. Figuring out about exercise in school, so kids do it as a matter of habit. Um, these are things which they’re a good investment, they tend not to be, uh, the things that the government is focused on.

John Donvan
Okay, lemme take this question to you, Peter, if you’re right, if this work can be done, if the progress can be made, and if it’s expensive, what are the possibilities that this is… You know, these are benefits that are gonna accrue to the wealthy and not to everybody else, particularly if the government can’t afford to be involved in it. Do you have that concern? An equity concern?

Peter Diamandis
I, I, I don’t. So first of all, we are living during an exponential age. Trying to put into place solutions that harken back to 30, 40 years ago is, for me, an immoral action, we’re not using the best technology that we have, right? We’ve got, you know, AI exploding into the world today, we’re all gonna have a version of an AI diagnostician, we’re all gonna be dumping data into the network, and so that we know what’s going on in our body constantly. You know, it’s interesting that the most powerful technology, John, uh, generative AI is effectively free to seven billion people on the planet with a smartphone. These are democratizing and demonetizing technologies. And I think that this is an extraordinary time to be alive. And if health is the new wealth, if the greatest gift we can give anybody is health, providing them the most powerful capabilities and technologies to support the right decisions, to give them access to new medical interventions, better diagnostics, right?

For most of us, um, you know, 70% of heart attacks have no precedence, no shortness of breath, nothing, and we die from a soft plaque eruption versus calcified plaque. 70% of the cancers that kill us, like glioblastoma and uh, and uh, uh, pancreatic cancer are never screened for, these things can be changed, so we can not die from stupid things, first and foremost, that’s the work that Fountain Life does. Yeah.

John Donvan
So, Peter, let me… I just wanna clarify something about the framing of the argument that you’re making in this debate. So the book behind you, on the shelf behind you, your new book coming out, um, has the word longevity in it, when you’re talking about two decades, are you’re talking about people living to be 120? Or are you talking about those last two decades of lifespan as it now goes, you know, conventionally now to about 85, are you talking about those last 20 years being healthier? Or are you talking about both?

Peter Diamandis
Yeah, for the purpose of this debate, I’m talking about adding 20 healthy years matching, you know, getting people up to healthy 80, right? At a minimum, this is, you know, what the XPRIZE and I’ll talk about that later, uh, is focused on increasing healthspan to match longevity. But yes, there are other technologies that will take us from 80 to 100. And for me, you know, Zeke, you may want die at 75 and not interventions, I wanna see as much of life as I can. And I think that it’s not… I think the technologies we’re gonna have, uh, that enable this are gonna be demonetized technologies. We… Every… All the 8 billion people on the planet have the same biology. We have the same… So something that works for someone in Mozambique or Mumbai is gonna work for someone in the Bronx as well.

Zeke Emanuel
We- we’ve had this promise of democratization. Look at, we, we have some possibilities of changing treatments, uh, changing genes, right? We’ve got gene therapies now. They’re not democratized, they’re $3 million a patient. And that is not going to be democratized. And I don’t care what promises are made by Peter, that has not been the trend in medicine that more high-tech gets you more democracy, just not true. And again, he keeps emphasizing it’s tech, tech, tech, that’s the intervention we need. It’s behavior, behavior, behavior. And the intervention for that has to be early training in young kids and adolescents and young adults and get them to have good habits. That is a much, much, uh, bigger problem, uh, than we have, uh, that… Than taking a pill. This is not about taking a pill. And I think it’s a mistake to sell people on the tech. Um, and I would finally say this really, it, it’s really not about, uh, uh, this fetish of, you know, I’ve gotta live to, uh, 100.

Right now, today our research shows, you know, the top 20% of Americans live to about 96 years of age, and the next 20% live to about 89 years of age. We already have 40% of our population living an long time. We should not invest a single penny in making them live longer. We’ve gotta go to the bottom where the average age of the bottom 20%, uh, at, at death is about 50 years, 52 years old. And we have to move them up and moving them up is, again, a lot of it is gonna be about getting them healthier lifestyles in their teens and 20s. And that’s a very different operation, that is not about a pill, it’s not about taking something different, it’s about changing how they live. And that’s a different kind of investment than funding the NIH or the NSF.

John Donvan
And Peter, what is your last take on this before we move on?

Peter Diamandis
Yeah, two, two things real quick. Yes, gene therapies for orphan diseases have been, uh, a million, two million, $3 million. But you know, the mRNA COVID vaccines were a gene therapy, they were a gene therapy and they cost a dollar a dose. It’s mRNA, it’s a nucleic acid, specifically put into cells, it’s a proof case of what’s possible.

John Donvan
Alright, thank you for that, Peter. Now we move on to the next part of this conversation where we invite additional panelists to ask questions of our debaters, they’re writers or thinkers or researchers themselves on the topic that we’re debating. And first up, I wanna welcome, Tanya Lewis, who is a senior health and medicine editor at Scientific American. Welcome, Tanya. Um, please come in with your question.

Tanya Lewis
Yeah, thanks for having me. So my question is, um, about some of the research by Dr. S. Jay Olshansky that suggests that human lifespan may actually have reached its upper limit and we’ll see diminishing returns from here on out. So I’m wondering if you could both address, you know, whether or not it’s worth investing in continued research to ex- expand lifespan and a- well and healthspan, if we are only gonna sort of hit this upper ceiling?

Zeke Emanuel
Well, I, I, I, look, I’m pretty clear about that and I said, uh, and have said we should not invest in it, there is no justification for the federal government investing in taking people from 90 to a 100, 100 to 110, absolutely zero justification for that. Is there justification in trying to reduce morbidity and, uh, deaths of people who are 60 years old? And the answer to that is yes, and I don’t think, uh… You know, I, I agree with Jay’s view that we, we probably do have an upper limit in human beings somewhere around 110, and we shouldn’t invest in pushing that further.

John Donvan
Peter, the question again is, um, you know, have we, have we reached the point where lifespan cannot get longer, that, you know, we’re genetically predisposed not to go further at this point?

Peter Diamandis
So Tanya, um, thanks for the question. Uh, again, we’re debating extended healthspan versus lifespan, but to turn it to lifespan for a second, um, there are reasons that some individuals can be healthy at 100 years old, um, can have their mental faculties, a good metabolism, have their strength and reasons that others are not. And once we realize that there is this discrepancy, the question is, can we raise the bar for everybody? Um, and it’s not just lifestyle there. Um, you can have people in great lifestyle that are living earlier, so there is something going on in addition to that. And I think that is discoverable, right? We have 40 trillion cells in our body each running somewhere between one billion to two billion chemical reactions per second. No human can understand this, this is an age of AI, this is an age of digital superintelligence that’s coming over the next five years. And I think the biggest impact AI is gonna have is being able to help us understand what’s going on and how to extend our healthspan and our longevity.

And I think we can take control of that. And if we can, that we should, it’s the greatest gift we can give anybody. Um, we need it from a population standpoint, we need it from a productivity standpoint. And I, for one, want it for my personal reasons, and I think others would as well.

John Donvan
Thanks very much for jo- uh, to joining us, Tanya and I now wanna welcome in Venki Ramakrishnan, who is, uh, a Nobel Prize winner, former president of the Royal Society, and author of Why We Die, the New Science of Aging, and the Quest for Immortality. Venki, welcome, thanks for joining the program, and please come in with your question for our debaters.

Venki Ramakrishnan
Thank you. Um, I have a question for each of them. Uh, for Pete, I, I would have to say what makes you think compression of morbidity is actually possible? Because almost all the evidence shows that as you improve healthspan, you’re also increasing lifespan with the result that the period of, uh, having four or more comorbidities has not declined as a fraction of our lives. In fact, we’re spending more years, uh, with comorbidity. Uh, many of us suspect that this movement by you and some of your like-minded colleagues is really an ex- an effort to extend lifespan, uh, because the idea that you’re gonna improve healthspan, uh, but keep lifespan fixed, uh, just doesn’t seem to have any evidence.

Peter Diamandis
So Venki, bu- honored to meet you and to speak with you, so thank you for your time today. Grateful for that. Um, and the answer of course is yes, both is what we’d like. Can we in fact move healthspan up by 20 years and increase lifespan as well? Now, one of the things to realize is in those additional 20 years of health, science is not standing still. And so I want to buy us additional healthy decades and of course, additional life during which additional breakthroughs will become possible. Now the question is, is it, is it from energetic, um, uh, you know, chemical, uh, physical improbability that we can extend? I don’t think so. You know, we do have examples of bowhead whales living 200 years, Greenland sharks living 500 years and having babies at 200 years old, life can do these things. Our ability to understand why in the underlying processes is what I’m so excited about during this next 20 years of exponential growth.

John Donvan
Thanks for your question, Venki. Alright, now we’re gonna take a break and when we come back, we’re gonna continue with our panelists. I’m John Donvan, this is Open to Debate.

Welcome back to Open to Debate. We’re taking on the question, could longevity science extend your healthspan by decades? Should the government fund it? We now continue with our expert questioners. Let’s hear now from Corinna Loeckenhoff, who is a professor of psychology and a professor of gerontology and medicine at Weill Cornell Medical College. Corinna, thank you so much for joining us and please come in with your question.

Corinna Loeckenhoff
Thank you so much for having me, and I’m going to come, uh, at this from a psychological angle because let’s be clear, if the technologies that Peter is advocating for come through, they could be adding decades to the lifespan for the people who can afford the technology. Now, my work on time perception shows that as we age, time seems to pass faster, each passing year seems shorter and our personality and our sense of self become more settled. So you could be adding decades to life, but the gains in subjective lived experience are much shorter, what is the point then? What could you do in the lifespan of 120 years that you couldn’t do reasonably in 80 years? And also, if we have limited resources, if we only have so much money for research, if our planet can only support so many people at a time, why wouldn’t we be allowing a larger number of people live shorter, but richer lives rather than investing in longer lives for fewer people?

John Donvan
That sounds to me, Peter, more of a challenge to your vision, so I’d like you to take that first.

Peter Diamandis
Yeah, sure. So, um, uh, what we’ve seen over the last century, uh, as much as 200 years is up into the right, increasing access to everything, that there is, very little truly scarce, increasing access to energy, to education, to literacy, uh, child mortality dropping, maternal mortality dropping, um, access to, uh, you know, all resources have been increasing substantially. Uh, and this has up-leveled much of humanity, taking us from 90% extreme poverty down to 10% pre- extreme poverty around the world. Our brains are large language models, they’re neural nets that are shaped by what we see, what we hear, what we feel, and when you’re seeing all this negative news around the world, of course you think the world’s going to hell in a handbasket, but it’s not a valid view of what’s going on the planet.

You discard all of the advancements, all the amazing work that’s going on. So I think that our ability to, uh, change how we see the future and create the future, you know, for me the best way to predict the future is create it yourself, and I think we can create an extraordinary future and up-level every man, woman, and child on this planet.

John Donvan
So, Peter, I just sort of an implication, I think I heard of the question is, I mean, do you see somebody being, you know, 95 and deciding to change careers and go back to college at, at that age? I mean, if, if they have that-

Zeke Emanuel
Brain plasticity doesn’t work that way.

John Donvan
Wait, wait, wait, Zeke, I asked a question. Can you hold for a second? I just want to… Peter, do you see that as a possibility?

Peter Diamandis
I think that people retire and shut down because of lack of energy, because of pain, because of morbidity, and I think those things can be changed, and I think if you’ve got the energy, if you’ve got the mobility, if you’ve got the cognition, retiring at 65 is the last thing you wanna do.

John Donvan
Okay, Zeke, uh, thanks for your patience, you wanted to jump in there?

Zeke Emanuel
Yeah, actually, if we look at what happens to people, and by the way, this is true… Just as true of healthy people, it is, uh, true of people who are lacking energy, what happens is they get to retirement at 65 and do they pursue mountain climbing or writing books or traveling to distant places or serving underprivileged kids and helping them to learn to read and write, that is not what actually happens. What actually happens is that we see a 40-hour-a-week increase in TV watching, passive life-

Peter Diamandis
Why? Why?

Zeke Emanuel
Because I think people don’t understand how to live a full life and don’t stay mentally engaged. Um, and we have not created a society to encourage that.

John Donvan
What was your point about brain plasticity before?

Zeke Emanuel
The point about brain plasticity is we all become set in our ways, now that’s just a euphemism for our brain. You know, it’s like survival of the fittest among your neurons and the pathways you use a lot, they get ramified and they get built up. And the pathways you don’t, which are the new ideas and things that, you know, go to the side as you become focused, they… We don’t rearrange our brain all the time. There are a few people who do have brain plasticity, we don’t exactly understand, I believe Benjamin Franklin was an example. Um, and there are a few others, Verdi composed music into his 80s. Uh, but that’s very, very rare. Most of us get, get set in our-

Peter Diamandis
Is that random?

Zeke Emanuel
… ways.

Peter Diamandis
Is that a random effect?

Zeke Emanuel
We don’t understand it at the moment.

Peter Diamandis
Right, and that’s where science and technology will enable us to understand what it is going on there. And the question is, if that’s possible, would you not want to have it? And I think that people would like that.

Zeke Emanuel
I don’t think we should be investing in the possibility of doing that, we should be more investing in, uh, getting people at the bottom up. You want the few people at the top to live longer and to have all the, uh, tech tools. I want everyone to live to 80, and that’s the challenge. And that’s not a-

Peter Diamandis
That’s not the argument.

Zeke Emanuel
… tech challenge.

Peter Diamandis
That’s not the argument I made here. My argument is how do we extend 20 healthy years from six… Early 60s to 80s.

Zeke Emanuel
But as was pointed out, what you really wanna do is extend longevity.

John Donvan
Well wait in, in fairness to, in fairness to Peter and to this debate, that is what he was brought here to argue, and that is the case that he’s making. Corinna, I wanna thank you for your question. Now, the name S. Jay Olshansky has come up a lot in this debate and he actually is our next questioner. He’s a professor at the School of Public Health at the University of Illinois in Chicago, chief scientist at, uh, Lapidus Solutions. Uh, Jay, welcome to Open to Debate and please come in with your question.

S. Jay Olshansky
Thanks for having me. Oh, and thanks for having this debate and it’s wonderful to hear from both of you, it really is. Uh, as my softball question is really gonna be pretty straightforward, I, I completely agree that extending healthy life should become the primary goal of longevity science and medicine in general, but the targets need to be realistic and scientifically testable. Shouldn’t the targets be twofold? Extending healthy life faster than lifespan itself so that morbidity is compressed, that hasn’t been happening as Zeke indicated, but that certainly would be a, a proper goal. And then as you’ve discussed, finding ways to develop and use longevity science to reduce lifespan and healthspan inequalities.

Zeke Emanuel
I think that’s what I’ve been arguing for, Jay and I (laughs), I, I, I, I completely agree with you. Our biggest… My, my view is our biggest problem is we need to focus on the bottom 40%, the 40% of people who don’t get to 75, and that needs to be our attention. And if we keep arguing about, you know, extending life, Metformin to get us to 100, that will not be… Our focus won’t be on the bottom 40%.

John Donvan
Peter.

Peter Diamandis
So, uh, a pleasure to meet you, Jay. And yes, I agree 100% with what you’re saying. Uh, and that is the fundamental. Now the question is, how do we do that, right? Do we do that by hoping? Do we do that by changing educational content in our schools? And there’s so much change, it has to be we’re not getting our kids ready for the future, let alone for a healthy life. You know, uh, you probably know the work of Arianna Huffington at Thrive Global. Yes? So Arianna is focused on using technology, uh, and AI to provide micro steps in your daily life that will de-stress you, that will help you make the positive changes in sleep, in diet, in exercise. And so technology becomes our partner. It becomes our daily minute to minute coach. These things are what’s gonna make this change possible, not in 30 or 50 years, but in the next five years.

And I think we have to view technology as the great enabler. It’s what is, what is different today than it was 20 or 30 years ago, and to ignore it, um, and to not develop it so that it is demonetized for everybody, right? This smartphone, whether you have an iPhone or whether you have a Android phone, is your future health coach, your diagnostician, helping you make those steps and changes. And yes, on top of that, we’re going to see science, understanding why we age, how to slow it and stop it and maybe reverse it. And I believe that is a possibility.

John Donvan
Thank you very much. And thank you, Jay, for joining the program. And that is a wrap on the discussion portion of the debate. We now move on to our closing round and in our closing round, each debater gets to make a closing statement of up to two minutes. Peter, you are up first for this. Once again, uh, reminding people that our question is, um, could longevity science extend your health spend by decades? Should the government fund it? You are arguing a very adamant yes, your last chance to explain your case.

Peter Diamandis
Thank you. So I think that humanity can do amazing things. We can pull off things that were thought of as impossible, that were fundamental limits. I believe in our abilities, uh, and it’s our intellect and our science and technology that enables these things. Uh, it was 30 years ago that I launched something called the XPRIZE. We… I organized a $10 million competition for private space flight, um, uh, it was 27 teams spent $100 million trying to win this $10 million prize. And it was won by Burt Rutan and Paul Allen. And that launched SpaceX and Blue Origin, changed the laws, brought capital in and changed we thought was possible in space. Uh, a year ago, uh, I launched $101 million Healthspan XPRIZE. And this is a competition that has challenged teams with a therapeutic lasting only one year to reverse functional loss in muscle, immune and cognition to bring you back a decade, as much as 20 years. We have 460 teams that have entered that competition, and they are basically driving this incredible future.

You know, to quote John F. Kennedy who kicked off the original moonshot, it is not enough for a great nation merely to have added new years to life. Our objective must be to add new life to those years. And I think that’s what we’re talking about here.

John Donvan
Thank you very much, Peter. Zeke, you get the last word in this, your closing statement in which, which you are arguing no, on both the science and the government funding.

Zeke Emanuel
I think we need to be clear about what we’re aspiring to. Human life is full of potential riches. Um, and what we want is people to be able to live a full human life and have it dedicated to having a fulfilling and meaningful life. We are not trying to get people to obsess about living another few weeks, months, or even years, uh, at 90. If we want people to live a full meaningful human life, they can’t be obsessed about, uh, their diet, about exercise, and about everything else. They need to be focused on other people, on some good beyond themselves, on values that will live on beyond their life.

We need to get the inequality, the people who are at the top in our society, both in terms of income, education and other positive attributes, are already gonna by and large live into their 90s and gonna live a pretty full life. They have lived healthy and well lives before. It is the problem that we have people at the bottom, 40% of our population that on average dies before 75. And those are people who we need to really focus on and who we need to bring up. We need to change our focus from increasing life expectancy to increasing the life expectancy of the bottom 40% of our population. And that change in focus, change in measurement is gonna be important. And the way to achieve it is the six wellness activities. Don’t do stupid things, have good rich social relationships, be mentally engaged, eat well, exercise in the three different ways, cardiovascularly, um, for strength and sleep well. We know what they are, our job now is to make sure every American can do that throughout their lives, beginning early in their lives.

John Donvan
Thanks very much, Zeke. Thanks to both of you. Thank you Peter Diamandis and Zeke Emanuel, we so appreciate that you showed up for this, that you talked, uh, across a single table with, uh, with your thoughtful disagreement, um, and that you taught us some things along the way. It’s what we really aim for at Open to Debate. So thank you to both of you for joining us for this one.

Peter Diamandis
Thank you John, pleasure to meet Zeke.

Zeke Emanuel
Great. Nice to be here.

Peter Diamandis
Look forward to seeing you in 20 or 30 years.

John Donvan
That’s a nice finish.

Zeke Emanuel
On average, both of us will make it there, that’s the problem.

Peter Diamandis
Or the wonderful thing.

John Donvan
I’m gonna jump in here real quickly now from the studio, because I wanna let you know that after we finished the debate itself, a lively conversation sprung up from everybody who took part in it, the debaters and also the questioners. And it was so interesting that we would like to share some of it with you. Please enjoy.

Corinna Loeckenhoff
Uh, seriously, if we’re really going to increase the lifespan, right? We are… We only have one planet. We already have an issue with overpopulation, how are we going-

Peter Diamandis
Wait, wait, w-

Corinna Loeckenhoff
… to deal with that?

Peter Diamandis
I don’t think you’re correct. I think we have a pop- we have an issue with underpopulation. You know, we’re gonna peak at nine and a half billion and very rapidly drop. We’re seeing, you know, it used to be 50 years ago, it was five children per family on average globally. Uh, today we’ve dropped it from five kids per family to, to 2.4 globally. Um, the US is below the replacement age. China, uh, South Korea, Japan, Italy-

Zeke Emanuel
But Peter, that’s one of the reasons you have a decrease in births is because you have an increase in life expectancy, um, and that is very highly related, you see this all over the world.

Peter Diamandis
I don’t, I, I think it’s microplastics, I think it’s all kinds of toxins in our environment that are driving down births. I think we-

Zeke Emanuel
No.

Peter Diamandis
… we see, we see as-

Zeke Emanuel
It’s, it’s the will of people.

Peter Diamandis
… as people become more affluent, they have less children.

Corinna Loeckenhoff
It’s, it’s women’s access to, to birth control.

Zeke Emanuel
Yes, of course.

Corinna Loeckenhoff
Right? If you educate women and give them access to birth control, you’re bringing down the birth rates. If you’re shifting the mindset right, there’s good evidence that there’s a different life history strategies, depending on your environment. If you are in a very insecure environment, you’re gonna have a lot of kids and you’re gonna have like a short life course where you’re gonna have lots of kids and then expecting today.

Peter Diamandis
But the data does… The demographics don’t lie.

Zeke Emanuel
And having fewer kids means fewer innovations.

Peter Diamandis
Uh, well, listen, Elon Musk did not have to have the CEO of General Motors die for him to become successful at Tesla. Better ideas dominate, and if you have breakthroughs that provide a product or service that’s 10 times better than the old one, I don’t care how old you are, you’re gonna have a, a successful company and disruption of the old industry. Um, we need young… We need youth, and we need all of us as well. Wisdom, my friend. Wisdom.

Venki Ramakrishnan
I, I think wisdom is highly overrated, frankly.

Peter Diamandis
(Laughing).

Corinna Loeckenhoff
(Laughing).

Zeke Emanuel
I agree.

Venki Ramakrishnan
You know, uh, because, uh, if you look at scientific discoveries or technological breakthroughs, they’re all made by young people.

Zeke Emanuel
Late 30s, early 40s.

Venki Ramakrishnan
Okay?

Zeke Emanuel
Yeah.

Peter Diamandis
They’re… Yeah.

Venki Ramakrishnan
You know, this is not about biological cognitive decline. What happens is when we’re young, we meet the world fresh, we’re seeing it with open eyes, uh, in the field of tech, as you must know, you know, big advances are done by young people.

Peter Diamandis
Yes.

Venki Ramakrishnan
And then they consolidate. Yes, you can run a bunch of VC firms or, you know, manage people, that’s fine. And what’ll happen is when you get older…

Peter Diamandis
You have more to lose.

Venki Ramakrishnan
You’ll accumulate power and networks-

Corinna Loeckenhoff
And knowledge. So, so from an evolutionary point of view, older adults evolve as repositories of information, right? In, uh, cultures that did not have written language. And so it was important for older adults to have a vast store of information that they were able to share with others. They actually get more engaging storytellers with age and to, to share this information, but not necessarily generate new information. And again, our perception of our lives, you, you all notice that, each year goes a little bit faster, right? And so the subjective added life experience that we’ll have with another couple of decades is not that much, right? And so, I, I don’t believe this abundance mindset, we have a limited planet, we have limited resources. And I believe that we should, you know, have more people have lived, live richer, but shorter lives rather than pushing everybody’s life to [inaudible

:06].

Peter Diamandis
I, I welcome you guys to die early. I will take your extra decades, uh, fascinating conversation.

Zeke Emanuel
Nice to meet you.

Venki Ramakrishnan
Very nice to meet all of you.

Corinna Loeckenhoff
Yes, that was a lot of fun.

Zeke Emanuel
Take care.

John Donvan
And now that wraps up our debate. Thank you again to our debaters and to our expert questioners, Tanya, Venki, Corinna and Jay, for making the conversation even richer. And I wanna thank all of you who are tuning into this episode of Open To Debate.

You know, as a nonprofit working to combat extreme polarization through what we do, which is civil debate, our work is made possible by listeners like you, by the Rosenkranz Foundation and by supporters of Open to Debate. Robert Rosenkranz is our chairman. Our CEO is Clea Conner. Lia Matthow is our chief content officer. Elizabeth Kitzenberg is our chief advancement officer. This episode was produced by Marlette Sandoval and Jessica Glazer. Editorial and research by Gabriella Mayer and Andrew Foote. Andrew Lipson and Max Fulton provided production support. The Open the Debate team also includes Gabrielle Iannucelli, Annalisa Cochrane, Rachel Kemp, Eric Gross, Mary Ragus, Savion Jackson, and Linda Lee. Damon Whittemore mixed this episode. Our theme music is by Alex Clement. And I’m John Donvan, we’ll see you next time on Open To Debate. Thanks so much for joining us.