I respectfully disagree on the first point. I am a doctor myself and given observable increase in investment in life extension (largely in well funded stealth startups or Google Calico), I have ~70% confidence that in the absence of superhuman AGI or other x-risks in the near term, we have a shot at getting to longevity escape velocity in 20 years.
While my p(doom) for AGI is about 30% now, down from a peak of 70% maybe 2 years ago after the demonstration that it didn’t take complex or abstruse techniques to reasonably align our best AI (LLMs), I can’t fully endorse acceleration on that front because I expect the tradeoff in life expectancy to be net negative.
YMMV, it’s not like I’m overly confident myself at 70% for life expectancy being uncapped, and it’s not like we’re probably going to find out either. It just doesn’t look like a fundamentally intractable problem in isolation.
I also see multiple technological pathways that would get us to longevity escape velocity that seem plausible without AGI in that timeframe.
If nothing else, with advances in tissue engineering I expect we will be able to regrow and replace every organ in the body except the brain by mid-century.
But I also think a lot of what’s needed is culturally/politically/legally fraught in various ways. I think if we don’t get life-extending tech, it will be because we made rules inadvertently preventing it or pretending it’s better not to have it.
I have ~70% confidence that in the absence of superhuman AGI or other x-risks in the near term, we have a shot at getting to longevity escape velocity in 20 years.
Is the claim here a 70% chance of longevity escape velocity by 2043? It’s a bit hard to parse.
If that is indeed the claim, I find it very surprising, and I’m curious about what evidence you’re using to make that claim? Also, is that LEV for like, a billionaire, a middle class person in a developed nation, or everyone?
Yes, you can reformat it in that form if you prefer.
This is a gestalt impression based off my best impressions of the pace of ongoing research (significantly ramped up compared to where investment was 20 years ago), human neurology, synthetic organs and finally non-biological alternatives like cybernetic enhancement. I will emphasize that LEV != actual biological immortality, but it leads to at least a cure for aging if nothing else.
Aging, while complicated and likely multifactorial, doesn’t seem intractable to analysis or mitigation. We have independent research projects tackling individual aspects, but as I’ve stated, most of them are in stealth mode even if they’re well-funded, and solving any individual mechanism is insufficient because of how aging itself is an exponential process.
To help, I’m going to tackle the top causes of aging in the West-
Heart disease- This is highly amenable to outright replacement of the organ, be it with a cybernetic replacement or one grown in-vitro. Obesity, which contributes heavily to cardiovascular disease and morbidity, is already being tackled by the discovery of GLP-1 antagonists like semaglutide, and I fully expect that the obesity epidemic that is dragging down life expectancy in the West will be over well before then.
Cancer- Another reason for optimism, CAR-T therapy is incredibly promising, as are other targeted therapies. So are vaccines for diseases like HPV that themselves cause cancer (said vaccine already exists, I’m talking more generally).
Unintentional injuries- The world has grown grossly safer, and only will continue to do so, especially as things get more automated.
Respiratory diseases- Once again, reason for optimism that biological replacements will be cheap enough that we won’t have to rely on limited numbers of donors for transplants.
Stroke and cerebrovascular disease- I’ll discuss the brain separately, but while this is a harder subject to tackle, mitigating obesity helps immensely.
Alzheimers- Same disclaimer as above
Diabetes- Our insulin pumps and formulations only get better and cheaper, and many of the drawbacks of artificial insulin supplementation will vanish (our pancreas is currently better at quickly and responsively adjusting blood sugar levels by releasing insulin than we are). Once again, a target for outright replacement of the organ.
These are ranked in descending order.
The brain remains incredibly difficult to regenerate, so if we run into something intractable to the hypothetical capabilities 20 years hence, this will likely be the biggest hurdle. Even then, I’m cautiously optimistic we’ll figure something out, or reduce the incidence of dementia.
Beyond organic replacement, I’m bullish on gene therapy, most hereditary disease will be eliminated, and eventually somatic gene therapy will be able to work on the scale of the entire body, and I would be highly surprised if this wasn’t possible in 20 years.
I expect regenerative medicine to be widely available, beyond our current limited attempts at arresting the progression of illness or settling for replacements from human donors. There’s a grab bag of individual therapies like thymic replacement that I won’t get into.
As for the costs associated with this, I claim no particular expertise, but in general, most such treatments are amenable to economies of scale, and I don’t expect them to remain out of reach for long. Organ replacement will likely get a lot cheaper once they’re being vat grown, and I put a decent amount of probability that ~universally acceptable organs can be created by careful management of the expression of HLA antigens such that they’re unlikely to be rejected outright. Worst case, patient tissue such as pluripotent stem cells will be used to fill out inert scaffolding like we do today.
As a doctor, I can clearly see the premium people put on any additional extension of their lives when mortality is staring them in the face, and while price will likely be prohibitive for getting everyone on the globe to avail of such options, I expect even middle class Westerners with insurance to be able to keep up.
Like I said, this is a gestalt impression of a very broad field, and 70% isn’t an immense declaration of confidence. Besides, it’s mostly moot in the first place, we’re very likely certainly getting AGI of some form by 2043.
To further put numbers on it, I think that in a world where AI is arrested at a level not significantly higher than GPT-4, I, being under the age of 30, have a ~80% chance of making it to LEV in my lifespan, with an approximately 5% drop for every additional decade older you are at the present.
I, being under the age of 30, have a ~80% chance of making it to LEV in my lifespan, with an approximately 5% drop for every additional decade older you are at the present.
You, being a relatively wealthy person in a modernized country? Do you think you’ll be able to afford the LEV by that time, or only that some of the wealthiest people will?
I’m a doctor in India right now, and will likely be a doctor in the UK by then, assuming I’m not economically obsolete. And yes, I expect that if we do have therapies that help provide LEV, they will be affordable in my specific circumstances as well as most LW readers, if not globally. UK doctors are far poorer compared to the their US kin.
Most biological therapies are relatively amenable to economies of scale, and while there are others that might be too bespoke to manage the same, that won’t last indefinitely. I can’t imagine anything with as much demand as a therapy that is proven to delay aging nigh indefinitely, for an illustrative example look at what Ozempic and Co are achieving already, every pharma industry leader and their dog wants to get in on the action, and the prices will keep dropping for a good while.
It might even make economic sense for countries to subsidize the treatment (IIRC, it wouldn’t take much more for GLP-1 drugs to reach the point where they’re a net savings for insurers or governments in terms of reducing obesity related health expenditures). After all, aging is why we end up succumbing to so many diseases in our senescence, not the reverse.
Specifically, gene therapy will likely be the best bet for scaling, if a simple drug doesn’t come about (seems unlikely to me, I doubt there’s such low hanging fruit, even if the net result of LEV might rely on multiple different treatments in parallel with none achieving it by themself).
Thanks for your reply. “70% confidence that… we have a shot” is slightly ambiguous—I’d say that most shots one has are missed, but I’m guessing that isn’t what you meant, and that you instead meant 70% chance of success.
70% feels way too high to me, but I do find it quite plausible that calling it a rounding error is wrong. However, with a 20 year timeline, a lot of people I care about will almost definitely still die, who could have not died if death were Solved, which group with very much not negligible probability includes myself. And as you note downthread, the brain is a really deep problem with prosaic life extension. Overall I don’t see how anything along these lines can be fast enough and certain enough to be a crux on AI for me, but I’m glad people are working on it more than is immediately apparent to the casual observer. (I’m a type 1 diabetic and would have died at 8 years old if I’d lived before insulin was discovered and made medically available, so the value of prosaic life extension is very much not lost on me.)
T1DM is a nasty disease, and much like you, I’m more than glad to live in the present day when we have tools to tackle it, even if other diseases still persist. There’s no other time I’d rather be alive, even if I die soon, it’s going to be interesting, and we’ll either solve ~all our problems or die trying.
However, with a 20 year timeline, a lot of people I care about will almost definitely still die, who could have not died if death were Solved, which group with very much not negligible probability includes myself
I understand. My mother has chronic liver disease, and my grandpa is 95 years old, even if he’s healthy for his age (a low bar!). In the former case, I think she has a decent chance of making it to 2043 in the absence of a Singularity, even if it’s not as high as I would like. As for my grandfather, at that age just living to see the next birthday quickly becomes something you can’t take for granted. I certainly cherish all the time I can spend him with him, and hope it all goes favorably for us all.
As for me, I went from envying the very young, because I thought they were shoe-ins for making it to biological immortality, to pitying them more these days, because they haven’t had at least the quarter decade of life I’ve had in the event AGI turns out malign.
Hey, at least I’m glad we’re not in the Worst Possible Timeline, given that awareness of AI x-risk has gone mainstream. That has to count for something.
I respectfully disagree on the first point. I am a doctor myself and given observable increase in investment in life extension (largely in well funded stealth startups or Google Calico), I have ~70% confidence that in the absence of superhuman AGI or other x-risks in the near term, we have a shot at getting to longevity escape velocity in 20 years.
While my p(doom) for AGI is about 30% now, down from a peak of 70% maybe 2 years ago after the demonstration that it didn’t take complex or abstruse techniques to reasonably align our best AI (LLMs), I can’t fully endorse acceleration on that front because I expect the tradeoff in life expectancy to be net negative.
YMMV, it’s not like I’m overly confident myself at 70% for life expectancy being uncapped, and it’s not like we’re probably going to find out either. It just doesn’t look like a fundamentally intractable problem in isolation.
I also see multiple technological pathways that would get us to longevity escape velocity that seem plausible without AGI in that timeframe.
If nothing else, with advances in tissue engineering I expect we will be able to regrow and replace every organ in the body except the brain by mid-century.
But I also think a lot of what’s needed is culturally/politically/legally fraught in various ways. I think if we don’t get life-extending tech, it will be because we made rules inadvertently preventing it or pretending it’s better not to have it.
Is the claim here a 70% chance of longevity escape velocity by 2043? It’s a bit hard to parse.
If that is indeed the claim, I find it very surprising, and I’m curious about what evidence you’re using to make that claim? Also, is that LEV for like, a billionaire, a middle class person in a developed nation, or everyone?
Yes, you can reformat it in that form if you prefer.
This is a gestalt impression based off my best impressions of the pace of ongoing research (significantly ramped up compared to where investment was 20 years ago), human neurology, synthetic organs and finally non-biological alternatives like cybernetic enhancement. I will emphasize that LEV != actual biological immortality, but it leads to at least a cure for aging if nothing else.
Aging, while complicated and likely multifactorial, doesn’t seem intractable to analysis or mitigation. We have independent research projects tackling individual aspects, but as I’ve stated, most of them are in stealth mode even if they’re well-funded, and solving any individual mechanism is insufficient because of how aging itself is an exponential process.
To help, I’m going to tackle the top causes of aging in the West-
Heart disease- This is highly amenable to outright replacement of the organ, be it with a cybernetic replacement or one grown in-vitro. Obesity, which contributes heavily to cardiovascular disease and morbidity, is already being tackled by the discovery of GLP-1 antagonists like semaglutide, and I fully expect that the obesity epidemic that is dragging down life expectancy in the West will be over well before then.
Cancer- Another reason for optimism, CAR-T therapy is incredibly promising, as are other targeted therapies. So are vaccines for diseases like HPV that themselves cause cancer (said vaccine already exists, I’m talking more generally).
Unintentional injuries- The world has grown grossly safer, and only will continue to do so, especially as things get more automated.
Respiratory diseases- Once again, reason for optimism that biological replacements will be cheap enough that we won’t have to rely on limited numbers of donors for transplants.
Stroke and cerebrovascular disease- I’ll discuss the brain separately, but while this is a harder subject to tackle, mitigating obesity helps immensely.
Alzheimers- Same disclaimer as above
Diabetes- Our insulin pumps and formulations only get better and cheaper, and many of the drawbacks of artificial insulin supplementation will vanish (our pancreas is currently better at quickly and responsively adjusting blood sugar levels by releasing insulin than we are). Once again, a target for outright replacement of the organ.
These are ranked in descending order.
The brain remains incredibly difficult to regenerate, so if we run into something intractable to the hypothetical capabilities 20 years hence, this will likely be the biggest hurdle. Even then, I’m cautiously optimistic we’ll figure something out, or reduce the incidence of dementia.
Beyond organic replacement, I’m bullish on gene therapy, most hereditary disease will be eliminated, and eventually somatic gene therapy will be able to work on the scale of the entire body, and I would be highly surprised if this wasn’t possible in 20 years.
I expect regenerative medicine to be widely available, beyond our current limited attempts at arresting the progression of illness or settling for replacements from human donors. There’s a grab bag of individual therapies like thymic replacement that I won’t get into.
As for the costs associated with this, I claim no particular expertise, but in general, most such treatments are amenable to economies of scale, and I don’t expect them to remain out of reach for long. Organ replacement will likely get a lot cheaper once they’re being vat grown, and I put a decent amount of probability that ~universally acceptable organs can be created by careful management of the expression of HLA antigens such that they’re unlikely to be rejected outright. Worst case, patient tissue such as pluripotent stem cells will be used to fill out inert scaffolding like we do today.
As a doctor, I can clearly see the premium people put on any additional extension of their lives when mortality is staring them in the face, and while price will likely be prohibitive for getting everyone on the globe to avail of such options, I expect even middle class Westerners with insurance to be able to keep up.
Like I said, this is a gestalt impression of a very broad field, and 70% isn’t an immense declaration of confidence. Besides, it’s mostly moot in the first place, we’re very likely certainly getting AGI of some form by 2043.
To further put numbers on it, I think that in a world where AI is arrested at a level not significantly higher than GPT-4, I, being under the age of 30, have a ~80% chance of making it to LEV in my lifespan, with an approximately 5% drop for every additional decade older you are at the present.
You, being a relatively wealthy person in a modernized country? Do you think you’ll be able to afford the LEV by that time, or only that some of the wealthiest people will?
I’m a doctor in India right now, and will likely be a doctor in the UK by then, assuming I’m not economically obsolete. And yes, I expect that if we do have therapies that help provide LEV, they will be affordable in my specific circumstances as well as most LW readers, if not globally. UK doctors are far poorer compared to the their US kin.
Most biological therapies are relatively amenable to economies of scale, and while there are others that might be too bespoke to manage the same, that won’t last indefinitely. I can’t imagine anything with as much demand as a therapy that is proven to delay aging nigh indefinitely, for an illustrative example look at what Ozempic and Co are achieving already, every pharma industry leader and their dog wants to get in on the action, and the prices will keep dropping for a good while.
It might even make economic sense for countries to subsidize the treatment (IIRC, it wouldn’t take much more for GLP-1 drugs to reach the point where they’re a net savings for insurers or governments in terms of reducing obesity related health expenditures). After all, aging is why we end up succumbing to so many diseases in our senescence, not the reverse.
Specifically, gene therapy will likely be the best bet for scaling, if a simple drug doesn’t come about (seems unlikely to me, I doubt there’s such low hanging fruit, even if the net result of LEV might rely on multiple different treatments in parallel with none achieving it by themself).
Thanks for your reply. “70% confidence that… we have a shot” is slightly ambiguous—I’d say that most shots one has are missed, but I’m guessing that isn’t what you meant, and that you instead meant 70% chance of success.
70% feels way too high to me, but I do find it quite plausible that calling it a rounding error is wrong. However, with a 20 year timeline, a lot of people I care about will almost definitely still die, who could have not died if death were Solved, which group with very much not negligible probability includes myself. And as you note downthread, the brain is a really deep problem with prosaic life extension. Overall I don’t see how anything along these lines can be fast enough and certain enough to be a crux on AI for me, but I’m glad people are working on it more than is immediately apparent to the casual observer. (I’m a type 1 diabetic and would have died at 8 years old if I’d lived before insulin was discovered and made medically available, so the value of prosaic life extension is very much not lost on me.)
T1DM is a nasty disease, and much like you, I’m more than glad to live in the present day when we have tools to tackle it, even if other diseases still persist. There’s no other time I’d rather be alive, even if I die soon, it’s going to be interesting, and we’ll either solve ~all our problems or die trying.
I understand. My mother has chronic liver disease, and my grandpa is 95 years old, even if he’s healthy for his age (a low bar!). In the former case, I think she has a decent chance of making it to 2043 in the absence of a Singularity, even if it’s not as high as I would like. As for my grandfather, at that age just living to see the next birthday quickly becomes something you can’t take for granted. I certainly cherish all the time I can spend him with him, and hope it all goes favorably for us all.
As for me, I went from envying the very young, because I thought they were shoe-ins for making it to biological immortality, to pitying them more these days, because they haven’t had at least the quarter decade of life I’ve had in the event AGI turns out malign.
Hey, at least I’m glad we’re not in the Worst Possible Timeline, given that awareness of AI x-risk has gone mainstream. That has to count for something.