Tech Tonic: Defying death

0:00Hey guys, it's Mark. This week our standard news briefing programming is going to be taking a break. Instead, we're going to share a range of shows with you from across the FT podcast network. And we're going to start with a new series from the FT's Tectonic podcast. It's all about the longevity movement. The series looks at all these weird treatments and technologies meant to help people live longer and how that idea of life extension has kind of gone mainstream. The series is called Defying Death. We're going to play the first episode for you. And if you like it, subscribe to the Tectonic podcast for more.

0:34We'll have a link to that in the show notes. Enjoy.

0:43I am going to put a tourniquet on. I'm going to put it as tight as possible, not too tight, but just so that the vein can pop out for me, okay? I'm sitting in a brightly lit private clinic in central London where a nurse is preparing a syringe. She swabs an area on my arm and then unwraps a fresh needle and canula and pops them on a metal tray. And I see two great amazing veins. I'm probably going to go for this one. OK, so you might feel a quick scratch. What I'm getting is called a wellness IV drip. The canula in my arm is attached to a transparent plastic bag full of saline solution packed with vitamins and antioxidants that are supposed to help me live a healthier, maybe even a longer life.

1:33So they both have antioxidants in them and HydroMax is also going to give you a one litre bag so it will give you hydration and it has magnesium so that's really good for fitness. Intravenous drips funnel nutrients directly into your bloodstream and are aimed at fostering healthy ageing. They're part of a growing list of longevity treatments. The wellness movement focused on extending and bettering your quality of life that is fast becoming mainstream. Sarah Lomas is the CEO of the medical technology firm Revive, who run this IV clinic. I know from our early days the superstars that we delivered it to, the politicians, the royal families, and it was the biggest kept secret.

2:14And the difference today is people are proud to say that they have IV therapy. Today, customers flock to this central London clinic, including on their lunch break, And Lomas says treatments and therapies like this are going to become front and centre of our medical future. The next generation of regenerative medicine you would see delivered via IV therapy. So for example, stem cells. For example, high-dose vitamin C infusions as part of a cancer protocol. Blood cleaning, blood filtration, it's going to play a role in the heart of all of the longevity and regenerative medicine clinics for the future.

2:53Once upon a time, the idea of radical interventions to combat the aging process was the preserve of the elite. The super rich celebrities and Silicon Valley tech bros trying to hack their productivity and alter their brain chemistry. You want to live longer, you want to be in your 80s, still fit and healthy, do a cold plunge and then an infrared sauna session and then get into a hyperbaric chamber. We should be incredibly concerned about microblastics. It's one of the biggest threats to the future of humans. Like organ meats are so good for you. The cartilage is so good for you. But then people think it's just like weird or like disgusting.

3:28I've had brain souffle. Ooh. Okay, yeah. I've heard people that have had like monkey brains. For a while, the trend was treated as a fad. People with too much money who wanted to live forever. We've taken science and measured biological age. And we've slowed my speed of aging, which means for every 12 months that pass, I age six months. This is the moment when humans figured out they wouldn't die. Over time, the culture has changed. And now, the idea of longevity healthcare has morphed into a multi-billion dollar industry. Supplements, beauty products and personalised plans have become the norm, with supposedly miracle drugs and ways of manipulating our genes being touted as strategies that might slow and even stop the ageing process.

4:15But is that really possible? Can science and technology really help us live longer or even defy death altogether?

4:31This is Tectonic from the Financial Times. I'm Michael Peel, the FT's science editor. And I'm Hannah Kuchler, the FT's global pharma editor. In this series, we'll be exploring the longevity movement from its origins decades ago. to how it became an obsession for a Silicon Valley elite, up to the present, as efforts to extend your life are going mainstream. So, where did the concept of longevity come from and what does it mean? Does the science really show we can slow or even stop ageing? And how did this movement become so popular with the tech super rich? Part 1. The Origins of Ageing

5:22hi so i'm here in the london studio with michael what i really want to know is how was your iv drip oh thanks hannah it felt good and uh it was just nice to be sort of cared for and you know sitting around and not having to do anything for an hour although i was of course chatting to the founder having very interesting chat and i suppose was an example of how this industry has moved from you know, high wealth individuals to being something more of a mass consumer proposition. And well, they'll even give it to someone like me. And so we think that longevity is this recent phenomenon, but it's actually been around for forever, really.

5:59Yeah, it's been explored culturally and scientifically for so long. I mean, look at the epic of Gilgamesh with its preoccupation for the quest for the secret of eternal life, all the way up to Harry Potter and the Philosopher's Stone and preoccupied people on a very scientific and practical level as well with all kinds of outlandish efforts to promote longevity, such as during the early 20th century to try and rejuvenate the human body by implanting monkey glands. The big difference, I guess, today is that it's now become much more of an industry, much more of a movement. And that raises the big question of what is longevity?

6:38and classically, naturally, you would say, well, it's about living as long as possible. But I think the big point here is that longevity has been on a journey from a fantastical fringe pursuit to something that is of genuine, credible interest today. And Hannah, you've lived some of that extraordinary journey, haven't you? Well, not all the way back to the epic of Gilgamesh. But yes, I was in Silicon Valley for the FT for many years up until about 2019. and during that period, tech leaders' longevity efforts were gossiped about, they were joked about, famously was subject of HBO's series, Silicon Valley.

7:18One of the executives had a blood boy that followed him around, giving him young blood. So it's been so interesting to see that now over the last five years or so, I've moved back to London and it's just become so much more mainstream and it's partly because of the interest in the tech industry and it's money that has poured into it and made it a commercial sector? This is figures like the technologist Ray Kurzweil, who's a big voice in futurist far out circles in Silicon Valley, right? And then there's Peter Thiel, the pro-Trump tech investor, and he's banked the Enhanced Games, a kind of steroid Olympics that's aimed at finding new longevity drugs, among other things.

7:57And then, of course, you have Brian Johnson, you know, big on the internet, who made his money with a startup that he sold to eBay. And he's publicly stated that his goal was to reduce his age to 18 through a rather brutal looking regimen of diet, supplements and exercise. Yeah, so this has become, you know, something that's quite wacky. And now it's becoming more mainstream, more scientific in some ways. And I now cover the pharma industry. And you see an interest, maybe not an embracing yet, but an interest from drug makers in the sector too. I guess my big question is, is all that energy, money the tech industry is investing in longevity actually worth it?

8:37Because a lot of scientists have actually been spending decades trying to figure that out. One of them is David Gems, a researcher in biology of ageing at University College London. Gems has dedicated his career to trying to figure out exactly what the process of ageing entails. What happens in the human body when we age? and he's done that by peering through the barrel of a microscope. I'm looking down a dissecting scope and somebody's put a couple of C. elegans on here. There's actually three of them. So this will be a... They set up a culture to grow a worm population here. His lab is set up with lines of microscopes and Petri dishes, each of which is home to a little population.

9:21You look very carefully at these tiny little dark things. wriggling about. They're young and full of zest for life. In the quest to discover the secret of how and why we age, James runs experiments with these zesty little worms called C. elegans. It's got a nervous system, it's got a reproductive system, it's got ageing, but it's only a millimetre long. It's very, very simple and cheap. So because the lifespan's so short, only a couple of weeks, because we can breed them so easily, and because they've got fantastic genetics, So it means there's lots and lots of sources for looking at how genes affect things in the worm.

9:55Back in the 1990s, when GEMS first started in the field, a recent breakthrough made studying these worms very, very exciting. What was found in the late 80s, early 90s, was that single gene changes in the worm could double and triple the lifespan. So that meant not only that there's some kind of central ageing process that you can manipulate, something which is in a way upstream of all of the diseases of ageing, something that controls ageing as a whole. But also it's something you can study in C. elegans, which is so easy to work with. That breakthrough led to a sort of blossoming in the field around different theories of ageing.

10:35Researchers believed that the experiments on C. elegans could help develop a theory of why we age. And from that, find ways to slow that process down or even stop it. And at that time, finding that theory of ageing, well, it seemed simple enough. Back then in the 90s, I would have said, you know, within 10 years, we'd be finding ways to manipulate ageing rate in humans, slow it down, delay all of the diseases of ageing, everything. Dementia, Alzheimer's disease, cardiovascular disease, cancer, which is mainly an ageing disease. And on and on and on and on. You could slow it all down. One of the most influential theories that emerged from the study of these worms was the idea that ageing is caused by damage to our DNA and other parts of our cells.

11:25According to the theory, this damage is caused by rogue molecules created by natural processes of the body, like breathing. And over time, the damage builds up. So damage accumulates. This accumulation of damage then kind of causes late-life disease and causes ageing and death. This theory became known as oxidative damage theory, and if proven true, theoretically, the process of ageing could be slowed down by stopping the damage from happening in the first place. Secondly, the theory suggested that you could prevent oxidative damage to your cells by consuming compounds known as antioxidants. In other words, a simple consumer product could protect your body from ageing and, in effect, extend your life.

12:13Soon, antioxidants were being marketed to consumers in everything. Antioxidant shampoo. Regular or for chemically treated hair. Packed with the antioxidants in pure pomegranate juice. And when myself are healthy, I feel good. I look great. Don't stress it. Refresh it. With 4G Antioxidants. The oxidative damage theory of ageing became incredibly popular among researchers. But the trouble was, the theory was just a theory. It took me a long time to realise that it was actually a hypothesis. Because everybody talked about it as if it was a fact. Jem says support for the theory dropped off when researchers started looking into whether antioxidants really worked.

12:59What the oxidative damage theory predicts is that if you boost your antioxidant defence in some way, well, that should slow down oxidative damage, should extend lifespan. But people tested this theory using the short-lived animal models, like mainly the worms, the elegans, the fruit fly and mice, and they didn't live longer. So then what happened to it? It was about 2008, 2009. There was an absolute watershed where the confidence in the theory collapsed. And it was like the grip of this theory was suddenly broken. And so I think really since the late noughties, the theory is sort of relegated.

13:36It's clear that oxidative damage and these sort of things, they're predominantly a consequence of ageing rather than a cause. Basically, oxidative damage appears to be just another symptom of ageing, like wrinkles. Wrinkles aren't the cause of ageing, they're a result of it. This isn't to say that antioxidants can't have a beneficial effect on your health by helping with the symptoms. But what the science tells us is oxidative damage is a consequence of ageing, rather than the underlying mechanism. And Jem says even after all the optimism and decades of research, we still don't know, on a biological level, what the process of ageing actually is.

14:18I think if there is a consensus, it's that theories are a waste of time because we had theories in the 90s and they didn't work. So I thought by now we'd be way into things that were showing all sorts of promise and some, but there isn't really anything. I think the fact is, is that you can't develop a scientific field without some kind of general explanatory framework. And the current fashion is actually to sort of say, oh, it's too complicated, ageing, you can't ever understand it. Better just to take an applied approach. After the excitement of the 1990s evaporated, much of the longevity movement turned from theorising to the task of finding practical treatments, products to help extend your life, rather than explanations for why you're ageing.

15:05Even if you can't understand the ageing process, you can still look for treatments that seem to work without having to worry about the why. Today we're going to talk about the science of ageing and longevity. So Dr. DeGray, welcome to the show. It's a huge pleasure to have you on. Well, thank you for having me. Among the major proponents of this philosophy was a researcher named Aubrey de Grey. The way in which we are going to bring aging under medical control is going to be through damage repair. You are basically turning back the clock. You're effectively reversing aging every so often. De Grey was hypothesizing that if we could come up with treatments to repair or reverse the damage caused by aging, we could increase our lifespan incrementally and ultimately defy death.

15:54For example, if we found a new therapy to lengthen our lives by one year every year, we would never run out of road. Immortality was in reach. Scientists will have to improve these interventions in order to stay one step ahead of the problem, such that people who are receiving state-of-the-art medicines at any time will not get biologically older. The Grey's ideas took hold in the tech world. It was the early days of the internet and the suggestion that you could adjust your own ageing, just like you might debug a computer program, was intriguing. And it wasn't just Silicon Valley. Even David Jem's students at UCL were seduced.

16:37So the idea was then if you do all of these things, you basically eliminate ageing. We can live to be a thousand. And he would go, I remember he came here to UCL to talk to students. And he said, some of you in the audience here will be some of the first people to live to be a thousand. You know, so, of course, people listen when they hear that. They don't want to hear this sort of stuff I say. You know, it's very unglamorous. We should say De Grey was ousted from the research institute he founded following claims of sexual harassment, which he says were fabricated. De Grey has since created a new organisation, the Longevity Escape Velocity Foundation.

17:14Since De Grey, all of the heady optimism around curing ageing, well, it's only become headier and more optimistic. A few years ago, David Gems attended a longevity conference in the Middle East. It was organised by Hevolution, a massive multi-billion dollar non-profit that funds research into the field, backed by Saudi Arabia's royal family. We were treated very nicely by the Saudi hosts, you know, it was very pleasant. But the whole meeting was bonkers. We'll actually be hearing from Hevolution in a later episode of this series. Because as the industry has grown, Hevolution became one of the best-funded players, promising to spend a billion dollars a year on scientific research to increase the length of healthy lives.

18:00And they spared no expense at the summit. Your excellencies, ladies and gentlemen, this is the Global Healthspan Summit 2023. There was even a sort of compare, you know, it's like a television show, you know, with a sort of a cheesy compare. And now we're out here. Please welcome to the stage Dr. Mahmoud Khan, Chief Executive, Evolution Foundation.

18:24For Gems, the money pouring into the industry has far surpassed the scientific progress around the theory of ageing. I think the problem was that a lot of people had gone there from labs around the world, essentially cap in hand, because they're hoping to get money, because their original plan was they were going to put a billion dollars a year into research on ageing. But the meeting was particularly concentrated with people making grand claims and really talking it up. I felt I was sort of in a kind of mad dream. A dream conjured by investors who see serious potential in the practical treatments, despite a lack of scientific understanding as to why we actually age.

19:07And sometimes those treatments are found almost by accident.

19:21Despite no one really knowing what causes aging, researchers and tech startups have been searching for treatments to re-engineer our bodies and help us live longer. And every once in a while, those treatments emerge from unexpected places. Biosphere 2 is a really interesting cultural and scientific phenomenon. This is Matt Kaberlein, an academic at the University of Washington and the CEO of a biotech company called OptiSpan. Back in the 1990s, just when UCL researcher David Gems was working with his worms, there were other teams of scientists doing a very different kind of research. The Biosphere 2 project was actually an attempt to see what it would be like to live on the planet Mars.

20:06So this was an experiment that was designed to test how and whether people could live in a completely self-contained environment for a long period of time. The idea being that if you ever want to travel to Mars, for example, humans are going to have to live in this sort of completely cut off, completely self-contained environment for months, maybe years. Listeners of Tectonic might recognize this from the last series, where we looked at the science and technology of landing on the red planet. Last week, the C-SPAN school bus stopped in Oracle, Arizona, site of Biosphere 2. Eight people lived in this biosphere for a period of two years.

20:43One of them was a guy named Roy Walford. And as it turns out, Roy was one of the leading scientists studying caloric restriction at that time. Caloric restriction essentially means eating less. And Wolford, the team doctor for Biosphere 2, happened to be interested in the effects this would have on the body. These people went into the biosphere and at some point in the first few months, they realized that somewhere along the way the engineering was off or a calculation was wrong and they weren't able to produce enough food or as much food as they anticipated being able to produce. And so a decision had to be made.

21:20Do we shut down the experiment or do we continue and just ration everybody's food? And Roy immediately recognized this is a great opportunity to do a human caloric restriction experiment. So he convinced them to ration the food. They did that for a series of several months. Wilford collected data on all those impromptu test subjects. And what he found was that these people appeared to be healthier after they were on caloric restriction than before. Things like blood pressure and lipid levels and fasting glucose. So while the participants of Biosphere 2 may have said they were starving, the accidental experience actually produced useful scientific data.

22:00So he wrote a book called The 120-Year Diet and became sort of a guru of sorts for a group of people who self-selected to practice caloric restriction. And so they named themselves the Caloric Restriction Society. They were actually very active in around, again, the time I was a graduate student. And so it sparked a cultural movement around this new way of potentially living longer. Doctors always tell us not to eat too much, but is it healthy to eat a lot less? A small but growing movement says yes. Dr. Emily Siné is here to tell us about calorie-restricted diets. Very interesting. Pay attention, Hannah.

22:39You're going to learn something. Today, we know this as intermittent fasting, which has become a popular method of dieting. But what Walford did was to suggest to the public that these treatments could be used to extend lifespan. You know, he spawned this movement. And, you know, these people were very knowledgeable. They collected lots of data on themselves. They say they feel years younger. You begin to feel stronger. Your memory may get sharper. I can never, ever remember having this much energy before. The caloric restriction movement was an early, rather unglamorous group of what we now call biohackers.

23:18People taking strange and extreme steps to try to live longer and measuring themselves carefully alongside. But starving yourself is really uncomfortable and not particularly practical. What if you could take a pill that could replicate eating less? Today, a lot of promising anti-aging treatments actually mimic the effects of caloric restriction. That includes a drug called rapamycin, which Cablein has spent his career studying. We published the first paper showing that rapamycin could slow aging in a laboratory model. And since then, that work has been replicated dozens of times in a variety of different animals.

24:01Rapamycin is a drug which was first isolated in 1972 in bacteria found on the Southern Pacific Territory of Easter Island. We know that rapamycin suppresses the immune system and reduces inflammation and the growth rates in cells. It's already used regularly for organ transplant patients so that their bodies don't reject new organs. But it's also shown promising results as an anti-aging pill. And even without understanding the entire mechanism of ageing, this is an example of how we might still be able to come up with the treatments that actually work. But Cableline does want to try and understand the underlying mechanism.

24:42To figure it out, he's enlisted some loyal helpers. At this point, there are more than 50 ,000 dogs around the United States participating in the study. Cableline runs something called the Dog Ageing Project, Just like the short lifespan worms in David Jem's lab, Cableine is hoping that we can understand how to slow aging more quickly by studying dogs, which of course live in dog years, not human years. But the big question is whether it will work in humans. To that end, Cableine is also taking the drug himself off-label, meaning for a purpose other than for what it was intended. It's a bit like people taking a Zen pick for weight loss when it was designed for those with diabetes.

25:27There are probably tens of thousands of people at this point around the world taking rapamycin off-label. I first took rapamycin about five years ago now. I had been diagnosed with something called adhesive capsulitis, also goes by the name frozen shoulder, relatively common in adults in their late 40s, early 50s. And so I thought to myself, people are using this drug off-label. We know a lot about dosing and safety. there's a chance that it might be effective at blunting my age-related inflammatory conditions. So I'm going to give it a try. And guess what? By the end of the 12 weeks, the pain was pretty much gone and I had 95 % range of motion back.

26:09But this more pragmatic approach, sometimes it can backfire. There may be a movement of tens of thousands of people taking rapamycin off-label, but that isn't evidence from medical trials. And without those trials, it can't be signed off by the regulators. like the Food and Drug Administration, for approval as an anti-aging treatment. You have to get it off-label, like Cableline or the Silicon Valley set. It's a vicious circle. Despite popular interest in longevity industry products, Big Pharma has been cautious about wasting money on research without being certain that the regulators will approve a medicine for aging, which isn't classified as a disease.

26:51And even when a drug is targeting an age-related disease like Alzheimer's, I've seen plenty of investment pour into trials that then fail. Maybe the best way to try and explain myself is with a biotech company started by a star longevity researcher in 2004, a Harvard scientist named David Sinclair. If he is right, Dr. David Sinclair has found one of the genetic keys that will reset our biological clocks. I think we've passed a turning point in our understanding of the aging process. Kabyline says he worked closely with Sinclair. He and I were in the same lab when I was a graduate student. He was a postdoc there.

27:31He was a mentor to me at that time. He then got a job at Harvard while I was still a graduate student, started his own lab. And one of the projects they started working on was around a molecule called resveratrol. It's a molecule found in red wine. And they published a paper reporting that resveratrol increased lifespan by 70 some percent. This was in single cell budding yeast. Resveratrol, by the way, is another molecule like rapamycin that may potentially mimic the effects of caloric restriction. And so when I was a postdoc, Brian Kennedy and I, for reasons that had really nothing to do with resveratrol, we were testing a hypothesis around caloric restriction, attempted to replicate David's results with resveratrol and we couldn't.

28:15Regardless, he went on to publish a couple of papers and started a company called Sirtris. Sirtris placed a big bet on resveratrol and other molecules like it in the hopes that it might have anti-aging effects. And there was excitement around the company. Lots of excitement. GlaxoSmithKline bought Sirtris for$750 million. This was actually$720 million, by the way. But still, a lot of money, which made what happened next even worse. GlaxoSmithKline shut down the research, depending on who you ask, because they couldn't reproduce the data and they realized it was all shoddy science or for other reasons.

28:54All of this was an expensive bet on a longevity medicine. And a bet that really mattered because that failed commercial venture impacted the entire anti-aging industry. This put a dramatic freeze on pharmaceutical industry interest in the longevity space. In my opinion, it set that aspect of the field back by a decade to 15 years. Now, I expect in the next year or two, we will see some announcements around top 10 pharma companies starting aging biology divisions within their companies. And I think that's a sign that the field and the science has matured to the point that, you know, professional drug developers see an opportunity there.

29:36We wanted to speak with David Sinclair about what happened at Sertris, but he never came back to us. The company was shut down in 2013. Unable to bring resveratrol to market, the pharma industry started to pull away from longevity. But as one door closed, another one opened. Silicon Valley was buying in, seduced by the search for an elixir of youth. Nootropics, also known as smart drugs, supplements some claim enhance brain function, helping to improve memory, focus, maybe even make you brilliant. Venture capital investors started stocking their medicine cabinets with supplements sometimes sourced from the grey market, supposedly meant to support brain health.

30:22Executives like Twitter co-founder Jack Dorsey began practicing unconventional eating habits. Health is the most precious thing we have and none of us really understand it. So being able to ask the question through experiments that I can perform on myself and learn about is compelling to me. YouTube amateurs flocked to high-performance longevity trends like bulletproof coffee. Basically, coffee drunk with a hearty serving of butter. You're not supposed to eat food when you drink bulletproof coffee. You're supposed to just get those fat calories in. And self-help celebrities like Tim Ferriss adopted cold plungers and stringent morning routines.

31:02Waking up and then I'll feed the dog, have some water, and then cold plunge. So 40 degrees at, say, three to five minutes. Then I'll go directly from that to hot tub for sort of hyperdilation. Amazon's Jeff Bezos, OpenAI's Sam Altman, and the heads of Google all backed biotech companies focused on longevity. There are a lot of rich people who are going to die soon, and they're counting down like Bezos. And they're saying, why not, if I'm worth 100 billion, put one, two, three billion into this? Because I've got nothing to lose because I'm dying in 20 years. So are these tech bros onto something that the pharma industry has missed?

31:42Or are they throwing away their dollars on an unachievable mission? Are there actually viable anti-aging treatments on the market today? Back to David Gems, the worm professor from UCL. It depends because there's a question about what does anti-aging actually mean? So for example, gum disease has knock-on effects on other aspects of your health. So if you go to the hygienist, that's going to help to prevent gum disease. So that's actually an anti-aging effect. Dental hygiene sounds much less glamorous than a pill that you can pop to achieve eternal youth. And most people who regularly keep their hygienist appointments aren't going so that they can live forever.

32:22They're going because it improves their quality of life. The same is true for another unglamorous treatment that's initially shown promising anti-aging results. The anti-shingles vaccine will protect you against Alzheimer's disease quite significantly. So to me, I thought, well, that's an anti-aging treatment. I'm going to get the shingles vaccine. I've been telling everyone that I've got the right age. Yeah, absolutely. That's an anti-aging treatment. As is another widespread mass market treatment. There is a powerful anti-aging treatment that does exist, and that's hormone replacement therapy.

32:58It also wasn't developed as an anti-aging treatment. It was meant to do exactly what it says on the box, replace hormones for women going through menopause. But for a long period of time, a lot of doctors actually dismissed HRT as too risky. There was a generation of women who could have had access to this treatment, but didn't. What you can see from HRT is protection against osteoporosis, protection against Alzheimer's, can reduce Alzheimer's risk. And even some of the newer data shows there's reductions in all-cause mortality. So it's life extension. So in one sense, I guess we've all become sort of longevity bros, whether we know it or not.

33:39Going to the dentist, getting an anti-shingles vaccine or taking HRT. These aren't extreme interventions, but viewing them as anti-aging treatments rather than day-to-day therapies is a new way of framing health. And if we start to see them in this way, the long-term benefits are within reach. It's just a matter of how we expend our energy. Here's Matt Cableline again. I don't see any fundamental barrier from a biological perspective to getting most people close to the species' maximum lifespan of about 120 years. Now, we may be decades away from that. This is, again, a resource allocation problem.

34:17If society decided this was worth devoting resources to, we could get there a lot faster. And even someone like David Gems, a scientist sceptical of the commercial side of longevity, concedes that while we may not understand how ageing works, the consequences are severe. We shouldn't give up on the quest for the cause or the cure. What this is really about is about people getting sick and dying. The ageing process is the mother of all diseases. People working on cancer, working on Alzheimer's disease, working on cardiovascular disease, working on rheumatology, on arthritis and on and on and on and on and yet the underlying cause of all of these diseases is ageing.

34:58If you want to treat a disease you need to understand what's causing it. It's incredibly important that we understand it because that will be key really to finding ways to enable people to stay healthier for longer. Staying healthier for longer that's coming up next as Michael takes us to Singapore a place where anti-ageing treatments are moving from the world of the super-rich to the mass market. Singapore is facing an ageing crisis. The government is trying to deal with that issue. But at the same time, there is clearly private sector interest because, well, there will be money to be made, for sure.

35:37Singapore, the longevity sector in microcosm. That's next time in this tectonic series, Defying Death, from the Financial Times. I'm Hannah Kuchler. And I'm Michael Peel. This episode was produced by Josh Gabbard-Dion. Our senior producer is Edwin Lane. Back-checking and additional help by Tara Cromey, Lucy Baldwin and Simon Greaves. Flo Phillips is executive producer. Mixing and scoring by Breen Turner and Sam Giovinco. Original music by Metaphor Music. Manuela Saragossa is our global acting co-head of audio.

36:20Thank you.