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When it comes to the future of healthcare, perhaps the only technology more powerful than CRISPR is artificial intelligence.
Over the past five years, healthcare AI startups around the globe raised over $4.3 billion across 576 deals, topping all other industries in AI deal activity.
During this same period, the FDA has given 70 AI healthcare tools and devices ‘fast-tracked approval’ because of their ability to save both lives and money.
The pace of AI-augmented healthcare innovation is only accelerating.
In Part 3 of this blog series on longevity and vitality, I cover the different ways in which AI is augmenting our healthcare system, enabling us to live longer and healthier lives.
In this blog, I’ll expand on:
Machine learning and drug design
Artificial intelligence and big data in medicine
Healthcare, AI & China
Let’s dive in.
Machine Learning in Drug Design
What if AI systems, specifically neural networks, could predict the design of novel molecules (i.e. medicines) capable of targeting and curing any disease?
Imagine leveraging cutting-edge artificial intelligence to accomplish with 50 people what the pharmaceutical industry can barely do with an army of 5,000.
And what if these molecules, accurately engineered by AIs, always worked? Such a feat would revolutionize our $1.3 trillion global pharmaceutical industry, which currently holds a dismal record of 1 in 10 target drugs ever reaching human trials.
It’s no wonder that drug development is massively expensive and slow. It takes over 10 years to bring a new drug to market, with costs ranging from $2.5 billion to $12 billion.
This inefficient, slow-to-innovate, and risk-averse industry is a sitting duck for disruption in the years ahead.
One of the hottest startups in digital drug discovery today is Insilico Medicine. Leveraging AI in its end-to-end drug discovery pipeline, Insilico Medicine aims to extend healthy longevity through drug discovery and aging research.
Their comprehensive drug discovery engine uses millions of samples and multiple data types to discover signatures of disease, identify the most promising protein targets, and generate perfect molecules for these targets. These molecules either already exist or can be generated de novo with the desired set of parameters.
In late 2018, Insilico’s CEO Dr. Alex Zhavoronkov announced the groundbreaking result of generating novel molecules for a challenging protein target with an unprecedented hit rate in under 46 days. This included both synthesis of the molecules and experimental validation in a biological test system—an impressive feat made possible by converging exponential technologies.
Underpinning Insilico’s drug discovery pipeline is a novel machine learning technique called Generative Adversarial Networks (GANs), used in combination with deep reinforcement learning.
Generating novel molecular structures for diseases both with and without known targets, Insilico is now pursuing drug discovery in aging, cancer, fibrosis, Parkinson’s disease, Alzheimer’s disease, ALS, diabetes, and many others. Once rolled out, the implications will be profound.
Dr. Zhavoronkov’s ultimate goal is to develop a fully-automated Health-as-a-Service (HaaS) and Longevity-as-a-Service (LaaS) engine.
Once plugged into the services of companies from Alibaba to Alphabet, such an engine would enable personalized solutions for online users, helping them prevent diseases and maintain optimal health.
Insilico, alongside other companies tackling AI-powered drug discovery, truly represents the application of the 6 D’s. What was once a prohibitively expensive and human-intensive process is now rapidly becoming digitized, dematerialized, demonetized and, perhaps most importantly, democratized.
Companies like Insilico can now do with a fraction of the cost and personnel what the pharmaceutical industry can barely accomplish with thousands of employees and a hefty bill to foot.
As I discussed in my blog on ‘The Next Hundred-Billion-Dollar Opportunity,’ Google’s DeepMind has now turned its neural networks to healthcare, entering the digitized drug discovery arena.
In 2017, DeepMind achieved a phenomenal feat by matching the fidelity of medical experts in correctly diagnosing over 50 eye disorders.
And just a year later, DeepMind announced a new deep learning tool called AlphaFold. By predicting the elusive ways in which various proteins fold on the basis of their amino acid sequences, AlphaFold may soon have a tremendous impact in aiding drug discovery and fighting some of today’s most intractable diseases.
Artificial Intelligence and Data Crunching
AI is especially powerful in analyzing massive quantities of data to uncover patterns and insights that can save lives. Take WAVE, for instance. Every year, over 400,000 patients die prematurely in US hospitals as a result of heart attack or respiratory failure.
Yet these patients don’t die without leaving plenty of clues. Given information overload, however, human physicians and nurses alone have no way of processing and analyzing all necessary data in time to save these patients’ lives.
Enter WAVE, an algorithm that can process enough data to offer a six-hour early warning of patient deterioration.
Just last year, the FDA approved WAVE as an AI-based predictive patient surveillance system to predict and thereby prevent sudden death.
Another highly valuable yet difficult-to-parse mountain of medical data comprises the 2.5 million medical papers published each year.
For some time, it has become physically impossible for a human physician to read—let alone remember—all of the relevant published data.
To counter this compounding conundrum, Johnson & Johnson is teaching IBM Watson to read and understand scientific papers that detail clinical trial outcomes.
Enriching Watson’s data sources, Apple is also partnering with IBM to provide access to health data from mobile apps.
One such Watson system contains 40 million documents, ingesting an average of 27,000 new documents per day, and providing insights for thousands of users.
After only one year, Watson’s successful diagnosis rate of lung cancer has reached 90 percent, compared to the 50 percent success rate of human doctors.
But what about the vast amount of unstructured medical patient data that populates today’s ancient medical system? This includes medical notes, prescriptions, audio interview transcripts, and pathology and radiology reports.
In late 2018, Amazon announced a new HIPAA-eligible machine learning service that digests and parses unstructured data into categories, such as patient diagnoses, treatments, dosages, symptoms and signs.
Taha Kass-Hout, Amazon’s senior leader in health care and artificial intelligence, told the Wall Street Journal that internal tests demonstrated that the software even performs as well as or better than other published efforts.
On the heels of this announcement, Amazon confirmed it was teaming up with the Fred Hutchinson Cancer Research Center to evaluate “millions of clinical notes to extract and index medical conditions.”
Having already driven extraordinary algorithmic success rates in other fields, data is the healthcare industry’s goldmine for future innovation.
Healthcare, AI & China
In 2017, the Chinese government published its ambitious national plan to become a global leader in AI research by 2030, with healthcare listed as one of four core research areas during the first wave of the plan.
Just a year earlier, China began centralizing healthcare data, tackling a major roadblock to developing longevity and healthcare technologies (particularly AI systems): scattered, dispersed, and unlabeled patient data.
Backed by the Chinese government, China’s largest tech companies—particularly Tencent—have now made strong entrances into healthcare.
Just recently, Tencent participated in a $154 million megaround for China-based healthcare AI unicorn iCarbonX.
Hoping to develop a complete digital representation of your biological self, iCarbonX has acquired numerous US personalized medicine startups.
Considering Tencent’s own Miying healthcare AI platform—aimed at assisting healthcare institutions in AI-driven cancer diagnostics—Tencent is quickly expanding into the drug discovery space, participating in two multimillion-dollar, US-based AI drug discovery deals just this year.
China’s biggest, second-order move into the healthtech space comes through Tencent’s WeChat. In the course of a mere few years, already 60 percent of the 38,000 medical institutions registered on WeChat allow patients to digitally book appointments through Tencent’s mobile platform. At the same time, 2,000 Chinese hospitals accept WeChat payments.
Tencent has additionally partnered with the U.K.’s Babylon Health, a virtual healthcare assistant startup whose app now allows Chinese WeChat users to message their symptoms and receive immediate medical feedback.
Similarly, Alibaba’s healthtech focus started in 2016 when it released its cloud-based AI medical platform, ET Medical Brain, to augment healthcare processes through everything from diagnostics to intelligent scheduling.
As Nvidia CEO Jensen Huang has stated, “Software ate the world, but AI is going to eat software.” Extrapolating this statement to a more immediate implication, AI will first eat healthcare, resulting in dramatic acceleration of longevity research and an amplification of the human healthspan.
Next week, I’ll continue to explore this concept of AI systems in healthcare.
Particularly, I’ll expand on how we’re acquiring and using the data for these doctor-augmenting AI systems: from ubiquitous biosensors, to the mobile healthcare revolution, and finally, to the transformative power of the health nucleus.
As AI and other exponential technologies increase our healthspan by 30 to 40 years, how will you leverage these same exponential technologies to take on your moonshots and live out your massively transformative purpose?
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2018 was bonkers for science.
From a woman who gave birth using a transplanted uterus, to the infamous CRISPR baby scandal, to forensics adopting consumer-based genealogy test kits to track down criminals, last year was a factory churning out scientific “whoa” stories with consequences for years to come.
With CRISPR still in the headlines, Britain ready to bid Europe au revoir, and multiple scientific endeavors taking off, 2019 is shaping up to be just as tumultuous.
Here are the science and health stories that may blow up in the new year. But first, a note of caveat: predicting the future is tough. Forecasting is the lovechild between statistics and (a good deal of) intuition, and entire disciplines have been dedicated to the endeavor. But January is the perfect time to gaze into the crystal ball for wisps of insight into the year to come. Last year we predicted the widespread approval of gene therapy products—on the most part, we nailed it. This year we’re hedging our bets with multiple predictions.
Gene Drives Used in the Wild
The concept of gene drives scares many, for good reason. Gene drives are a step up in severity (and consequences) from CRISPR and other gene-editing tools. Even with germline editing, in which the sperm, egg, or embryos are altered, gene editing affects just one genetic line—one family—at least at the beginning, before they reproduce with the general population.
Gene drives, on the other hand, have the power to wipe out entire species.
In a nutshell, they’re little bits of DNA code that help a gene transfer from parent to child with almost 100 percent perfect probability. The “half of your DNA comes from dad, the other comes from mom” dogma? Gene drives smash that to bits.
In other words, the only time one would consider using a gene drive is to change the genetic makeup of an entire population. It sounds like the plot of a supervillain movie, but scientists have been toying around with the idea of deploying the technology—first in mosquitoes, then (potentially) in rodents.
By releasing just a handful of mutant mosquitoes that carry gene drives for infertility, for example, scientists could potentially wipe out entire populations that carry infectious scourges like malaria, dengue, or Zika. The technology is so potent—and dangerous—the US Defense Advances Research Projects Agency is shelling out $65 million to suss out how to deploy, control, counter, or even reverse the effects of tampering with ecology.
Last year, the U.N. gave a cautious go-ahead for the technology to be deployed in the wild in limited terms. Now, the first release of a genetically modified mosquito is set for testing in Burkina Faso in Africa—the first-ever field experiment involving gene drives.
The experiment will only release mosquitoes in the Anopheles genus, which are the main culprits transferring disease. As a first step, over 10,000 male mosquitoes are set for release into the wild. These dudes are genetically sterile but do not cause infertility, and will help scientists examine how they survive and disperse as a preparation for deploying gene-drive-carrying mosquitoes.
Hot on the project’s heels, the nonprofit consortium Target Malaria, backed by the Bill and Melinda Gates foundation, is engineering a gene drive called Mosq that will spread infertility across the population or kill out all female insects. Their attempt to hack the rules of inheritance—and save millions in the process—is slated for 2024.
A Universal Flu Vaccine
People often brush off flu as a mere annoyance, but the infection kills hundreds of thousands each year based on the CDC’s statistical estimates.
The flu virus is actually as difficult of a nemesis as HIV—it mutates at an extremely rapid rate, making effective vaccines almost impossible to engineer on time. Scientists currently use data to forecast the strains that will likely explode into an epidemic and urge the public to vaccinate against those predictions. That’s partly why, on average, flu vaccines only have a success rate of roughly 50 percent—not much better than a coin toss.
Tired of relying on educated guesses, scientists have been chipping away at a universal flu vaccine that targets all strains—perhaps even those we haven’t yet identified. Often referred to as the “holy grail” in epidemiology, these vaccines try to alert our immune systems to parts of a flu virus that are least variable from strain to strain.
Last November, a first universal flu vaccine developed by BiondVax entered Phase 3 clinical trials, which means it’s already been proven safe and effective in a small numbers and is now being tested in a broader population. The vaccine doesn’t rely on dead viruses, which is a common technique. Rather, it uses a small chain of amino acids—the chemical components that make up proteins—to stimulate the immune system into high alert.
With the government pouring $160 million into the research and several other universal candidates entering clinical trials, universal flu vaccines may finally experience a breakthrough this year.
In-Body Gene Editing Shows Further Promise
CRISPR and other gene editing tools headed the news last year, including both downers suggesting we already have immunity to the technology and hopeful news of it getting ready for treating inherited muscle-wasting diseases.
But what wasn’t widely broadcasted was the in-body gene editing experiments that have been rolling out with gusto. Last September, Sangamo Therapeutics in Richmond, California revealed that they had injected gene-editing enzymes into a patient in an effort to correct a genetic deficit that prevents him from breaking down complex sugars.
The effort is markedly different than the better-known CAR-T therapy, which extracts cells from the body for genetic engineering before returning them to the hosts. Rather, Sangamo’s treatment directly injects viruses carrying the edited genes into the body. So far, the procedure looks to be safe, though at the time of reporting it was too early to determine effectiveness.
This year the company hopes to finally answer whether it really worked.
If successful, it means that devastating genetic disorders could potentially be treated with just a few injections. With a gamut of new and more precise CRISPR and other gene-editing tools in the works, the list of treatable inherited diseases is likely to grow. And with the CRISPR baby scandal potentially dampening efforts at germline editing via regulations, in-body gene editing will likely receive more attention if Sangamo’s results return positive.
Neuralink and Other Brain-Machine Interfaces
Neuralink is the stuff of sci fi: tiny implanted particles into the brain could link up your biological wetware with silicon hardware and the internet.
But that’s exactly what Elon Musk’s company, founded in 2016, seeks to develop: brain-machine interfaces that could tinker with your neural circuits in an effort to treat diseases or even enhance your abilities.
Last November, Musk broke his silence on the secretive company, suggesting that he may announce something “interesting” in a few months, that’s “better than anyone thinks is possible.”
Musk’s aspiration for achieving symbiosis with artificial intelligence isn’t the driving force for all brain-machine interfaces (BMIs). In the clinics, the main push is to rehabilitate patients—those who suffer from paralysis, memory loss, or other nerve damage.
2019 may be the year that BMIs and neuromodulators cut the cord in the clinics. These devices may finally work autonomously within a malfunctioning brain, applying electrical stimulation only when necessary to reduce side effects without requiring external monitoring. Or they could allow scientists to control brains with light without needing bulky optical fibers.
Cutting the cord is just the first step to fine-tuning neurological treatments—or enhancements—to the tune of your own brain, and 2019 will keep on bringing the music.
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With the Thanksgiving holiday upon us, it’s a great time to reflect on the future of food. Over the last few years, we have seen a dramatic rise in exponential technologies transforming the food industry from seed to plate. Food is important in many ways—too little or too much of it can kill us, and it is often at the heart of family, culture, our daily routines, and our biggest celebrations. The agriculture and food industries are also two of the world’s biggest employers. Let’s take a look to see what is in store for the future.
Over the last few years, we have seen a number of new companies emerge in the robotic farming industry. This includes new types of farming equipment used in arable fields, as well as indoor robotic vertical farms. In November 2017, Hands Free Hectare became the first in the world to remotely grow an arable crop. They used autonomous tractors to sow and spray crops, small rovers to take soil samples, drones to monitor crop growth, and an unmanned combine harvester to collect the crops. Since then, they’ve also grown and harvested a field of winter wheat, and have been adding additional technologies and capabilities to their arsenal of robotic farming equipment.
Indoor vertical farming is also rapidly expanding. As Engadget reported in October 2018, a number of startups are now growing crops like leafy greens, tomatoes, flowers, and herbs. These farms can grow food in urban areas, reducing transport, water, and fertilizer costs, and often don’t need pesticides since they are indoors. IronOx, which is using robots to grow plants with navigation technology used by self-driving cars, can grow 30 times more food per acre of land using 90 percent less water than traditional farmers. Vertical farming company Plenty was recently funded by Softbank’s Vision Fund, Jeff Bezos, and others to build 300 vertical farms in China.
These startups are not only succeeding in wealthy countries. Hello Tractor, an “uberized” tractor, has worked with 250,000 smallholder farms in Africa, creating both food security and tech-infused agriculture jobs. The World Food Progam’s Innovation Accelerator (an impact partner of Singularity University) works with hundreds of startups aimed at creating zero hunger. One project is focused on supporting refugees in developing “food computers” in refugee camps—computerized devices that grow food while also adjusting to the conditions around them. As exponential trends drive down the costs of robotics, sensors, software, and energy, we should see robotic farming scaling around the world and becoming the main way farming takes place.
Exponential technologies are not only revolutionizing how we grow vegetables and grains, but also how we generate protein and meat. The new cultured meat industry is rapidly expanding, led by startups such as Memphis Meats, Mosa Meats, JUST Meat, Inc. and Finless Foods, and backed by heavyweight investors including DFJ, Bill Gates, Richard Branson, Cargill, and Tyson Foods.
Cultured meat is grown in a bioreactor using cells from an animal, a scaffold, and a culture. The process is humane and, potentially, scientists can make the meat healthier by adding vitamins, removing fat, or customizing it to an individual’s diet and health concerns. Another benefit is that cultured meats, if grown at scale, would dramatically reduce environmental destruction, pollution, and climate change caused by the livestock and fishing industries. Similar to vertical farms, cultured meat is produced using technology and can be grown anywhere, on-demand and in a decentralized way.
Similar to robotic farming equipment, bioreactors will also follow exponential trends, rapidly falling in cost. In fact, the first cultured meat hamburger (created by Singularity University faculty Member Mark Post of Mosa Meats in 2013) cost $350,000 dollars. In 2018, Fast Company reported the cost was now about $11 per burger, and the Israeli startup Future Meat Technologies predicted they will produce beef at about $2 per pound in 2020, which will be competitive with existing prices. For those who have turkey on their mind, one can read about New Harvest’s work (one of the leading think tanks and research centers for the cultured meat and cellular agriculture industry) in funding efforts to generate a nugget of cultured turkey meat.
One outstanding question is whether cultured meat is safe to eat and how it will interact with the overall food supply chain. In the US, regulators like the Food and Drug Administration (FDA) and the US Department of Agriculture (USDA) are working out their roles in this process, with the FDA overseeing the cellular process and the FDA overseeing production and labeling.
Tech companies are also making great headway in streamlining food processing. Norwegian company Tomra Foods was an early leader in using imaging recognition, sensors, artificial intelligence, and analytics to more efficiently sort food based on shape, composition of fat, protein, and moisture, and other food safety and quality indicators. Their technologies have improved food yield by 5-10 percent, which is significant given they own 25 percent of their market.
These advances are also not limited to large food companies. In 2016 Google reported how a small family farm in Japan built a world-class cucumber sorting device using their open-source machine learning tool TensorFlow. SU startup Impact Vision uses hyper-spectral imaging to analyze food quality, which increases revenues and reduces food waste and product recalls from contamination.
These examples point to a question many have on their mind: will we live in a future where a few large companies use advanced technologies to grow the majority of food on the planet, or will the falling costs of these technologies allow family farms, startups, and smaller players to take part in creating a decentralized system? Currently, the future could flow either way, but it is important for smaller companies to take advantage of the most cutting-edge technology in order to stay competitive.
Food Purchasing and Delivery
In the last year, we have also seen a number of new developments in technology improving access to food. Amazon Go is opening grocery stores in Seattle, San Francisco, and Chicago where customers use an app that allows them to pick up their products and pay without going through cashier lines. Sam’s Club is not far behind, with an app that also allows a customer to purchase goods in-store.
The market for food delivery is also growing. In 2017, Morgan Stanley estimated that the online food delivery market from restaurants could grow to $32 billion by 2021, from $12 billion in 2017. Companies like Zume are pioneering robot-powered pizza making and delivery. In addition to using robotics to create affordable high-end gourmet pizzas in their shop, they also have a pizza delivery truck that can assemble and cook pizzas while driving. Their system combines predictive analytics using past customer data to prepare pizzas for certain neighborhoods before the orders even come in. In early November 2018, the Wall Street Journal estimated that Zume is valued at up to $2.25 billion.
While each of these developments is promising on its own, it’s also important to note that since all these technologies are in some way digitized and connected to the internet, the various food tech players can collaborate. In theory, self-driving delivery restaurants could share data on what they are selling to their automated farm equipment, facilitating coordination of future crops. There is a tremendous opportunity to improve efficiency, lower costs, and create an abundance of healthy, sustainable food for all.
On the other hand, these technologies are also deeply disruptive. According to the Food and Agricultural Organization of the United Nations, in 2010 about one billion people, or a third of the world’s workforce, worked in the farming and agricultural industries. We need to ensure these farmers are linked to new job opportunities, as well as facilitate collaboration between existing farming companies and technologists so that the industries can continue to grow and lead rather than be displaced.
Just as importantly, each of us might think about how these changes in the food industry might impact our own ways of life and culture. Thanksgiving celebrates community and sharing of food during a time of scarcity. Technology will help create an abundance of food and less need for communities to depend on one another. What are the ways that you will create community, sharing, and culture in this new world?
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