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#434637 AI Is Rapidly Augmenting Healthcare and ...

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.

Conclusion
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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Posted in Human Robots

#434580 How Genome Sequencing and Senolytics Can ...

The causes of aging are extremely complex and unclear. With the dramatic demonetization of genome reading and editing over the past decade, and Big Pharma, startups, and the FDA starting to face aging as a disease, we are starting to find practical ways to extend our healthspan.

Here, in Part 2 of a series of blogs on longevity and vitality, I explore how genome sequencing and editing, along with new classes of anti-aging drugs, are augmenting our biology to further extend our healthy lives.

In this blog I’ll cover two classes of emerging technologies:

Genome Sequencing and Editing;
Senolytics, Nutraceuticals & Pharmaceuticals.

Let’s dive in.

Genome Sequencing & Editing
Your genome is the software that runs your body.

A sequence of 3.2 billion letters makes you “you.” These base pairs of A’s, T’s, C’s, and G’s determine your hair color, your height, your personality, your propensity to disease, your lifespan, and so on.

Until recently, it’s been very difficult to rapidly and cheaply “read” these letters—and even more difficult to understand what they mean.

Since 2001, the cost to sequence a whole human genome has plummeted exponentially, outpacing Moore’s Law threefold. From an initial cost of $3.7 billion, it dropped to $10 million in 2006, and to $5,000 in 2012.

Today, the cost of genome sequencing has dropped below $500, and according to Illumina, the world’s leading sequencing company, the process will soon cost about $100 and take about an hour to complete.

This represents one of the most powerful and transformative technology revolutions in healthcare.

When we understand your genome, we’ll be able to understand how to optimize “you.”

We’ll know the perfect foods, the perfect drugs, the perfect exercise regimen, and the perfect supplements, just for you.
We’ll understand what microbiome types, or gut flora, are ideal for you (more on this in a later blog).
We’ll accurately predict how specific sedatives and medicines will impact you.
We’ll learn which diseases and illnesses you’re most likely to develop and, more importantly, how to best prevent them from developing in the first place (rather than trying to cure them after the fact).

CRISPR Gene Editing
In addition to reading the human genome, scientists can now edit a genome using a naturally-occurring biological system discovered in 1987 called CRISPR/Cas9.

Short for Clustered Regularly Interspaced Short Palindromic Repeats and CRISPR-associated protein 9, the editing system was adapted from a naturally-occurring defense system found in bacteria.

Here’s how it works:

The bacteria capture snippets of DNA from invading viruses (or bacteriophage) and use them to create DNA segments known as CRISPR arrays.
The CRISPR arrays allow the bacteria to “remember” the viruses (or closely related ones), and defend against future invasions.
If the viruses attack again, the bacteria produce RNA segments from the CRISPR arrays to target the viruses’ DNA. The bacteria then use Cas9 to cut the DNA apart, which disables the virus.

Most importantly, CRISPR is cheap, quick, easy to use, and more accurate than all previous gene editing methods. As a result, CRISPR/Cas9 has swept through labs around the world as the way to edit a genome.

A short search in the literature will show an exponential rise in the number of CRISPR-related publications and patents.

2018: Filled With CRISPR Breakthroughs
Early results are impressive. Researchers from the University of Chicago recently used CRISPR to genetically engineer cocaine resistance into mice.

Researchers at the University of Texas Southwestern Medical Center used CRISPR to reverse the gene defect causing Duchenne muscular dystrophy (DMD) in dogs (DMD is the most common fatal genetic disease in children).

With great power comes great responsibility, and moral and ethical dilemmas.

In 2015, Chinese scientists sparked global controversy when they first edited human embryo cells in the lab with the goal of modifying genes that would make the child resistant to smallpox, HIV, and cholera.

Three years later, in November 2018, researcher He Jiankui informed the world that the first set of CRISPR-engineered female twins had been delivered.

To accomplish his goal, Jiankui deleted a region of a receptor on the surface of white blood cells known as CCR5, introducing a rare, natural genetic variation that makes it more difficult for HIV to infect its favorite target, white blood cells.

Setting aside the significant ethical conversations, CRISPR will soon provide us the tools to eliminate diseases, create hardier offspring, produce new environmentally resistant crops, and even wipe out pathogens.

Senolytics, Nutraceuticals & Pharmaceuticals
Over the arc of your life, the cells in your body divide until they reach what is known as the Hayflick limit, or the number of times a normal human cell population will divide before cell division stops, which is typically about 50 divisions.

What normally follows next is programmed cell death or destruction by the immune system. A very small fraction of cells, however, become senescent cells and evade this fate to linger indefinitely.

These lingering cells secrete a potent mix of molecules that triggers chronic inflammation, damages the surrounding tissue structures, and changes the behavior of nearby cells for the worse.

Senescent cells appear to be one of the root causes of aging, causing everything from fibrosis and blood vessel calcification, to localized inflammatory conditions such as osteoarthritis, to diminished lung function.

Fortunately, both the scientific and entrepreneurial communities have begun to work on senolytic therapies, moving the technology for selectively destroying senescent cells out of the laboratory and into a half-dozen startup companies.

Prominent companies in the field include the following:

Unity Biotechnology is developing senolytic medicines to selectively eliminate senescent cells with an initial focus on delivering localized therapy in osteoarthritis, ophthalmology and pulmonary disease.
Oisin Biotechnologiesis pioneering a programmable gene therapy that can destroy cells based on their internal biochemistry.
SIWA Therapeuticsis working on an immunotherapy approach to the problem of senescent cells.

In recent years, researchers have identified or designed a handful of senolytic compounds that can curb aging by regulating senescent cells. Two of these drugs that have gained mainstay research traction are rapamycin and metformin.

Rapamycin
Originally extracted from bacteria found on Easter Island, Rapamycin acts on the m-TOR (mechanistic target of rapamycin) pathway to selectively block a key protein that facilitates cell division.

Currently, rapamycin derivatives are widely used as immunosuppression in organ and bone marrow transplants. Research now suggests that use results in prolonged lifespan and enhanced cognitive and immune function.

PureTech Health subsidiary resTORbio (which started 2018 by going public) is working on a rapamycin-based drug intended to enhance immunity and reduce infection. Their clinical-stage RTB101 drug works by inhibiting part of the mTOR pathway.

Results of the drug’s recent clinical trial include:

Decreased incidence of infection
Improved influenza vaccination response
A 30.6 percent decrease in respiratory tract infections

Impressive, to say the least.

Metformin
Metformin is a widely-used generic drug for mitigating liver sugar production in Type 2 diabetes patients.

Researchers have found that Metformin also reduces oxidative stress and inflammation, which otherwise increase as we age.

There is strong evidence that Metformin can augment cellular regeneration and dramatically mitigate cellular senescence by reducing both oxidative stress and inflammation.

Over 100 studies registered on ClinicalTrials.gov are currently following up on strong evidence of Metformin’s protective effect against cancer.

Nutraceuticals and NAD+
Beyond cellular senescence, certain critical nutrients and proteins tend to decline as a function of age. Nutraceuticals combat aging by supplementing and replenishing these declining nutrient levels.

NAD+ exists in every cell, participating in every process from DNA repair to creating the energy vital for cellular processes. It’s been shown that NAD+ levels decline as we age.

The Elysium Health Basis supplement aims to elevate NAD+ levels in the body to extend one’s lifespan. Elysium’s clinical study reports that Basis increases NAD+ levels consistently by a sustained 40 percent.

Conclusion
These are just a taste of the tremendous momentum that longevity and aging technology has right now. As artificial intelligence and quantum computing transform how we decode our DNA and how we discover drugs, genetics and pharmaceuticals will become truly personalized.

The next blog in this series will demonstrate how artificial intelligence is converging with genetics and pharmaceuticals to transform how we approach longevity, aging, and vitality.

We are edging closer to a dramatically extended healthspan—where 100 is the new 60. What will you create, where will you explore, and how will you spend your time if you are able to add an additional 40 healthy years to your life?

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Posted in Human Robots

#434534 To Extend Our Longevity, First We Must ...

Healthcare today is reactive, retrospective, bureaucratic, and expensive. It’s sick care, not healthcare.

But that is radically changing at an exponential rate.

Through this multi-part blog series on longevity, I’ll take a deep dive into aging, longevity, and healthcare technologies that are working together to dramatically extend the human lifespan, disrupting the $3 trillion healthcare system in the process.

I’ll begin the series by explaining the nine hallmarks of aging, as explained in this journal article. Next, I’ll break down the emerging technologies and initiatives working to combat these nine hallmarks. Finally, I’ll explore the transformative implications of dramatically extending the human health span.

In this blog I’ll cover:

Why the healthcare system is broken
Why, despite this, we live in the healthiest time in human history
The nine mechanisms of aging

Let’s dive in.

The System is Broken—Here’s the Data:

Doctors spend $210 billion per year on procedures that aren’t based on patient need, but fear of liability.
Americans spend, on average, $8,915 per person on healthcare—more than any other country on Earth.
Prescription drugs cost around 50 percent more in the US than in other industrialized countries.
At current rates, by 2025, nearly 25 percent of the US GDP will be spent on healthcare.
It takes 12 years and $359 million, on average, to take a new drug from the lab to a patient.
Only 5 in 5,000 of these new drugs proceed to human testing. From there, only 1 of those 5 is actually approved for human use.

And Yet, We Live in the Healthiest Time in Human History
Consider these insights, which I adapted from Max Roser’s excellent database Our World in Data:

Right now, the countries with the lowest life expectancy in the world still have higher life expectancies than the countries with the highest life expectancy did in 1800.
In 1841, a 5-year-old had a life expectancy of 55 years. Today, a 5-year-old can expect to live 82 years—an increase of 27 years.
We’re seeing a dramatic increase in healthspan. In 1845, a newborn would expect to live to 40 years old. For a 70-year-old, that number became 79. Now, people of all ages can expect to live to be 81 to 86 years old.
100 years ago, 1 of 3 children would die before the age of 5. As of 2015, the child mortality rate fell to just 4.3 percent.
The cancer mortality rate has declined 27 percent over the past 25 years.

Figure: Around the globe, life expectancy has doubled since the 1800s. | Image from Life Expectancy by Max Roser – Our World in Data / CC BY SA
Figure: A dramatic reduction in child mortality in 1800 vs. in 2015. | Image from Child Mortality by Max Roser – Our World in Data / CC BY SA
The 9 Mechanisms of Aging
*This section was adapted from CB INSIGHTS: The Future Of Aging.

Longevity, healthcare, and aging are intimately linked.

With better healthcare, we can better treat some of the leading causes of death, impacting how long we live.

By investigating how to treat diseases, we’ll inevitably better understand what causes these diseases in the first place, which directly correlates to why we age.

Following are the nine hallmarks of aging. I’ll share examples of health and longevity technologies addressing each of these later in this blog series.

Genomic instability: As we age, the environment and normal cellular processes cause damage to our genes. Activities like flying at high altitude, for example, expose us to increased radiation or free radicals. This damage compounds over the course of life and is known to accelerate aging.
Telomere attrition: Each strand of DNA in the body (known as chromosomes) is capped by telomeres. These short snippets of DNA repeated thousands of times are designed to protect the bulk of the chromosome. Telomeres shorten as our DNA replicates; if a telomere reaches a certain critical shortness, a cell will stop dividing, resulting in increased incidence of disease.
Epigenetic alterations: Over time, environmental factors will change how genes are expressed, i.e., how certain sequences of DNA are read and the instruction set implemented.
Loss of proteostasis: Over time, different proteins in our body will no longer fold and function as they are supposed to, resulting in diseases ranging from cancer to neurological disorders.
Deregulated nutrient-sensing: Nutrient levels in the body can influence various metabolic pathways. Among the affected parts of these pathways are proteins like IGF-1, mTOR, sirtuins, and AMPK. Changing levels of these proteins’ pathways has implications on longevity.
Mitochondrial dysfunction: Mitochondria (our cellular power plants) begin to decline in performance as we age. Decreased performance results in excess fatigue and other symptoms of chronic illnesses associated with aging.
Cellular senescence: As cells age, they stop dividing and cannot be removed from the body. They build up and typically cause increased inflammation.
Stem cell exhaustion: As we age, our supply of stem cells begins to diminish as much as 100 to 10,000-fold in different tissues and organs. In addition, stem cells undergo genetic mutations, which reduce their quality and effectiveness at renovating and repairing the body.
Altered intercellular communication: The communication mechanisms that cells use are disrupted as cells age, resulting in decreased ability to transmit information between cells.

Conclusion
Over the past 200 years, we have seen an abundance of healthcare technologies enable a massive lifespan boom.

Now, exponential technologies like artificial intelligence, 3D printing and sensors, as well as tremendous advancements in genomics, stem cell research, chemistry, and many other fields, are beginning to tackle the fundamental issues of why we age.

In the next blog in this series, we will dive into how genome sequencing and editing, along with new classes of drugs, are augmenting our biology to further extend our healthy lives.

What will you be able to achieve with an extra 30 to 50 healthy years (or longer) in your lifespan? Personally, I’m excited for a near-infinite lifespan to take on moonshots.

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Posted in Human Robots

#434532 How Microrobots Will Fix Our Roads and ...

Swarms of microrobots will scuttle along beneath our roads and pavements, finding and fixing leaky pipes and faulty cables. Thanks to their efforts, we can avoid costly road work that costs billions of dollars each year—not to mention frustrating traffic delays.

That is, if a new project sponsored by the U.K. government is a success. Recent developments in the space seem to point towards a bright future for microrobots.

Microrobots Saving Billions
Each year, around 1.5 million road excavations take place across the U.K. Many are due to leaky pipes and faulty cables that necessitate excavation of road surfaces in order to fix them. The resulting repairs, alongside disruptions to traffic and businesses, are estimated to cost a whopping £6.3 billion ($8 billion).

A consortium of scientists, led by University of Sheffield Professor Kirill Horoshenkov, are planning to use microrobots to negate most of these costs. The group has received a £7.2 million ($9.2 million) grant to develop and build their bots.

According to Horoshenkov, the microrobots will come in two versions. One is an inspection bot, which will navigate along underground infrastructure and examine its condition via sonar. The inspectors will be complemented by worker bots capable of carrying out repairs with cement and adhesives or cleaning out blockages with a high-powered jet. The inspector bots will be around one centimeter long and possibly autonomous, while the worker bots will be slightly larger and steered via remote control.

If successful, it is believed the bots could potentially save the U.K. economy around £5 billion ($6.4 billion) a year.

The U.K. government has set aside a further £19 million ($24 million) for research into robots for hazardous environments, such as nuclear decommissioning, drones for oil pipeline monitoring, and artificial intelligence software to detect the need for repairs on satellites in orbit.

The Lowest-Hanging Fruit
Microrobots like the ones now under development in the U.K. have many potential advantages and use cases. Thanks to their small size they can navigate tight spaces, for example in search and rescue operations, and robot swarm technology would allow them to collaborate to perform many different functions, including in construction projects.

To date, the number of microrobots in use is relatively limited, but that could be about to change, with bots closing in on other types of inspection jobs, which could be considered one of the lowest-hanging fruits.

Engineering firm Rolls-Royce (not the car company, but the one that builds aircraft engines) is looking to use microrobots to inspect some of the up to 25,000 individual parts that make up an engine. The microrobots use the cockroach as a model, and Rolls Royce believes they could save engineers time when performing the maintenance checks that can take over a month per engine.

Even Smaller Successes
Going further down in scale, recent years have seen a string of successes for nanobots. For example, a team of researchers at the Femto-ST Institute have used nanobots to build what is likely the world’s smallest house (if this isn’t a category at Guinness, someone needs to get on the phone with them), which stands a ‘towering’ 0.015 millimeters.

One of the areas where nanobots have shown great promise is in medicine. Several studies have shown how the minute bots are capable of delivering drugs directly into dense biological tissue, which can otherwise be highly challenging to target directly. Such delivery systems have a great potential for improving the treatment of a wide range of ailments and illnesses, including cancer.

There’s no question that the ecosystem of microrobots and nanobots is evolving. While still in their early days, the above successes point to a near-future boom in the bots we may soon refer to as our ‘littlest everyday helpers.’

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Posted in Human Robots

#434324 Big Brother Nation: The Case for ...

Powerful surveillance cameras have crept into public spaces. We are filmed and photographed hundreds of times a day. To further raise the stakes, the resulting video footage is fed to new forms of artificial intelligence software that can recognize faces in real time, read license plates, even instantly detect when a particular pre-defined action or activity takes place in front of a camera.

As most modern cities have quietly become surveillance cities, the law has been slow to catch up. While we wait for robust legal frameworks to emerge, the best way to protect our civil liberties right now is to fight technology with technology. All cities should place local surveillance video into a public cloud-based data trust. Here’s how it would work.

In Public Data We Trust
To democratize surveillance, every city should implement three simple rules. First, anyone who aims a camera at public space must upload that day’s haul of raw video file (and associated camera meta-data) into a cloud-based repository. Second, this cloud-based repository must have open APIs and a publicly-accessible log file that records search histories and tracks who has accessed which video files. And third, everyone in the city should be given the same level of access rights to the stored video data—no exceptions.

This kind of public data repository is called a “data trust.” Public data trusts are not just wishful thinking. Different types of trusts are already in successful use in Estonia and Barcelona, and have been proposed as the best way to store and manage the urban data that will be generated by Alphabet’s planned Sidewalk Labs project in Toronto.

It’s true that few people relish the thought of public video footage of themselves being looked at by strangers and friends, by ex-spouses, potential employers, divorce attorneys, and future romantic prospects. In fact, when I propose this notion when I give talks about smart cities, most people recoil in horror. Some turn red in the face and jeer at my naiveté. Others merely blink quietly in consternation.

The reason we should take this giant step towards extreme transparency is to combat the secrecy that surrounds surveillance. Openness is a powerful antidote to oppression. Edward Snowden summed it up well when he said, “Surveillance is not about public safety, it’s about power. It’s about control.”

Let Us Watch Those Watching Us
If public surveillance video were put back into the hands of the people, citizens could watch their government as it watches them. Right now, government cameras are controlled by the state. Camera locations are kept secret, and only the agencies that control the cameras get to see the footage they generate.

Because of these information asymmetries, civilians have no insight into the size and shape of the modern urban surveillance infrastructure that surrounds us, nor the uses (or abuses) of the video footage it spawns. For example, there is no swift and efficient mechanism to request a copy of video footage from the cameras that dot our downtown. Nor can we ask our city’s police force to show us a map that documents local traffic camera locations.

By exposing all public surveillance videos to the public gaze, cities could give regular people tools to assess the size, shape, and density of their local surveillance infrastructure and neighborhood “digital dragnet.” Using the meta-data that’s wrapped around video footage, citizens could geo-locate individual cameras onto a digital map to generate surveillance “heat maps.” This way people could assess whether their city’s camera density was higher in certain zip codes, or in neighborhoods populated by a dominant ethnic group.

Surveillance heat maps could be used to document which government agencies were refusing to upload their video files, or which neighborhoods were not under surveillance. Given what we already know today about the correlation between camera density, income, and social status, these “dark” camera-free regions would likely be those located near government agencies and in more affluent parts of a city.

Extreme transparency would democratize surveillance. Every city’s data trust would keep a publicly-accessible log of who’s searching for what, and whom. People could use their local data trust’s search history to check whether anyone was searching for their name, face, or license plate. As a result, clandestine spying on—and stalking of—particular individuals would become difficult to hide and simpler to prove.

Protect the Vulnerable and Exonerate the Falsely Accused
Not all surveillance video automatically works against the underdog. As the bungled (and consequently no longer secret) assassination of journalist Jamal Khashoggi demonstrated, one of the unexpected upsides of surveillance cameras has been the fact that even kings become accountable for their crimes. If opened up to the public, surveillance cameras could serve as witnesses to justice.

Video evidence has the power to protect vulnerable individuals and social groups by shedding light onto messy, unreliable (and frequently conflicting) human narratives of who did what to whom, and why. With access to a data trust, a person falsely accused of a crime could prove their innocence. By searching for their own face in video footage or downloading time/date stamped footage from a particular camera, a potential suspect could document their physical absence from the scene of a crime—no lengthy police investigation or high-priced attorney needed.

Given Enough Eyeballs, All Crimes Are Shallow
Placing public surveillance video into a public trust could make cities safer and would streamline routine police work. Linus Torvalds, the developer of open-source operating system Linux, famously observed that “given enough eyeballs, all bugs are shallow.” In the case of public cameras and a common data repository, Torvald’s Law could be restated as “given enough eyeballs, all crimes are shallow.”

If thousands of citizen eyeballs were given access to a city’s public surveillance videos, local police forces could crowdsource the work of solving crimes and searching for missing persons. Unfortunately, at the present time, cities are unable to wring any social benefit from video footage of public spaces. The most formidable barrier is not government-imposed secrecy, but the fact that as cameras and computers have grown cheaper, a large and fast-growing “mom and pop” surveillance state has taken over most of the filming of public spaces.

While we fear spooky government surveillance, the reality is that we’re much more likely to be filmed by security cameras owned by shopkeepers, landlords, medical offices, hotels, homeowners, and schools. These businesses, organizations, and individuals install cameras in public areas for practical reasons—to reduce their insurance costs, to prevent lawsuits, or to combat shoplifting. In the absence of regulations governing their use, private camera owners store video footage in a wide variety of locations, for varying retention periods.

The unfortunate (and unintended) result of this informal and decentralized network of public surveillance is that video files are not easy to access, even for police officers on official business. After a crime or terrorist attack occurs, local police (or attorneys armed with a subpoena) go from door to door to manually collect video evidence. Once they have the videos in hand, their next challenge is searching for the right “codex” to crack the dozens of different file formats they encounter so they can watch and analyze the footage.

The result of these practical barriers is that as it stands today, only people with considerable legal or political clout are able to successfully gain access into a city’s privately-owned, ad-hoc collections of public surveillance videos. Not only are cities missing the opportunity to streamline routine evidence-gathering police work, they’re missing a radically transformative benefit that would become possible once video footage from thousands of different security cameras were pooled into a single repository: the ability to apply the power of citizen eyeballs to the work of improving public safety.

Why We Need Extreme Transparency
When regular people can’t access their own surveillance videos, there can be no data justice. While we wait for the law to catch up with the reality of modern urban life, citizens and city governments should use technology to address the problem that lies at the heart of surveillance: a power imbalance between those who control the cameras and those who don’t.

Cities should permit individuals and organizations to install and deploy as many public-facing cameras as they wish, but with the mandate that camera owners must place all resulting video footage into the mercilessly bright sunshine of an open data trust. This way, cloud computing, open APIs, and artificial intelligence software can help combat abuses of surveillance and give citizens insight into who’s filming us, where, and why.

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