Articles, Blog

A cure for no cures – the next generation of medicine | Ashkan Fardost | TEDxBerlin

March 1, 2020


Translator: Leonardo Silva
Reviewer: Denise RQ In the 1920s, a state-of-the-art airplane
looked like this, a Nieuport 17, topping a speed
of 200 kilometers per hour, one of the most powerful
airplanes of World War I. Drugs, in the 1920s, looked like this. This is aspirin,
a champion drug of the 20s, relieving pain for millions. And aspirin came in the form of a pill. Moving to the 60s, airplanes became
even more powerful. Here, a Tupolev 134, now traveling
at a speed of 1,000 kilometers per hour. Drugs, in the 1960s, looked like this. And they came in the form of a pill. Fast-forward to the 21st century: an F-22 Raptor, one of the most
advanced fighter jets of all time, now traveling at a whopping speed
of 2,400 kilometers per hour. And drugs, in the 21st century,
looked like this. And they came in the form of a pill. And today, aircraft can look like this, SpaceShipTwo, by Virgin Galactic. It goes to freaking space. And drugs today still come
in the form of a pill. I know what you’re thinking, “The content that’s inside the pills
must have changed,” right? Haven’t modern medicine
and state-of-the-art chemistry brought advances to this stuff
that’s inside the pills? I spent ten years
studying pharmaceuticals, researching pharmaceuticals, and obtaining a PhD degree
in the pharmaceutical sciences. And like every PhD student on the planet, I had an existential crises
every week in my lab. And one day, I asked myself, “Where the hell are we going
with all of this research? Why is progress in pharmaceuticals
feeling so damn slow?” Because progress felt slow to me, because I’ve been a computer
and tech geek since age ten, and for the last 20 years, I’ve been
obsessively following the progress, the exponential progress
of computing and technology. And as many of you know,
computing is an exponential technology, which means it advances
really, really fast. So, why aren’t pharmaceuticals
advancing as fast? Or maybe they are,
but I just couldn’t see it back then. So I decided to find out. But first, to make my point clear, let me take you to a small journey through the world
of computing and technology. The story starts with Moore’s Law, first described by Gordon Moore,
cofounder of Intel. And in the mid 60s, he discovered
that computers became twice as powerful roughly every second year. And the data behind this
phenomenon looks like this, and it’s an exponential curve. An exponential curve can also
be viewed on a logarithmic scale, which means that the exact same data
will, instead, look like this. And now, we can see
a smooth and clear trend, which allows us to predict
the power of computing in the future. And the same goes
for the cost of computing. The price of computing power
is decreasing exponentially. And thanks to these trends, we can predict the price
of computing in the future. These trends have been going
steady for many decades now, and we can see them in other technologies,
such as megapixels in cameras, the cost of genetic sequencing,
the performance of LED lights, and so on. And today, many industries
rely on these trends to continue, because if they don’t, the survival
of their industry will be at stake. But looking at data like this
can be quite deceptive sometimes. There’s a more truthful way
to look at exponential progress, and from a broader perspective,
it really looks like this. It’s a series of overlapping S curves, and in this example, we have
the history of computing power, and it began with the old
electromechanical computers that used punch cards. And zooming in on their S curve,
we will see three phases. The first phase is the experimental phase,
the exploration phase. This is where experiments are happening
with brand new technologies. And things are often risky,
there might be ethical concerns, and new technologies are usually
opposed by skeptics and critics, but eventually comes a breakthrough, and the technology gets adopted
and rapidly developed as new competitors in the field arise. And now, we have reached mastery, technology is progressing exponentially, but eventually, all technologies
will reach a limit. This is the limit where progress,
beyond this point, will give little returns anymore. And the electromechanical computers
were replaced by the relay computers, when they got to a breakthrough. And the story continued
with the vacuum tube computers, and then the transistor-based one, and then finally came
the integrated circuit: the microchip, the computing technology that’s been
with us for over four decades now. And this technology will too
reach its limit one day, and then, we will be
in a dire need of a replacement. So, in a hundred years time, computing has been revolutionized
over and over, several times. So, almost in the same period of time, what has happened
in the field of pharmaceuticals? Did the content inside the pills
actually become better? Rest assured: they did.
No doubt about it. But I think there’s an even more
important question here. I think the question is: are new and groundbreaking
discoveries in pharmaceuticals coming fast enough? I think that’s
the billion-dollar question. So, after digging through FDA’s
publicly available database, this is what I found. So, the number of new pharmaceutical
inventions available on the market is growing, and it’s growing fast. And it’s looking good: we can see
the first half of the S curve, and we’ve passed the breakthrough point,
and the curve is just soaring, right? So, according to this data,
if we’re looking to the future, well, by the year 2050, we will have 30,000 new pharmaceutical
inventions on the market. And that seems great at a first glance. But the thing with S curves
is that it’s really hard to predict when a technology
is going to reach its limit, and when the curve starts to dip. Because how can we be sure
that this trend is going to continue? So, we need to dig deeper
into the data to find out. So, instead of market growth, let’s look at how many new inventions
from the pharmaceutical industry see the light of day on a yearly basis. In other words, what’s the speed
of inventiveness of the pharmaceutical industry? Now, that’s a totally different picture. The peek of pharma inventions
was in year 2010. That year, 100 new pharmaceutical
inventions were released to the market, but after that, it’s starting to dip. And to add to the bad news, the number of new discovered drugs
per dollars spent on research is actually decreasing,
exponentially fast. So, the data, so far, is not in favor
of pharmaceutical progress. But here’s the most shocking fact: of all the pharmaceutical
inventions since 1945, only 3% are actual cures. And these cures are mostly
antibiotics and antifungals. As it turns out, pharmaceuticals
are excellent at killing germs, but for the majority of diseases that are
due to malfunctions in our own bodies, what do pharmaceuticals do? They can only treat the symptoms. That’s what 97% of all pharmaceuticals do. They treat symptoms. We have no cures. And I believe the ultimate goal
of health science should be to deliver cures. And pharmaceutical technology
has utterly failed to do so. So, number one: pharma’s speed
of inventiveness is slowing down. Two: research of pharmaceuticals
is becoming more and more expensive – so this is the opposite of Moore’s Law; this is the opposite
of exponential progress. And three, and most importantly: pharmaceutical technology seems
incapable of actually producing cures. So, if cures are what we’re looking for, I believe pharmaceutical therapy
has reached its technological limit. And to find cures, we’re in a dire need of a replacement. But here’s the good news: there is actually a new S curve in town, and it’s called genetics. And it’s been just 60 years since Watson and Crick discovered
the structure of the DNA molecule, and that changed
our understanding of life forever. And our understanding of genetics
is advancing exponentially fast. “Scientists identify schizophrenia’s
‘Rosetta Stone’ gene,” from Cardiff University. “Gene therapy restores
auditory function in deaf mice,” from Harvard Medical School. “How to reprogram cancer cells
back to normal,” from Mayo Clinic. And “Scientists successfully
edit human immune cells,” from UCSF. And these headlines are just a tiny pick from the last 60 days. That’s how fast genetic
research is advancing. And for the first time, we’re actually closing in on real cures, real fixes to the defects
of the human body, because the power of genetics
allows us to do so. Pharmaceutical technology does not. But here’s the best news of all: this is a revolution
that all of us can partake in, thanks to the rise
of the biohacker movement. For example, like Kay Aull, who built her own genetic testing kit, in her closet, for small-time money, after her father got diagnosed
with a hereditary disease, as written in Discovery magazine. And just like many other technologies,
genetics is progressing exponentially, and the price of doing genetics
is dropping in the same fashion. For example, you can now order
an open-source DNA copying machine, for 600 bucks, online. This is something that would cost tens
of thousands of dollars just a decade ago. And as forward-thinking teachers
are bringing programming and hacking into their classroom, the hacker movement will grow
even faster every generation. These efforts, together with the forward
thinkers of academia and industry, will help to hypercharge
the science of genetics. And for the first time,
the art of actually finding cures is finding its way into the hands
of us, ordinary citizens. But, of course, there is
a lot of room for concern. This is a new technology, and the ethical dilemmas of genetics
are just as mind-boggling as genetics itself. And I don’t think anyone has the answers
to these ethical dilemmas yet, because we are, after all,
playing with the code of life. But this is how its supposed to be. Genetics will be fought by skeptics. Genetics will be fought by critics. And we should welcome it, or else it wouldn’t be new
and exciting groundbreaking science, because that’s what genetics is. So, don’t forget: we’re at the beginning of a new S curve; the next generation of health, the generation of genetics. Let’s climb it together. Thank you very much. (Applause)

13 Comments

  • Reply EccentricSM October 14, 2015 at 4:05 pm

    Our medical system isn't built to cure people, just bandaid them well enough to get back to work, and first and foremost, make profits. Hopefully technology can save us from our out of control system soon.

  • Reply Alina N October 14, 2015 at 5:28 pm

    happy to see that those topics are publically brought up on Ted! great speach !

  • Reply David Garcia October 14, 2015 at 10:59 pm

    Computers have nothing to do with farmaceuticals. Illness is a business as technology obsolescence is. I dont understand why pedestrians are ushering technology as if it had anything to do with them. If the case was to be making a better place to live in, things would be way different by now. That is certainly not the case. Smart stash though… Genetics is so defcon dependant.

  • Reply cosmicmanik October 15, 2015 at 5:00 am

    Big Pharma is not stupid. Big Pharma is not interested in cure the diseases. That would make them to be out of business. They need to maintain and manage diseases, so the patient needs to buy and buy the same medication over and over again. It's just about profit, no matter how many people dies or suffers, profit is the most important thing, and it has been like that since the beginning of pharma.

    Genetics can be a breakthrough, but it is not the solution. Scientists still see the human body as a total disconnection, it is useless to modify a cell, if the cell is still receiving the same order from the brain, for example "to proliferate". It is useless to artificially modify the "behaviour" of a cell, if the person can't modify his behaviour and his way of thinking and understandig what is causing to have a particular disease.

    The next generation of medication, could be the one that gives up the idea of having to "cure" a disease, where there is nothing to be cured. If a doctor wants to heal a patient, he better start listening to the story of the patient that is behind the disease (that would be a really breakthrough in the way we treat a disease) and yes, prescribe a medication just to regulate the symptoms so they can be more bearable, but knowing that a pill is not the solution to the problem; the patient needs to take responsability of his own body and symptoms and become aware of the situation that is causing them.

    Genes are like clay, they do not determine who we are, they all the time ask to us, who we want to become, so we can pass what we learn from our experiences and the way we solve our conflicts, to the next generation.

    Scientist are still playing the "God" game, but they are still far to become one. The frame from where they look at things, since Pasteur, has been completely wrong.

  • Reply Octav Reghina January 4, 2016 at 12:52 pm

    There are no money in making cures. Why cure asthma, for example, when you have a huge base of "clients" who are forced to buy your medicine, month after month.Because, if they don't, you know -they die. What's the monetary incentive to invest money in curing a stable base of profits? See, that's the dark side of capitalism and running after profit.

  • Reply Gina Salminen April 4, 2016 at 12:55 am

    Managed Care is failing us too!!

  • Reply Supadubya August 24, 2017 at 6:52 am

    Perhaps the author is right, but there are many other approaches to treating and curing diseases besides genetic ones out there… It's a little premature to say what the next big thing in Biology will be- and there's been a general decline in the willingness of researchers to take risks that hasn't helped either…

  • Reply JuanitaX September 12, 2017 at 1:46 pm

    This is a really great speech. You make me interested to know more about genetic therapy. And I'm excited to see what pharmacuetical industry will do and how the pharmacist will work in the nealy future.

  • Reply T M April 2, 2019 at 10:53 pm

    We shall see.

  • Reply GrandHack April 9, 2019 at 3:18 am

    Просто невероятно интересно. Спасибо что перевели это на русский для нас. Китайский учёный генетически модифицировал ребенка до рождения чтобы тот не смог заболеть вирусом иммунодефицита человека.

  • Reply Ехидный Сыр October 24, 2019 at 12:46 pm

    It is capitalist pharmaceuticals. We are all doomed. Number of incurable diseases are growing exponentially, so the cost of treatment. But new cures aren't even researched, its not profitable. I wouldn't bring a child into this world until it changes.

  • Reply Nigel Magic December 7, 2019 at 1:12 am

    Finding cures for everyday ailments illness and viral pathogens is mainly dependent on the prescribed drugs to treat these ailments to target direct pathogens without damaging the host

  • Reply Greg1 McIntosh December 28, 2019 at 4:01 am

    Losers. The answers lay not in technology. The answers lay in Nature. Shur rup. Get over yourselves. Your body responds to its environment. If it starts to corrode step away. If it starts to ossify, step in. My ancestors lived to nearky 100 over two centuries ago. They lived off the land. And they had a healthy Fear of God. Looooooosers.

  • Leave a Reply