Reimagining the future of health
5 June 2017
Imagine if you could change your own conditions for life and death, erasing genes that increase your risk for diseases and halting the aging process in your body, or even replacing them with genes that make you healthy, happy, and just brilliant. Would you? Genetic editing, nanobots in your blood stream, artificially intelligent doctors... Technology is changing the world at an exponential pace. But how will the development that we witness in biomedicine, nanotechnology, artificial intelligence and big data affect our future and the future of healthcare? These are some of the questions that I reflect upon on a daily basis. And well, the truth is that no one knows. But it is my core belief that whatever we predict is an underestimation of the future.
Know your past to predict the future
The last century has been great in regards to progress in the medical field. We have eradicated deadly infections through vaccinations. We have decreased cancer mortality with 25% during the last 25 years. However, this is nothing compared to what we will witness in the years to come. Just think about what genetic editing will be able to do in regards to cancer. The new fast, cheap and precise tools will, just like in a digital writing document, be able to cut and paste in our DNA, eradicating cancer, replacing it with healthy cells. Indeed, we are just entering the digitalisation of health and the technological advancements are exponential. Put into simple words, exponential in this context means that the coming century will be equivalent to not 100 years of progress in today’s pace, but about 20,000 years. Considering how our world has changed during the recent 20 years regarding computer usage and smartphones, try to use your imagination to predict the future for the coming 20 years. The point is that incredibly powerful technologies will be available sooner than you think. And this time, not only in the field of technologies regarding our phones and computers, but in the field of medicine and human biology; technologies such as genetic editing, artificial intelligence and nanotechnology.
Exponential explosion of innovations
As a neuroscientist, I know how brilliant the human brain is. But I also know its limitations. One such limitation is its incapacity in thinking in exponential terms. Imagine that you take 30 steps (measured in metres). Your brain can easily picture those steps from here to the parking lot (1, 2, 3, 4, 5, etc.), ending 30 metres away. Right? Now, try to imagine 30 exponential steps, meaning that this time, you double the number by each step (1, 2, 4, 8, 16, etc.). Your brain will have a difficult time to understand the magnitude of that trip. In fact, 30 exponential steps result in more than 1 billion metres (1,073,741,824 metres) or roughly 26 times around planet Earth. This is in essence why we are so bad at understanding and predicting future trends. Our brain thinks linearly, while technology moves exponentially.
The mismatch between our linear brain and exponential technology can be seen again and again. In the early 80’s, AT&T asked McKinsey to predict how many mobile phones that would be in use by the year 2000. Their prediction was a total market size of 900,000 devices (aware of the many challenges that the industry faced due to bulky devices, high cost of data usage, poor battery life, etc.). By 1999, there were 900,000 people signing up for a mobile phone service every 3 days. Another great example of exponential growth is the Human Genome Project. Seven years into the 10-year project, only 1% of the genome had been sequenced. This received lots of complaints by mainstream critics who stated that the project would take some 700 years to finish. Thanks to advances in DNA sequencing technology entering the exponential curve in 2008, the project was finished ahead of time. And the price began to drop exponentially. 13 years ago, it took more than 10 years to sequence one individual’s genome and cost more than $3 billion, whereas it can be done by hours today and costing around $1000. Similarly, we will see a revolutionary progress within the field of medicine thanks to game changing technologies such as the so-called genetic scissors and artificial intelligence.
Disrupt or die trying
Imagine the financial benefits if you could accurately spot future trends. Internalising the implications of exponential growth can present enormous business opportunities. In fact, the world’s largest challenges are also the largest opportunities. And the harsh fact is that today, regardless of your area of business, you either disrupt or will be disrupted. The same goes for my area as a medical doctor, healthcare and the future of medicine. The development of an exponentially advancing technology can make the previous paradigm effectively obsolete, out-performing it in both effectiveness and cost. As we all know, within healthcare there is a huge gap between great technologies, and the use of these technologies in the clinical setting. This leaves the whole healthcare industry at risk for disruption. That is also why we see that the most influential players in this field are changing from previously being owned by the hospitals and healthcare institutions to today being led by companies like Apple, Google, IBM and Tesla.
Human doctor vs artificially intelligent doctor?
A common question that I get is: “Will robots replace you as a doctor?” The fast pace of technological development is accelerating for every day and artificial intelligence and robots are taking over our jobs. As with all jobs, mine too will be massively affected by the rise and sophistication of artificial intelligence. But how will it feel to go to the doctor and meet a robot instead of a human being? Some years ago IBM’s supercomputer Watson outperformed human doctors in diagnosing lung cancer, where the computer was right 90% of the time versus the human doctors who only were right 50% of the time. Recently, a woman in Japan got the right treatment thanks to this supercomputer. The woman had a rare kind of leukaemia and the team of specialist doctors had given her several treatments without any success, so they turn to the supercomputer, who went through her genetic data and 20 million publications within 10 minutes, coming up with the right treatment suggestion. This is of course something that the human brain is incapable of doing. And this is just the beginning. Artificial intelligence will be a game changer. Everything will be put into question. Our mortality. Humanity. And much more.
I am certain that in the future, as individuals, we will be empowered more than ever before to take ownership of our health and be in control of our own life. You will be the CEO of your health. Will that mean that a smartphone with three powerful medical apps and a few devices will take over my job as a doctor? That is possible but really not that important. The important thing here is to leverage technologies to secure earlier detection of diseases, earlier intervention and more precise treatments. Just imagine a world without diseases and human suffering – a world where every man, woman and child is healthy and happy.
The world is better than ever
Before diving further into the future, let’s take a look at where we are today. For the first time in history of humankind, more people die from eating too much than too little, more people die from agerelated diseases than from infections, and more commit suicide than are killed by soldiers, terrorists and criminals combined. Poverty has decreased from 94% to under 10% in the world during the last two centuries. Furthermore, we live longer and longer – lifespan has more than doubled since the 19th century. Yet, the threat of scarcity still dominates our worldview. In fact, most people believe that the world is a worse place today. Why is that? We are bombarded with bad news on a daily basis. And the brain is wired such that it gives 10 times more attention to bad news than to good news. This has probably been a good thing for our survival in the past when we were living in the jungle and had to protect ourselves from predators. However, since our brain has not evolved as fast as the technology that we have created, we are constantly fooled by our brain to make wrong decisions based on erroneous presumptions. Both on a societal level, as well as in our businesses and our private lives.
Professor Hans Rosling beautifully stated that most people know less about the world than chimpanzees do. Nevertheless, contrary to what most (90%) people think, the world is really a better place than ever before. And it is all thanks to science and disruptive innovations. Our generation have access to more calories, watts, lumen-hours, square-feet, gigabytes, food miles, megahertz, nanometres etc. than any other generation before us. An often overlooked fact is also that time is a resource. Take electricity as an example. Today, one hour of light will cost half a second of work time. In 1880 it would cost 15 minutes to 6 hours of work time. In 1750 BC it cost more than 50 hours of work. That is a 350.000 fold timesaving difference from today. Technology is a resource-liberating mechanism, it can make the once scarce the now abundant. When seen through the lens of technology, few resources are truly scarce; they are mainly inaccessible. Optimism is thus a sounder philosophical position.
Rich and famous
Thus, the gain of these technologies are not only for the rich and famous. Not at all. That is why they truly are game changers. The exponential character of technology and its fast and accelerating pace, will lead to the democratisation of all these wonderful technologies. As smartphones have become a natural part of our lives (even for the poor ones), good health and better standards of living will also be accessible for everyone in a near future. We enter an era of radical transformation in which technology has the potential to significantly raise the basic standards of living for every person on the planet. In fact, wireless technology, internet and mobile phones have made poor people today having access to more information and better communication than the president of the US did 30 years ago.
The only constant factor is change
Or, well, not really… To be correct, the rate of change is only increasing…. If you are an entrepreneur or a business leader, you surely experience enormous challenges. How can you run your business well when you have no clue of the future and when the changes are moving faster and faster? The single most important factor is the ability to adapt to the fast pace of change. It is hard to overstate the staggering implications of the disruptive advances in genetic modification, augmented and virtual reality, artificial intelligence, and other exponentially advancing domains that will unfold in our lifetimes. Businesses, governments, and we as individuals will need to drastically modify our predictive models to adapt to this changing landscape. And it all start with the ability to change your mindset. Today, it is not enough to think outside the box. You need to be able to think outside the room that the box is located in.
Leadership is more important than ever
I am an optimist and a dreamer. I believe in a brighter future – but I am also a realist. Having mapped the DNA code and invented genetic scissors, we will ultimately be able to create and recreate life to our preference. In essence “play God”. This will raise a series of ethical questions and I believe that leadership and the human touch will become more important than ever. Tesla’s Elon Musk has introduced his newest endeavour: merging humans with AI. Great! Facebook’s Zuckerberg just signed a death warrant for smartphones, and it involves augmented reality. Beautiful! But remember: Leadership and morality is more important than ever. In the end, it is not the technology per se, but our passion, the very obsession about making a difference, and taking action each and one of us for a better world, that matters. In fact, it is not the technologies that are the game changers, but us, you and I. In the case of artificial intelligence and the future of the human race, many people think that machines are not biased. But machines are trained on human data. And humans are biased. Just as we teach our values to our children, computers too are prejudiced in a similar way that children are. Computers learn to be racist, sexist, or loving and compassionate etc. from their creators. It all depends on us. So now that you will be able to play God, will you be a game changer making the world a better place? Remember, you are not a passive object in the course of evolution anymore. There are no excuses. You and I create our own future. So let’s create something great!
On 5 October, the SCC is hosting a Life Science Forum focused on cancer care
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