Bringing Science Fiction to Life

Introduction

No matter how much we yearn to recover our lost youth or the health that went along with it, every day brings us closer to death, the ultimate irritating limit. As Roman emperor Marcus Aurelius said, “do not act as if you were going to live ten thousand years. Death hangs over you.”

Image Source: When Did the Roman Empire Start and End?

Today, we’re living in a world where our understanding of biology has dramatically increased not only our collective lifespan, but also our healthspan. While Marcus Aurelius was wealthy on a scale beyond belief, he couldn’t escape the fact that the average life expectancy during his reign was a mere 25 years. Today, we have solutions and tools that those with wealth, power and fame like Marcus Aurelius couldn’t have possibly imagined.

For example, while I was at the California Institute for Regenerative Medicine, I had the pleasure of getting to know a family and an eight-year-old little girl by the name of Evie. Evie was born with a genetic immune disorder called Severe Combined Immunodeficiency (SCID). At the age of one, Evie was treated with a gene therapy to replace the defective copy of the gene responsible for causing her disease. Today, Evie is cured. She’s living a normal life, goes to school, and she loves to surf!

All these things would have been previously impossible for Evie, or for any child born with SCID. And, there are 28 other children just like Evie who have been successfully treated and cured with the technology CIRM funded.

Source: 2017 Annual Report, California Institute for Regenerative Medicine.

What the Tech Visionaries Know

As Steve Jobs famously said before his passing in 2011, “I think the biggest innovations of the 21st century will be at the intersection of biology and technology. A new era is beginning.” But it’s not just Jobs who believed that this intersection of biology and technology holds the key to unlocking powerful forces of innovation.

Since Bill Gates retired as CEO of Microsoft, he’s devoted his time, energy, and vast fortune to developing technologies that can solve global healthcare challenges through The Bill & Melinda Gates Foundation. Another early Microsoft visionary, Paul Allen, created the Allen Institute with a mission to unlock the complexities of bioscience and advance our knowledge and improve human health. The Chan Zuckerberg Initiative, founded by Dr. Priscilla Chan and Mark Zuckerberg, provides funding to find new ways to leverage technology in an effort to ‘eradicate disease.’ Sean Parker, the Napster Founder and early Facebook investor, created The Parker Institute for Immunotherapy, which focuses on accelerating the development of breakthrough immune therapies to turn all cancers into curable diseases. And, of course, there’s Elon Musk and Neuralink, which is implanting chips into the human brain to help treat neurological disorders.

Why are all of these forward-thinking tech visionaries putting their money to work to solve health-related challenges? And why now?

The Velocity of Biological Innovation

Although we’ve been waging war against death for several millennia, the first giant leap didn’t take place until the mid-19th Century with the discovery of germ theory, led by the efforts of Louis Pasteur, Robert Koch, and Joseph Lister. The idea that germs were responsible for disease was a revolutionary advancement in our understanding of biology, leading to the development of sanitation systems. By the late 19th and early 20th centuries, most major cities had constructed extensive sewer systems to help control the outbreaks of disease. This, in turn led to the eradication of diseases such as cholera, dysentery and typhoid, which all thrived in the unsanitary conditions that came with dense urban living before modern sanitation.

Cholera alone was responsible for five separate pandemics from 1817–1892 and killed millions. Although these infections are still rampant in the developing world — which desperately deserve our attention — they are largely non-existent in the developed world. Based on these advances and others, by 1900, our collective life expectancy had increased to an average of 48.2 years, an increase of 92% since the days of Marcus Aurelius.

Fast forward to 1948 and the birth of the randomized controlled trial, or RCT, at the end of World War II. The RCT created an ethical code for conducting clinical trials as well as the structural framework to allow for the statistical testing of the null hypothesis. The RCT remains the gold standard for approving new drugs today and has led to the approval of over 1,600 drugs in the U.S. Thanks in part to our newfound ability to test the effectiveness of new medications and approve them for mass consumption, by 1975 our collective life expectancy increased to 71.4 years, an increase of 184% since the days of Marcus Aurelius and an increase of 48% in the span of merely 75 years — less than a single human lifetime.

Today, we’re again witnessing profound advancements in our understanding of biology, but this time we’ve coupled these advancements with a fundamental shift in how we’re applying technology to understand our biology. The diversity of the technologies being applied coupled with the rate at which they are being applied is unparalleled in human history. This coupling of speed plus volume is directly related to the velocity of innovation we’re witnessing today.

Source: Life Expectancy website.

Today, the United Nations estimates the average global life expectancy is 72.6 years, and in the United States life expectancy is 78.9 years. With each passing year, the newly born live about three months longer than those born the prior year. And the best part is we’re only just beginning to scratch the surface of what’s possible. As astounding as this may sound, there is no fundamental biological reason we can’t continue pushing our collective life expectancy, along with our healthspan, ever higher.

Source: The Atlantic, What Happens When We All Live to 100?, by Gregg Easterbrook.

The Tools of the Trade

With new tools — such genetic engineering and modification, cell and tissue engineering, AI-enabled drug discovery, digital health and remote monitoring, cellular profiling and biomarker identification, and genetic sequencing and pharmacogenomics — we can now make in days, weeks or months things that previous generations couldn’t possibly create in a lifetime.

Source: Bioverge, Inc.

For example, one of our portfolio companies, Volumetric, has developed a stereolithography 3D printing process that unlocks the ability to generate complex biological structures like blood vessels and lung alveoli, offering a viable path towards replacement organs. Another company in our portfolio is working on turning fat stem cells into functioning liver cells, or hepatocytes. If successful, Hepatx will have devised a solution to replace the need for liver transplants (which although curative, less than 3% of people on the waiting list receive one) with a virtually unlimited supply of donor cells.

For some, the challenge with organ replacement is limited availability — a shocking 60% of properly donated organs are ultimately wasted due to a short viability clock on donor organs (just a few hours) and the fact that many donated organs ultimately aren’t functioning well enough to permit transplant into a recipient. And for others, the transplant complications continue within them after surgery in the form of chronic rejection by their immune system.

Source: Volumetric, Inc.

It’s recently been estimated that viable whole organ replacements, bridging treatments, and specialized engineered tissue could prevent >30% of all deaths, enhance longevity, and vastly improve quality of life for all.

Other companies in our portfolio such as Foresight Mental Health are bringing new technology-enabled solutions to the mental health crisis in this country by transforming the current standard of care from qualitative (i.e. “how are you feeling today”) to be data-driven, highly personalized, and objective. In light of the COVID-19 pandemic and increasing demand for mental health services in this country, Foresight is one of the fastest growing startups we’ve ever seen.

Source: Foresight, Inc.

Another company, EnClear Therapies, is taking an orthogonal approach to treating neurodegenerative diseases by creating a filtration system, similar to kidney dialysis, to remove the toxic proteins thought to cause neurodegenerative diseases such as ALS. And it’s not just Bioverge who see the value in these innovative companies, Thiel Capital is an investor in EnClear along with Amgen Ventures and several other highly-specialized healthcare investors.

Source: EnClear Therapies, Inc.

Large strategic acquirors are stepping in as well. For example, Virgin Pulse recently acquired our portfolio company Blue Mesa Health, who developed a digital therapeutic for remote diabetes care, support and prevention. In 2019, 463 million adults were living with diabetes and that number is expected to soar to near 700 million by 2045. Digital therapeutics — defined as software solutions that are designed to help patients change their behavior — is an emerging area that holds tremendous promise to help nudge people into making healthier lifestyle choices through proper diet and exercise.

Today, we are, quite literally, curing what was previously thought to be incurable.

How You Can Change the World

When you’re lying on your death bed, contemplating the meaning of your life, what do you think will matter the most you? Will it be that fancy new car you were so excited about driving during your mid-life crisis, that vacation home you bought and used a couple weekends per year, or that additional time you spent with your children, your parents, your sister, your brother, or your friends?

What if I told you there were a way to participate and wage war against death itself, together? What if you could join the fight to continue pushing our collective lifespan and healthspan ever higher — maybe just 5 or 10 years higher — or maybe to 150 years and beyond?

Today, we all have the opportunity to invest in the same types of technologies that cured Evie, they are literally a click away if you know where to look. We’re already living in a world where we’re routinely bringing science fiction to life, why not join the fight against death itself? As Marcus Aurelius said, “When you arise in the morning think of what a privilege it is to be alive, to think, to enjoy, to love …”

Join us at Bioverge to learn how you can invest in visionary entrepreneurs with the aim of transforming healthcare and help bring science fiction to life.

-Neil J. Littman, MS, Founder, CEO & Managing Director, Bioverge, Inc.