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I'm going to talk to you today about
hopefully converting fear into hope.
When we go to the physician today --
when we go to the doctor's office and we walk in,
there are words that we just don't want to hear.
There are words that we're truly afraid of.
Diabetes, cancer, Parkinson's, Alzheimer's,
heart failure, lung failure --
things that we know are debilitating diseases,
for which there's relatively little that can be done.
And what I want to lay out for you today is
a different way of thinking about how to treat debilitating disease,
why it's important,
why without it perhaps our health care system will melt down
if you think it already hasn't,
and where we are clinically today, and where we might go tomorrow,
and what some of the hurdles are.
And we're going to do all of that in 18 minutes, I promise.
I want to start with this slide,
because this slide sort of tells the story the way Science Magazine thinks of it.
This was an issue from 2002
that they published with a lot of different articles on the bionic human.
It was basically a regenerative medicine issue.
Regenerative medicine is an extraordinarily simple concept
that everybody can understand.
It's simply accelerating the pace at which the body heals itself
to a clinically relevant timescale.
So we know how to do this in many of the ways that are up there.
We know that if we have a damaged hip, you can put an artificial hip in.
And this is the idea that Science Magazine used on their front cover.
This is the complete antithesis of regenerative medicine.
This is not regenerative medicine.
Regenerative medicine is what Business Week put up
when they did a story about regenerative medicine not too long ago.
The idea is that instead of figuring out how to ameliorate symptoms
with devices and drugs and the like --
and I'll come back to that theme a few times --
instead of doing that, we will regenerate lost function of the body
by regenerating the function of organs and damaged tissue.
So that at the end of the treatment,
you are the same as you were at the beginning of the treatment.
Very few good ideas -- if you agree that this is a good idea --
very few good ideas are truly novel.
And this is just the same.
If you look back in history,
Charles Lindbergh, who was better known for flying airplanes,
was actually one of the first people
along with Alexis Carrel, one of the Nobel Laureates from Rockefeller,
to begin to think about, could you culture organs?
And they published this book in 1937,
where they actually began to think about,
what could you do in bio-reactors to grow whole organs?
We've come a long way since then.
I'm going to share with you some of the exciting work that's going on.
But before doing that, what I'd like to do
is share my depression about the health care system
and the need for this with you.
Many of the talks yesterday talked about
improving the quality of life, and reducing poverty,
and essentially increasing life expectancy all around the globe.
One of the challenges is that the richer we are, the longer we live.
And the longer we live, the more expensive it is
to take care of our diseases as we get older.
This is simply the wealth of a country
versus the percent of population over the age of 65.
And you can basically see that the richer a country is,
the older the people are within it.
Why is this important?
And why is this a particularly dramatic challenge right now?
If the average age of your population is 30,
then the average kind of disease that you have to treat
is maybe a broken ankle every now and again,
maybe a little bit of asthma.
If the average age in your country is 45 to 55,
now the average person is looking at diabetes,
early-onset diabetes, heart failure, coronary artery disease --
things that are inherently more difficult to treat,
and much more expensive to treat.
Just have a look at the demographics in the U.S. here.
This is from "The Untied States of America."
In 1930, there were 41 workers per retiree.
41 people who were basically outside of being really sick,
paying for the one retiree who was experiencing debilitating disease.
In 2010, two workers per retiree in the U.S.
And this is matched in every industrialized, wealthy country in the world.
How can you actually afford to treat patients
when the reality of getting old looks like this?
This is age versus cost of health care.
And you can see that right around age 45, 40 to 45,
there's a sudden spike in the cost of health care.
It's actually quite interesting. If you do the right studies,
you can look at how much you as an individual spend on your own health care,
plotted over your lifetime.
And about seven years before you're about to die, there's a spike.
And you can actually --
(Laughter)
-- we won't get into that.
(Laughter)
There are very few things, very few things that you can really do
that will change the way that you can treat these kinds of diseases
and experience what I would call healthy aging.
I'd suggest there are four things,
and none of these things include an insurance system or a legal system.
All those things do is change who pays.
They don't actually change what the actual cost of the treatment is.
One thing you can do is not treat. You can ration health care.
We won't talk about that anymore. It's too depressing.
You can prevent.
Obviously a lot of monies should be put into prevention.
But perhaps most interesting, to me anyway, and most important,
is the idea of diagnosing a disease much earlier on in the progression,
and then treating the disease to cure the disease
instead of treating a symptom.
Think of it in terms of diabetes, for instance.
Today, with diabetes, what do we do?
We diagnose the disease eventually, once it becomes symptomatic,
and then we treat the symptom for 10, 20, 30, 40 years.
And we do OK. Insulin's a pretty good therapy.
But eventually it stops working,
and diabetes leads to a predictable onset of debilitating disease.
Why couldn't we just inject the pancreas with something
to regenerate the pancreas early on in the disease,
perhaps even before it was symptomatic?
And it might be a little bit expensive at the time that we did it,
but if it worked, we would truly be able to do something different.
This video, I think, gets across the concept that I'm talking about quite dramatically.
This is a newt re-growing its limb.
If a newt can do this kind of thing, why can't we?
I'll actually show you some more important features
about limb regeneration in a moment.
But what we're talking about in regenerative medicine
is doing this in every organ system of the body,
for tissues and for organs themselves.
So today's reality is that if we get sick,
the message is we will treat your symptoms,
and you need to adjust to a new way of life.
I would pose to you that tomorrow --
and when tomorrow is we could debate,
but it's within the foreseeable future --
we will talk about regenerative rehabilitation.
There's a limb prosthetic up here,
similar actually one on the soldier
that's come back from Iraq.
There are 370 soldiers that have come back from Iraq that have lost limbs.
Imagine if instead of facing that, they could actually
face the regeneration of that limb.
It's a wild concept.
I'll show you where we are at the moment in working towards that concept.
But it's applicable, again, to every organ system.
How can we do that?
The way to do that is to develop a conversation with the body.
We need to learn to speak the body's language.
And to switch on processes that we knew how to do when we were a fetus.
A mammalian fetus, if it loses a limb during the first trimester of pregnancy,
will re-grow that limb.
So our DNA has the capacity to do these kinds of wound-healing mechanisms.
It's a natural process,
but it is lost as we age.
In a child, before the age of about six months,
if they lose their fingertip in an accident,
they'll re-grow their fingertip.
By the time they're five, they won't be able to do that anymore.
So to engage in that conversation with the body,
we need to speak the body's language.
And there are certain tools in our toolbox that allow us to do this today.
I'm going to give you an example of three of these tools
through which to converse with the body.
The first is cellular therapies.
Clearly, we heal ourselves in a natural process,
using cells to do most of the work.
Therefore, if we can find the right cells