Engineering the Future

Mark Zuckerberg wants to cure all disease by the end of this century. That’s not as ridiculous as you think.

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By the end of this century, Mark Zuckerberg and his wife, Priscilla Chan, think we can cure all disease.

On Wednesday, the couple’s philanthropic arm, the Chan Zuckerberg Initiative, announced that over the next decade it will spend $3 billion toward this goal.

“Can we cure, prevent or manage all diseases in our child’s lifetime?” Zuckerberg asked, taking the stage after Chan. Ultimately, he said, the answer is yes.

“That doesn’t mean that people will never get sick,” Zuckerberg added. “But it does mean people will get sick a lot less and when they do we can quickly manage it.”

(For the record Chan and Zuckerberg’s daughter, Max, is just 10 months old.)

The idea of a world free of bodily ailments might seem like a techno-utopian vision that only a billionaire Silicon Valley CEO would dream up. But the idea isn’t quite as crazy as you might think.

The history of medicine as we know it is relatively short.

The first true antibiotic, penicillin, was only discovered by Alexander Fleming in 1928, less than a century ago. Now we have well over 100 antibiotics that can treat everything from strep throat to acne.

In the last century, we have come up with treatments that make manageable everything from cancer to AIDS. We have rid the world of smallpox, a disease that not so long ago was one of the world’s most devastating killers, and are close to eradicating polio, too. Still nascent technologies like genetic engineering have gotten us closer than ever to managing the spread of diseases like malaria and dengue fever, which together kill millions each year. Most babies born in the year 1900 did not live past 50. Now, in many developed nations, the average life expectancy reaches into the 80s.

Breakthroughs in both technology and the understanding of the human body have allowed for the progress of medical science at an increasingly rapid rate.

But there is still so much we don’t know about our basic biology. What, for example, actually causes us to age? How many types of cells are in the body? Why are some babies born fatally early while others make it to term? What the heck causes a hiccup?

If we seek to understand the very basic bodily functions that eventually, down the line, wind up causing these things, we may have a better shot of understanding and fixing things that go wrong. This is the crux of Chan and Zuckerberg’s point. By doubling down on basic biological research and investing in new technology to help us understand it, they think we can make our batting average even better than it already is.

Our society today spends 50 times more treating people who are sick than we are trying to find cures so people don’t get sick in the first place,” Zuckerberg said.

Zuckerberg sees this as a logical fallacy. In this thinking he is not alone. In the science of aging, for example, there has been a call for more basic research to better understand the body. The goal is to prevent disease rather than to cure it.

And if we are going to cure all disease, Zuckerberg said, it’s pretty clear where to start: heart disease, cancer, infectious disease and neurological disease are the four biggest killers. If many brilliant minds focus on curing those diseases, he said, there’s no reason why eventually it won’t happen.

“The more people who believe we can cure all diseases in our child’s lifetime,” he said, “the more likely it is to happen.

The Chan Zuckerberg Initiative was founded in December with a mission to “advance human potential and promote equality in areas such as health, education, scientific research and energy.” It’s first investment was $24 million into Andela, an organization that trains developers in Africa. Zuckerberg has pledged $1 billion a year of his Facebook stock to the initiative.

The institute’s first step towards ending disease will be a $600 million investment over 10 years to build a Biohub, a new center at the University of California, San Francisco that will work on developing new tools to measure and treat disease.

The efforts towards tackling disease will focus on three major things: bringing scientists and engineers together, developing new technological tolls and inspiring more funding of science. Its first project will be to build a “cell atlas” of the human body, a database that will characterize all of the different types of cells and their interactions. Zuckerberg said that other projects might include building artificial intelligence software to help with imaging the brain or machine learning software to analyze large databases of cancer genomes.

Cori Bargmann, a celebrated neurobiologist, will lead the institute’s science efforts.

Everything we develop, every tool, every piece of data, every cell line will be available to all scientists everywhere,” she said. “Basic science works.”

Zuckerberg cautioned against reading his bold proclamation as an oversimplification of the complexities of biology. The body is not an engineering problem. It is unlikely that we will see big breakthroughs that solve everything all at once. But, Zuckerberg said, he is hopeful that with new technologies and more funding towards basic research, scientists might discover common strategies that will go a long way.

To be sure, Zuckerberg and Chan’s plan is optimistic. It is bold. But it is not altogether unrealistic.

In recent years, we have already seen how many breakthroughs one key discovery can inspire. Take CRISPR, a gene-editing technique that in the few short years since its discovery has opened up the possibility of simply editing out problematic bits of DNA to cure everything from HIV to blindness, an idea that until very recently seemed most like science fiction.

“It’s a magical time to bring this group together to tackle these problems,” Bill Gates said, taking the stage to show his support. Gates, of course, has poured millions of dollars of his own money into using genetic engineering to wipe out malaria. “We need more science,” he told the crowd.

When Priscilla Chan announced the investment, she started by describing her work as a pediatrician. So many times she was faced with giving parents devastating news of a heartbreaking diagnosis. She started crying, telling the story of young patients she had lost to an incurable disease.

“We are at the limit of what we understand about the human body and disease,” Chan said. “We want to push back that boundary.”

There will probably always be things that ail us. But it’s not all that difficult to imagine that many of the most deadly diseases of our time may one day be far less of a threat, just as HIV, polio and smallpox have become.

The institute’s goal, Chan acknowledged, is a lofty one. But after spending years consulting with experts, she said she’s become convinced that it’s possible.

“My heart is full of hope,” she said. “And I am eager to get started.”