Living Longer

Human aging is being controlled and researchers have proven that human cells can be created and in this century people will begin to live 100, 200 or even 300 years. Mice are already living 50% longer with the help of genetic inventions. Thanks to the human genome project, scientists are closer to identifying ways to decelerate human aging. Contrarily, with incompetent, insufficient, and laughable healthcare system in place, Pakistan seems to continue grappling with policy lapses. Due to factors related to high fertility rates, high illiteracy, high mortality, and above all uncreative methods of policy planning, Pakistan stands as a stranger to such a milieu. Its policymakers don’t even sense the world passing through a profound transformation. They lack their understanding for making decisions to understand forthcoming breakthroughs and strategically plan for new environs.

The rapid pace of technology and medicine are quickly posing the prospect of banishing aging and disease, and yes even most causes of death. Some of the most extreme but very possible aspects of technologies such as molecular manufacturing and nanomedicine promise continual cellular maintenance that will alleviate aging altogether and make it impossible for disease or toxins to injure one's body or take one's life. Present anti-aging treatments do not slow aging and do not extend life span more than quitting smoking, exercising, eating vegetables, or heeding ordinary medical advice does. While all over the world we have seen improvements in health and life spans, Pakistan has large gaps and much effort needs to be spent in narrowing that gap.

Although vainly wrestling with high female mortality at younger ages and during the reproductive years, Pakistan claims a life span of 65. This predominantly seems farce when almost one-half of women receive no antenatal care during their pregnancy and 72 percent receive no postnatal care at all.

The advancements in longevity can be generally attributed to improvements in sanitation, the discovery of antibiotics, and medical care. Despite tall claims, Pakistan’s record on these areas is hopeless. Now, as scientists make headway against chronic diseases like cancer and heart disease to extend anti-aging even further, such diseases in Pakistan are greater than ever and basic healthcare service is inaccessible to a vast majority.

There are theories on aging. The programmed theories hold that aging follows a biological timetable, perhaps a continuation of the one that regulates childhood growth and development. The damage or error theories emphasize environmental assaults to our systems that gradually cause things to go wrong.

Lengthening life expectancies in the industrialized nations are bringing about substantial changes including large increases in the number of elderly and in their proportion in the population. Such changes have occurred, for example, in the type of economic activity, housing, social services, and population make-up of the communities. With growth in the health care system and changes in the service mix provided, the elderly continue to consume more health care per capita and need different services.

Health care institutions, including hospitals, which are widely expected to experience increasing demand as the elderly population grows; organizations will provide home-based medical care and other types of assistance, allowing the individual to remain in their own residence; and a variety of assisted living facilities, ranging from adult day care to residential care to nursing homes.

Of greater concern, the already awful health care industry of Pakistan finds itself ill prepared to handle significant increases in the number of the very elderly. Today, there are almost 9.7 million senior citizens. When it has no policy in place for this population today, it has no concern for tomorrow. Neither public nor private sectors are equipped financially to deal with the problems caused by aging population. When a society starts aging, its economic vitality becomes inferior to that of young societies and sluggish economic growth reduces its opportunities to become well heeled. Thus, in Pakistan an aging population will become a heavy public burden, forcing its people to bring down the cost by establishing large institutions so that, by virtue of economies of scale, they could manage to provide the elderly with the most basic care and medical needs.

The health sector of Pakistan offers an inadequate remedy for the serious problems of an outdated and basically unsound system and hence needs an offensive. People must be offered a vision of a revitalized health care system that provides incentives for increased quality and technological innovation, while at the same time, reducing costs. Pakistanis need a system that gives them control over healthcare decisions, while encouraging them to set aside the resources they need to purchase this care.

The policy makers of Pakistan should keep themselves abreast of technological advances and management strategies by constantly scanning the literature and media, interviewing authorities, and drawing on other sources to identify emerging trends. These trends then need to be analyzed to select those that are most significant.

It needs to begin to prepare now for what will be a very different future. The key questions it needs to think about include: What is it that we should be asking? What is it that its policymakers need but do not get in their human development courses? People should be asking about connections -- connections between existing mindsets and human development. These connections simply are not made in most textbooks available for use in human development courses. In fact, effective change requires more than knowledge of human development. Effective change also requires the ability to devise strategies that take advantage of that knowledge … strategies for connecting research and practice. Asif J. Mir, Organizational Transformation

Talking about Genomics

Molecular biology has long held out the promise of transforming medicine from a matter of serendipity to a rational pursuit grounded in a fundamental understanding of the mechanisms of life. Molecular biology has begun to infiltrate the practice of medicine; genomics will hasten the advance. Within 50 years, we expect comprehensive genomics-based health care to be the norm. We will understand the molecular foundation of diseases, be able to prevent them in many cases and design accurate, individualized therapies for illnesses.

In the next decade, genetic tests will routinely predict individual susceptibility to disease. When the genome is completely open to us, such studies will reveal the roles of genes that individually contribute weakly to diseases but interact with other genes and with environmental influences, like diet, infection and prenatal exposures to affect health.

By 2010 to 2020, gene therapy should also become a common treatment, at least for a small set of conditions. Within 20 years, novel drugs will be available that derive from a detailed molecular understanding of common illnesses like diabetes and high blood pressure. The drugs will be designer therapies that target molecules logically and are therefore potent without significant side effects. Drugs like those for cancer will routinely be matched to a patient’s likely response, as predicted by molecular fingerprinting. Diagnoses of many conditions will be much more thorough and specific than now. For example, a patient who learns that he has high cholesterol will also know which genes are responsible, what effect the high cholesterol is likely to have, and what diet and pharmacologic measures will work best for him.

By 2050, many potential diseases will be cured at the molecular level before they arise, though large inequities worldwide in access to these advances will continue to stir tensions. When people become sick, gene therapies and drug therapies will home in on individual genes, as they exist in individual people, making for precise and customized medical treatment. The average life span will reach 90 to 95 years, and a detailed understanding of human aging genes will spur efforts to expand the maximum span of human life.

In Future, the complete DNA sequencing of more and more organisms, including humans, will revolutionize biology and medicine. It is predicted that genomics will answer many important questions, such as how organisms evolved, whether synthetic life will ever be possible, and how to treat a wide range of medical disorders.

If, within a few years, scientists can expect to amass a tidy directory of the gene products—RNA as well as proteins—essential for life, they may well be able to make a new organism from scratch by stringing DNA bases together into an invented genome coding for invented products. If this invented genome crafts a cell around itself and the cell reproduces reliably, the exercise would be the ultimate proof that we understand the basic mechanisms of life.

In the last 50 years, a single gene or a single protein often dominated a biologist’s research. In the next 50 years, researchers will shift to studying integrated functions among many genes, the web of interactions among gene pathways, and how outside influences affect the whole system.

Within 50 years, with all genes identified and all possible cellular interactions and reactions charted, pharmacologists are developing a drug or toxicologists trying to predict whether a substance is poisonous may well turn to computer models of cells to answer their questions.

Being able to model a single cell will be impressive, but to fully understand the life forms we are most familiar with, we’ll plainly have to consider additional levels of complexity. We will have to consider how genes and their products behave in place and time—that is, in different parts of the body and in a body that changes over a lifespan.

So far, developmental biologists have striven to find signals that are universally important in establishing an animal's body plan, the arrangement of its limbs and organs. In time, they will also describe the variations—in gene sequence, perhaps in gene regulation—that generate the striking diversity of forms among different species. By comparing species, we’ll learn how genetic circuits have been modified to carry out distinct programs, so that almost equivalent networks of genes fashion, for example, small furry legs in mice and arms with opposable digits in humans.

In 50 years, we will fill in many details about the history of life, though we may still not understand how the first self-replicating organism came about; we will learn when and how – by inventing, adopting, or adapting genes – various lineages acquired, for example, new sets of biochemical reactions and different body plans. The gene-based perspective of life will have taken hold so deeply among scientists that the basic unit they consider will likely no longer be an organism or a species, but a gene. They will chart which genes have traveled together for how long in which genomes.

Scientists will also address the question that has dogged people since Darwin’s day: What makes us human? What distinguishes us as a species? Undoubtedly, many other questions will arise over the next 50 years. As in any fertile scientific field, the data will fuel new hypotheses. Paradoxically, as it grows in importance, genomics may not even be a common concept in 50 years, as it radiates into many other fields and ultimately becomes absorbed as part of the infrastructure of all biomedicine.

Genetic information and technology will afford great opportunities to improve health and alleviate suffering. But any powerful technology comes with risks, and the more powerful the technology, the greater the risks. In the case of genetics, people of ill will today use genetic arguments to try to justify bigoted views about different racial and ethnic groups. How we will come to terms with the explosion of genetic information remains an open question. Asif J. Mir, Organizational Transformation

Latching on Nanotechnology

Today I reassemble excerpts of my lectures, delivered at various local universities, on Nanotechnology—the largest breakthrough of 21st Century—the act of purposefully manipulating matter at an atomic scale and has the ability to manage universe at a molecular perspective. The nano-era is just around the corner and I see a multi-trillion dollar industry coming for a jumpstart within 5-10 years.

Nanotechnology is going to change the face of present day solutions to health problems. For instance the tiny autonomous robots that will work in bloodstream, clearing out plaque deposits, fixing various genetic flaws, looking for and eliminating cancer cells, and working in tandem with brain cells will vastly increase the human intellectual capacity. They will be like built-in doctors—cruising about, taking samples, communicating diagnosis, and finally, at your design, they will deal with whatever problem they encounter by administering drugs, or performing minute surgery.

The story of nanotechnology in medicine will be the story of extending surgical control to the molecular level. The easiest applications will be aids to the immune system, which will selectively attack invaders outside tissues. Immune machines will have no difficulty identifying cancer cells, and ultimately be able to track them down and destroy them wherever they may be growing. Destroying every cancer cell will cure the cancer.

Devices working in the bloodstream will nibble away at atherosclerotic deposits, widening the affected blood vessels. Cell herding devices will restore artery walls and artery linings to health, by ensuring that the right cells and supporting structures are in the right places. This would prevent heart attacks.

With constant monitoring of our every bodily function, and continuous removal of dead cells, nanites will keep us at 100% peak health, giving us life-spans far exceeding those we can expect today—100, 200 or even 300 years; cancer cells—gone; poorly functioning kidney fixed; broken bone repaired; funny looking nose tweeked. Out and out, memory of one human being will be more and sharper than of several PCs of today.

It will impact the practice of medicine in many ways. The tools of medicine will become cheaper and more powerful. Research and diagnosis will be far more efficient, allowing rapid response to new diseases, including engineered diseases. Small, cheap, numerous sensors, computers, and other implantable devices may allow continuous health monitoring and semi-automated treatment. Several new kinds of treatment will become possible. As the practice of medicine becomes cheaper and less uncertain, it can become available to more people.

With real-time monitoring of the body's systems, it will be possible via nanotechnology to detect undesired effects far earlier, allowing a more aggressive and experimental approach to treatment. Researchers will be able to gather far more data and process it with computers millions of times more powerful. The result will be a detailed model of the body's systems and processes, and the ability to predict the effects of any disease or treatment. Diagnosis will also be far easier and more informative. It will be possible to build thousands of diagnostic tests, including invasive tests and imaging tests, into a single, cheap, hand-held device. A variety of single-molecule detection technologies will be available even with early nanotechnology. Trustworthy diagnosis will make medicine far more efficient, and also reduce the risk of malpractice.

The practice of medicine today involves a lot of uncertainty. Doctors must guess what condition a patient has, and further guess how best to treat it without upsetting the rest of the body's systems. By contrast, when pathogens and chemical imbalances will be directly detected, many conditions will be treatable with no uncertainty, allowing the use of computer-selected treatment in common cases. This may further reduce the cost of medical care, although doctors, regulatory agencies, or the patients themselves may resist the practice initially.

Many organs in the body perform fairly simple functions. Already, sophisticated machinery can replace lung function for hours, heart function for months, and kidney function for years. Since nanotechnology can build machines smaller than cells, many other organs will be candidates for replacement or augmentation, including skin, muscles, various digestive organs, and some sensory functions.

With nanotechnology, we should be able to build mass storage devices that can store more than a hundred billion billion bytes in a volume the size of sugar cube. RAM that can store a mere billion billion bytes in such a volume and massively parallel computers of same size that can deliver a billion billion instructions per second

One aspect of nanotechnology is about building working mechanisms using components with nanoscale dimensions, such as super small computers (bacteria sized) with today’s MIPS capacity, or super computers the size of sugar cubes, possessing the power of a billion laptops, or a regular sized desktop model with the power of trillions of today’s PCs

The nano-engineered materials will have superior physical properties—stronger, cheaper and lighter. Material strengths are currently limited by lattice defects and intermolecular bond energies. Nanoscale materials, in contrast, might be produced with microstructures that are ordered over the long range. This could lead to stronger and lighter materials. In a similar way, the hardness and surface smoothness of nano-engineered materials would be controllable to a greater extent than at present. They will be much cheaper than the products produced by conventional industry.

The military aspects of nanotechnology have gotten more attention. We see upcoming weapons that are simultaneously more effective and less lethal. Weapons that are enormously powerful, but non-lethal, might tend to be used a lot. Pentagon is doing research for development of nano-weapons. Mastery of nanotechnology could lead to the kind of military supremacy that mastery of steam power and repeating firearms gave the West in the 19th Century

Pakistan should create awareness, prepare for nano-era, include nanotechnology as a subject matter in core curriculum and most importantly our industry needs to stay vigilant and stop making un-informed decisions for investment. (www.asifjmir.com)