At Ending Age-Related Diseases 2021, Greg Grinberg of ActualFood discussed philanthropy, what attracts people to causes like ours, and how we need to approach this subject.
Script
“It’s ironic, isn’t it? All this magnificent technology, we still find ourselves susceptible to the ravages of old age. Loss of dignity, slow betrayal of our bodies by forces we cannot master. Do you still want to be one of us, Data?”
There’s a pattern that I see playing out again and again: a patient gets diagnosed with a chronic disease, a horrible, debilitating, progressive, chronic disease. They ask their doctor to do everything that they can, and the doctor prescribes them pharmaceuticals, and then procedures are scheduled, and then again, the patient asks their doctor to do everything that they can. Then, finally, something catastrophic happens. As the patient is being wheeled from the emergency room into the surgical bay, the patient or their family members plead with the medical team, “Do everything you can.”
That’s why I love this community. I’m so happy to be here, and I’m so honored and thankful to Keith and Elena for inviting me here to give this final talk at this 2021 Ending Age-Related Diseases conference.
I really also want to thank and acknowledge all the previous speakers and participants for making this the high-impact conference that it is. It’s really clear that we in the regenerative medicine community are giving tremendous heart, brainpower, and sheer force of will to bring an end to this epidemic of chronic disease and to do that for everybody.
But, are we doing everything that we can? I’m here to argue today that the answer is no, and that that’s actually a good thing, because that means that there’s something that we can do to end this epidemic even faster
Compared to what some of you are already done or already doing, I would argue that it’s downright straightforward. It’s actually not one thing, it’s two things that are inextricably related, and we’ll get there. Before that, let’s pick up on two of the challenges that Aubrey enumerated in his opening talk on Thursday.
First, let’s look at the lifecycle of basic research in our industry. Tesearch starts off unpredictable in its cost and its timeframes and in the therapeutic fruit that it will bear. It is, in almost every case, pre-investable, but it’s also not particularly expensive, at least not compared to the follow-on investment once it becomes investable.
Research coming out of the SRF, for example, has enjoyed a 20x follow-on investment multiplier, and that’s so far. A billion dollars invested for $50 million spent philanthropically to date, and there’ll probably actually be more money invested in those existing spinoff companies, making that investment multiplier quite a bit higher than 20x when all is said and done.
There’s a conceit that I’ve heard from a handful of people in our community, people who I tremendously respect, by the way, but on this point with whom I vehemently disagree, that investment alone will carry all of us over the finish line in this effort. I would argue that that’s not true, that there’s a qualitative difference between philanthropy and investment, the former being far more risk-tolerant.
There is today easily $600 million worth of science in the lab that’s ready to go. We could be raising money 10 times faster than we are today, philanthropically, and find very good uses for it. This is to say nothing against our investors. We love our investors in this community. We love that it’s an abundant source of capital, but I think it’s a conceit and a false one and a dangerous one, to think that investment alone is going to win the day for us.
I say that in part because I had the opportunity to invite Congresswoman DeLauro. And for those of you who don’t pay attention to these kinds of things, Congresswoman DeLauro is the chair of the Appropriations Committee in the US House of Representatives. That’s the committee that controls the purse strings of the $6.8 trillion federal budget here in the US.
I had the honor to invite her to tour David Siegel’s lab along with Aubrey, where the total synthesis of glucosepane was developed. That scientific achievement was incredibly impressive on its own, the total synthesis of glucosepane, never mind developing therapeutics and reagents to actually cleave that apart, to cleave that protein crosslink apart, just synthesizing it was a huge multi-year effort that took many years of steady funding that was conditioned only on the continuation of the science. In other words, not conditioned on commercial milestones.
Without that patient capital coming from philanthropic sources, it’s really hard for me to imagine how something like that gets done. I would argue that money should never be a rate-limiting factor in what we do. To fully fund the work that is ready to be done, we should be raising ten times as much as we currently are.
That means, first of all, engaging a broader circle of philanthropists than who currently give to regenerative medicine. There are so many people, including billionaire high net worth donors who have signed the giving pledge who currently give to health care research directed at chronic disease, so why are they not giving money to regenerative medicine?
The second thing that we need to do that’s related but not the same thing, and it’s really important to emphasize these are related things, but not the same, we need to engage the public, partly because of one of the things that that Congresswoman DeLauro said to us at that meeting. At one point, Rosa sort of stopped us as we were kind of imploring her to make more money available in the federal budget for research for our field.
She said, “Look, I want to do this, but you need to actually make me do this, you need to create a public movement that demands this. The wheels of Congress don’t just turn because one member of Congress, even the chair of the Appropriations Committee, wants to do something.”
I see two routes here to remove money as this rate limiting factor in our efforts. One, again, engage new donors in philanthropic support, targeting very specifically high net worth donors, donors who have signed the giving pledge, donors who already give money to healthcare research, direct it to the chronic disease epidemic, but then also engage the public.
How do we do that? Well, both, first of all, require some really clear messaging. Again, the messaging is not necessarily the same for these two groups, the general public on the one hand and high net worth donors on the other. But, it seems clear that if we want to expand the circle of financial support, there are some common themes that we can take advantage of.
A lot of this is not new. Keith mentioned this in his opening talk, but I think that really refocusing on health in our messaging is really important. This is definitely something that both high net worth giving pledge donors and the general public can wrap their arms around. Even the best scientific efforts need a strong brand to back them up.
What we have here is a testable hypothesis. The testable hypothesis is that if we message around health, we can build that brand. That’s a much more effective fundraising tool, than what we’ve been doing so far, and it might be something like this.
Again, it’s subject to market research and testing because it has to be. There is a professional way to raise money philanthropically. It starts with studying our market and interviewing high net worth donors who are currently not giving to regenerative medicine, pre-investable research, but who ought to be.
If we go and we test this, though, there is a clear path in terms of creating a brand and a messaging strategy around this, because right now, the general public, when they think about things that are threats to their health, they’re probably thinking about things like this. These are the types of things that are generally in the headlines.
Obviously, we know that when you actually add up what actually kills people around the world, it doesn’t actually look anything like this, it looks more like this. Again, this is something that we can expect people who are not initiated in our field to wrap their heads around; this is becoming less and less of a shock. I think that we can make it very clear for both the general audience, as well as an audience of high net worth donors, that these things that we call chronic disease are not grouped together for no reason.
I think it’s not such a far stretch to convince them that they share common root causes, and they are root causes that we can do something about, and indeed, that we must do something about, because they are, of course, responsible for more than two-thirds of death worldwide
Of course, in the wake of COVID, it’s also worth pointing out that remembering those infectious diseases, those also are strongly correlated with chronic disease status, and so in some sense, they are diseases of aging as well.
Going back to the crux of the testable hypothesis, here, I do a lot of my work in applied research and applied lifestyle medicine, and I don’t find that it’s particularly difficult to talk with the public about what we do. It’s becoming common knowledge that that lifestyle medicine works. To offer the general public this schematic, this part of it, the idea that lifestyle medicine can slow down and even reverse, in some cases, metabolic damage is not really so far-fetched.
Certainly to high net worth donors who give money to chronic disease research, this is not far fetched at all. The testable hypothesis here is that messaging that combines lifestyle medicine on the one hand and regenerative medicine on the other is more effective than just messaging around regenerative medicine on its own.
That’s what we intend to test. What we like about this strategy is that it can be rolled out in phases, much like regenerative medicine therapies are will be rolled out in phases in the real world. For example, once we’ve made this point about lifestyle medicine having an effect on metabolic damage, it’s not so crazy to ask the audience of high net worth donors, “Why don’t we want to deal with the forms of age-related damage that lifestyle interventions, chiefly food, don’t deal with on their own, or at least as far as we know today, can’t deal with on their own?” “Why wouldn’t we want to develop some sort of therapy that can come in and undo that damage after it’s accumulated?”
Once we’ve done that, we can gradually introduce the idea that this is a therapy that can be applied over and over again, and that since healthy organisms do tend to stay alive, we are increasing not just the healthspan but the lifespan as well. but starting very much with that, increasing the healthspan and talking about lifespan as a side effect, that seems promising, and that’s the crux of the messaging that we would like to test.
The second part of this which is so crucial is recruiting the right people to this. There are, after all, professional fundraisers in the world who know how to solve this problem. I think that the first step is actually recruiting the people who can recruit the people who can recruit the rest of the people. Finding that one person who can be that bridge between our worlds, the world of regenerative medicine and the more conventional philanthropic world.
I think that we found that person in Pat Nicklin. Pat is a serial architect of successful organizations. In Management Sciences for Health, she launched the No More Epidemics campaign in response to the Ebola epidemic of 2015, and she co wrote a book called The End of Epidemics, which, frankly, I really wish more people had read.
At the National Park Foundation, she built and managed a campaign that raised $300 million to support the National Park Service. At Share Our Strength, she invented the No Kid Hungry Campaign, which makes her a hero in my eyes to end the childhood hunger in the US. That campaign took an organization with $10 million in annual donor revenues and brought them to 100 million. My friends, please join me in welcoming Pat Nicklin to this virtual stage.
I’m glad to be here and to speak with you today. My message to you is, we can do this, we can raise $600 million for pre-investment research for regenerative medicine, and we can do it through philanthropy. When I first learned about rejuvenation biotechnology and regenerative medicine, it was only three months ago. I was not convinced that this was fundable, frankly, from philanthropy.
I learned more about the science and the impact that you’re making through your scientific research, and the impact that it could have on our health and on aging, and I’m pretty convinced that you can raise the $600 million. I think some things need to be in place before you can do that in order to be successful with the campaign. There are four things that I’ve found in raising money for many causes that really work.
The first is telling a great story. You really do need to make a strong case for support for major donations. Why do you need the money? What exactly will the science accomplish? Donors give, not just intellectually, but they give emotionally to causes. They want to know that your ask is urgent and that it’s credible.
I think by respecting them and telling them the story of the science, the real background story, what is it accomplishing? How much will their specific donation achieve? What will their specific donation achieve? Why do you need their donation now, rather than later? If you were able to have the funding now for your scientific projects, what would that allow the entire field to advance? So, telling the story.
The second is identifying the right donors. You have your existing, but can you get them to help you work with them to identify new donors that would be willing to give? Also, back that up with some research. Who out there has the capacity to give? How can they be reached? Who knows them? What is that web of connection? How do you reach them? How can you track? We call it “moves management”. Who’s the target donor, who’s the right donor?
You really have to approach this with the same kind of data analysis and rigorous research that you apply to your science, because there are a lot of potential asks you can make out there, but if you don’t target the right one, you’re going to waste a lot of time and money.
Thirdly, and this might be the most important one, is that the field needs to invest in fundraising infrastructure. $600 million is not chump change; you’re not going to raise it with a few scientists asking his or her buddies for more money. You really, really need to hire, we really need to hire, a strong fundraising team to recruit and to sustain and to build and to cultivate those relationships with donors.
Boards of Directors need to support you so that the scientists can focus on the science and the professional fundraising staff, the staff, the Board of Directors, the entire organization, can participate in helping us raise this money
Then, finally making the ask. Wayne Gretzky said, ice hockey great, you miss 100% of the shots you don’t take, and raising a lot of money requires making a lot of asks. I think we need to get out there; it’s a numbers game. Fundraising is a numbers game, and ask for the great story and with a great fundraiseing infrastructure behind you. That’s it. Thanks very much. We look forward to working with you, and let’s go.
Thanks so much, Pat. Pat, by the way, is one of these people who convinces me that if all I did in life was just introduced the smartest people I know to each other, I would probably be doing a hell of a lot. I’m really happy to be bringing Pat into this world and to be introducing you to her.
Over the next couple of months, what we would like to do is to put some of these hypotheses that we’ve come up with around raising money to the test. In order to do that, one of the things that we’d like to ask for from you, particularly the scientists in our community who are working on pre-investable research, is to come to us with your stories and what you would want to do, what you want to see funded. Let’s weave all of your stories together into a cohesive case for support.
As Pat mentioned, it’s really unrealistic for each of us individually to go out and try to raise philanthropic money to end this epidemic of chronic disease within our lifetimes. On the other hand, it is something that is eminently doable if we do it together. Those next steps of testing those hypotheses and beginning to put together a team of people who professionally raise money and who have professionally raised money at this level of hundreds of millions of dollars a year is so crucial.
I’d like to also just spend a little bit of time talking about why it’s so crucial for us to invest also, not just on the fundraising side, but also on the public relations side. I’d like to talk to you a little bit about some of the stuff that has happened in the past, some of our approach to public relations that we’ve had as a community in the past, and explain why I think that underfunding doesn’t really work very well.
I think it’s safe to say that, that historically, maybe not so much our current approach, but historically, our approach to media has been kind of a mess. When we rely on outside content creators to tell our story, we kind of end up with, we get what we pay for. We put nothing in, but we actually get very little out; sometimes we get negative brand value out of it.
I think it’s especially true when, when legitimate regenerative medicine, research is conflated with pseudoscience or just flat out non-scientific efforts. Low production value doesn’t help either. Also dangerous is that even when we do have some pretty good production value, like with Veritasium, we get these non-expert curatorial and editorial opinions along with the facts, and in this particular video that this screenshot here is from, the host expresses the opinion that no matter what we do, we’re not going to see the end of the chronic disease epidemic through regenerative medicine research any time soon, so it’s just of presented as an intellectual curiosity.
To this point, as Pat pointed out, people don’t give to intellectual curiosities. They give to things that affect them personally. There is a lot of crosstalk between public relations and donor relations. Very similar story on the side of media relations, if we don’t have sufficient resources for media relations, we get these clickbait headlines on immortality, we get an abject failure to appropriately proportion and contextualize the so-called risks of what we’re doing, the throwaway questions that people have, what if dictators live forever, or whatever, versus the absolutely horrific reality that the chronic disease epidemic represents today.
We do get this cartoonish treatment of our leading scientists as well, and I think that that’s a tragedy. I don’t think it’s going to take a lot of money to fix this, but it will take some. As Pat was pointing out about building up an infrastructure for fundraising, we also need to build up an infrastructure to really step up our game in in terms of media relations, and I think that that applies across our entire community.
I would like to just do a quick time check here and looks like we do have some time. First of all, before I close, on this topic of media relations and public relations, my opening clip is not a coincidence. It’s really telling that even in Gene Roddenberry’s vision of Star Trek, this near-term future with warp drive and transporters and a capitalist economy that’s been replaced by a gift economy in which currency doesn’t exist anymore, and poverty doesn’t exist anymore, and people work together and work to better themselves.
It’s so telling that even in that imagined near-term future universe, we don’t see the end of chronic disease, we don’t see the end of the diseases of aging or the end of the aging process itself. I do think that that’s why efforts like Tim Maupin’s are so important, also, it’s not just about non-fiction and media relations, in terms of news outlets, and documentaries, such as, like what we’re working on and putting together as part of this overall effort, but also engaging, engaging viewers in narrative works and works of fiction, the world that we envision and can share that vision with the public.
Certainly, we’ve all seen in our lifetimes that fiction, really good science fiction tends to have a way of becoming science fact, at least a lot of the time by igniting the public imagination. I’d like to close here with a personal story, in some sense, doing kind of crazy things in service of the health of our fellow humans runs in my family.
My grandfather was a physician and also a Holocaust survivor. After the war, he, days after his liberation, in an unbelievable twist of fate and confluence of circumstances, ended up commandeering, with the help of an American army captain named Otto Raymond, a German army hospital. He ended up commandeering this hospital from the German army, two guys, one American army captain and my grandfather, who was an emaciated Holocaust surviving physician. That story has so many teachable lessons in it for us today.
My grandfather made a speech at a pretty well-attended liberation concert, they organize the concert to celebrate their liberation a month after or so, and in giving that speech, there are two things that I think are really worth pointing out here. First of all, my grandfather flatly rejected the idea of revenge against the German people. As a physician, I think he saw human conflicts not through the lens of a lawyer or the lens of retributive justice, but through the lens of health. I think that just as we don’t vilify someone who catches a cold, I don’t think my grandfather could imagine vilifying someone who contracted an equally contagious disease of hatred in that process.
The other thing, though, that he did that’s directly relevant here is that he asked for help. He needed help, because even though he was able to take over this hospital through that crazy set of circumstances that happened, the hospital was chronically under-supplied, was chronically under-resourced, and that was systemic. The American army at the time, the policy of the occupying forces was to prevent any supplies from getting into these so-called DP camps, displaced persons camps. That was part of the motivation for holding this liberation concert. It was to, in whatever way they could, engage the outside world and ask for help. That help came in the form of a 19-year-old American private, a private in the army named Robert Hilliard.
What Bob did is he, after speaking with my grandfather and realizing how critical it was to the continued survival of these Holocaust survivors who are being treated in this hospital, that supplies get through, that the hospital get the resources that it needs. Bob and his friend Ed Herman embarked on a letter-writing campaign, the social media of 1945. They sent hundreds of letters, almost 1000 letters, back home to the US, and implored their friends, their family leaders of churches and synagogues, leaders of community organizations, to get involved and to pressure the government to reverse their policy and allow supplies to get through.
The craziest part of this story is that it worked, that one of these letters actually ended up on President Truman’s desk. Through another series of events, President Truman sent a special envoy over to Europe to investigate, to see if the claims that Bob and Ed had made in this letter-writing campaign were true. Of course they were, and so President Truman ordered then-General Eisenhower to reverse the American army’s policy and allow these supplies to get through.
Although my grandfather is not here today with us, it is a real thrill for me to be able to close out my talk and help to close out this conference by inviting that American army private Bob Hilliard, who’s become a personal friend and like a family member to me and my family, to this virtual stage to share some thoughts on how his experiences can inform our state today in regenerative medicine.
I know why Greg Grinberg wanted me to say this, because I am sure many of you trying new things and trying to get regenerative medicine accepted, developed and spread out as needed throughout the country have felt the same lack of power, same lack of health operation.
All you have to do is stick your neck out. We were threatened with court martial: General Eisenhower had sent a colonel to threaten Ed Herman and me and said, look, the war’s over, you guys may be going home soon, but if you continue to send letters, we’re going to send you to Aleutian Islands. A general threatened lowly privates; we stood up for what we believed in, and what we believed in was humanity. All I can say to you is, in your endeavors and what you are trying to do, stick your neck out, try. It may fail, but if you succeed, you will have accomplished a lot in making this.
Sorry, everyone, I think we lost Bob’s video feed there. I just want to thank Bob for joining us and for sharing that message. Bob is a personal inspiration to me, and I think he and Joanne are both living arguments for what we’re trying to do.
I think it serves us well to remember why we’re all really doing this. I think we believe, all of us in some way shape or form, that everybody, that everyone, every single person, is a human being of infinite, inherent, immutable value and potential and that one of the highest forms of work that we can do is in protecting that value and that potential with that most essential of the inalienable rights: the right to live.
It’s really clear that we’ve all put our hearts and souls into this and our minds and our work. Now, it’s the time to remember that while this effort is not about and can’t critically depend on any one of us, it really is for every single one of us. Thank you very much for this opportunity to address this conference, and I look forward in the coming months to working with you to come together, I hope as we never have before, to engage the public, and to engage Congress, and to engage high net worth donors outside of our community and bring them into our fold. Let’s unlock all of these rate limiting factors to our progress and the chronic disease epidemic as soon as possible for as many people as possible. Thank you.
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