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Open Consultation of the WHO on Research Priorities for Healthy Aging

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Very recently, the World Health Organization, which is essentially the United Nations’ agency for coordinating international health-related efforts, has launched The Global Online Consultation on Research Priority Setting for Healthy Aging. A corresponding survey is available on the WHO website and can be filled until September 30. As WHO is the main source of policy recommendations for the UN member states, its position can significantly influence the allocation of state funding to different areas of scientific research.

This is why we at LEAF urge you to step in and fill out the WHO survey; our community needs to demand more focused efforts to understand the basic mechanisms of aging, to develop innovative therapies to address these mechanisms, and to remove the barriers delaying the implementation of rejuvenation technologies into clinical practice.

Why is this important

While UN and WHO strategic documents, such as the world report on ageing and health (2015), the global strategy and action plan on ageing and health (2016) and the new set of Sustainable Development Goals include some provisions to encourage scientific research and development of new medicines, studies on biological aging and development of rejuvenation biotechnologies have never been made one of the main priorities.

Furthermore, the application of medical technologies able to slow down, postpone and reverse the main mechanisms of aging has not been considered a viable approach to cope with the growing morbidity of age-related diseases provoked by rapid population aging. Instead, the main measures suggested to prepare our society to these demographic changes are to stimulate the birthrate while adapting healthcare systems and transforming living environments to become more age-friendly.

This situation is mostly a result of slow dissemination of information from academia to the general public and different decision makers. Even though studies on aging have a long history, there have been very recent breakthroughs, such as senolytics, Yamanaka factors, and gene therapies to extend telomeres.

Due to remarkable progress in taming several hallmarks of aging, we might see the first powerful rejuvenation therapies enter the market in the next 5 years. The more prepared our society will be to support their development and implementation, the better. The most efficient way to accomplish this is to make an opinion leader like WHO accumulate the corresponding data faster and to form an official position that will be delivered right to the heads of the ministries of health and science around the globe.

Step in to help set longevity-friendly research priorities!

We encourage every member of our community to fill out the form – you don’t need a background in science for your response to be taken seriously. This is an open consultation, a disseminated “think tank” to provide the working group at WHO with a spectrum of ideas. If our opinion is represented in a significant share of surveys, we shall see it appear in the resulting WHO recommendations. The input of our community here could be vital, shifting the focus of research towards fundamental and translational gerontology and true control of the aging process for decades to come.

LEAF volunteers have prepared a series of answers to inspire your own response to the different questions presented in the form. You can find these below, in the section entitled “Examples for response”. We need to send no fewer than 200 forms to be heard. However, there are only 20 people on the LEAF team. Please give us a hand and fill out this survey before September 30!

Examples for response

Priority Area 1: Developing age-friendly environments
(This focuses on creating environments that are age-friendly and fostering functional ability, including enabling older people’s participation and autonomy.)

Recommended answers in the field Q5 and Q6 (choose one for each field):

What is the best way to make anti-aging therapies and preventive programs accessible to everybody in all areas, with the goal being that people advancing in age could live independently in all environments and settlement types to the maximum degree possible?

What is a feasible age-friendly environment that includes easily accessible qualified medical care services and healthy lifestyle-oriented facilities (gyms, beaches, public swimming pools) to facilitate the use of therapies that prevent or treat the diseases of aging?

What is the cost-effectiveness of building an age-friendly environment compared to developing and implementing into clinical practice the drugs and therapies to slow down, stop and reverse the main mechanisms of aging (hallmarks of aging)?

How does building an age-friendly environment affect the economic growth in a given country?

What is the most effective way to encourage city and regional authorities to facilitate the development of aging-related clinical trials and medical cohort studies and promote the accessibility of corresponding health-maintaining therapies?

Priority Area 2: Aligning health systems to the needs of older populations
(This focuses on transforming health systems to ensure affordable access to integrated services that are centred on the needs and rights of older people)

Recommended answers in the field Q7 and Q8 (choose one for each field):

What is a good framework for clinical practice guidelines that to prevent and treat not only aging-related diseases but aging as a pathological process per se (i.e. clinical practice guidelines for systemic primary prevention in middle and old ages)?

What kind of drugs and therapies to slow down, stop and reverse age-related damage accumulation have a sufficient level of evidence to be immediately and globally implemented into clinical practice, and which drugs and therapies are expected to enter the market during the Decade of Healthy Aging?

How can WHO enable medical practitioners to prescribe anti-aging, evidence-based lifestyle interventions, medicines and other therapies, with the goal of ultimately enabling every person to have access to such therapies?

What are the main reasons why the existing approaches to slow down, stop and reverse age-related damage accumulation are not yet implemented into clinical practice, and how could the member states remove these barriers for faster adoption of these innovative medical technologies?

What is an effective way to facilitate the introduction and development of national electronic medical record systems and AI-based medical information systems to give researchers and clinical practitioners access to anonymized medical record databases, thereby ensuring better medical advice in terms of effective preventive measures?

What is the most feasible way to encourage hospital and healthcare providers to initiate clinical trials on damage-repair, aging-preventive therapies that follow the Hallmarks of Aging model? What should WHO do to encourage governmental health organizations to initiate, lead and finance such trials involving medical universities and research institutions?

What warnings should WHO give to life insurance companies, who may be interested in diversifying their investments into aging-related clinical developments as a way to balance financial risks they already might face due to increasing life expectancy?

Priority Area 3: Developing sustainable and equitable systems for long-term care
(This focuses on the systems of long-term care that are required if older people with significant losses of capacity are to live lives of meaning and dignity – this can take place within their homes, communities, or institutions)

Recommended answers in the field Q9 and Q10 (choose one for each field):

What is the cost-effectiveness of developing long-term care institutions compared to developing and applying evidence-based interventions to slow down, stop and reverse the main processes of aging (hallmarks of aging) and age-related damage accumulation to a significant share of population?

What steps must be taken to ensure that elderly people in community care or retirement homes have, in addition to necessary care, access to evidence-based and experimental therapies and lifestyle interventions that can reverse some age-related damage and alleviate their health impairment? How could WHO encourage, through information and clinical practice guidelines, medical personnel and social workers in these facilities to offer such therapies?

What is the best way to ensure that care recipients, caregivers and care providers are properly informed about the potential and advancement of R&D related to aging and longevity, thereby becoming able to make informed health decisions? How can care providers and people in community care and retirement homes get involved in ethical clinical trials on anti-aging interventions that have a high benefit/risk ratio?

Priority Area 4: Improving measurement, monitoring and research for Healthy Ageing
(This focuses on strengthening capacities, evidence, frameworks and mechanisms to monitor progress and fill in evidence gaps on what can be done to support Healthy Ageing worldwide, in diverse contexts and populations)

Recommended answers in the field Q11 and Q12 (choose one for each field):

How can the concept of biological aging be shifted from an unavoidable damage accumulation to a process that can be manipulated to the point of a significant delay, deceleration and partial reversal? What steps should the academic community undertake to encourage this shift in the perception of the general public in accordance with the existing evidence?

What can be the benefits and downsides of classifying aging as a disease in the ICD-11, and how will this affect R&D related to aging and healthy longevity?

What is the most feasible way to support large cohort and other studies of the biomarkers of aging, which are needed to monitor and develop adequate health solutions, including interventions to stop, prevent or reverse age-related diseases? What research must be done to develop a consensus on the biomarkers of aging? How should genetic trait analysis be integrated into these biomarker systems to significantly contribute to health improvement  and ensure more effective development of gene therapies and other medical solutions in the near future?

Priority Area 5: Commitment to action on Healthy Ageing in every country
(This focuses on creating national policies and frameworks for action, enabling countries and governments to access and use existing evidence, and making concrete efforts to tackle ageism as an essential step in fostering Healthy Ageing)

Recommended answers in the field Q13 and Q14 (choose one for each field):

What should be done to improve national and international coordination on biomedical research on aging and development of drugs and therapies to address the root causes of aging and to prevent, postpone and reverse age-related diseases? What should be the local and the global priorities for both fundamental and translational research on aging?

What are the main bottlenecks decelerating the development of evidence-based anti-aging interventions (drugs and therapies addressing the hallmarks of aging)? What measures can the governments undertake to identify these barriers and remove them?

How can informing the population about the advancements of gerontology (namely, the pipeline of evidence-based anti-aging interventions) affect decision making and policy making about research priorities?

Additional Priority Areas?

Q15. Are there other priority areas or themes, for research that should be added, beyond the 5 listed? Please indicate up to 3.

Priority Area 1: Developing age-friendly environments

Priority Area 2: Aligning health systems to the needs of older populations

Priority Area 3: Developing sustainable and equitable systems for long-term care

Priority Area 4: Improving measurement, monitoring and research for Healthy Ageing

Priority Area 5: Commitment to action on Healthy Ageing in every country

Recommended answers in the field Q15 (three additional priority areas):

Inclusion of aging as a disease into the ICD-11.

The World Health Organization should promote research necessary to include aging into the International Classification of Diseases (ICD). Advanced aging, specifically “Senility”, already has an ICD-10 code of R54 (World Health Organization, 1992). However, this code refers only to the late stages of the pathogenesis of aging. This definition lacks enough detail to facilitate the development of new life-saving technologies to address aging. The beta version of the ICD-11 includes MJ43, “Old age”, instead of the ICD-10 code. This code is even less functional, as clearly, a person’s calendar age is an objective parameter and cannot be treated as a health condition.

Therefore, there should be a new parent category of “Aging and aging-related pathological changes and processes”, which would include both new and old categories, as this is allowed by the new “multiple parenting” principle introduced in ICD-11.

Promote fundamental research into the root causes of aging and translational research to develop damage repair therapies that permanently and systematically address the root causes of aging. Accelerate clinical trials of promising anti-aging interventions, such as senolytics, stem cell therapies, gene therapies, Yamanaka factors activators, anti-amyloid therapies, and cross-link breakers.

Assess the cost effectiveness of geroprotective interventions (addressing the root causes of aging and preventing age-related diseases) as compared to the existing means to treat age-related diseases. Assess the long-term impact of geroprotective interventions on demographic trends (population aging, life expectancy, healthy life expectancy) along with social and economic development.

This section proposes criteria for prioritising research questions in each of the priority areas addressed in Section 1, and asks if other criteria are needed.

Q16. How important is each criterion in assessing global priority research questions and their fit towards Healthy Ageing?

Recommended shares:

0%        Answerability (will get an answer)

0%        Feasibility (can be done in many countries)

0%        Applicability (results will matter)

100%   Impact on intrinsic capacity and/or functional ability (Healthy Aging will improve)

0%        Improving Equity (reducing unfair differences)

Q17. Is there another criterion that should be used to assess global priority research question and their fit towards Healthy Ageing? Please indicate.

Recommended answer in the field Q17

Healthspan extension

Maximum lifespan extension

Life expectancy changes

Q18. In your opinion which research designs to advance Healthy Ageing would draw the attention of funders the most? (select up to 3).

Recommended answers in the field Q18

  • longitudinal research (research that documents information on the same people repeatedly over a long period of time, to study events throughout lifetimes and to better understand cause and effect)

  • cluster or randomized trials (clinical or community based research design that minimizes bias and includes comparison groups to better determine any effects of the treatment or intervention)

  • basic science research (research on the physical and the natural world – such as biology, physics, chemistry, earth sciences, etc. — that advance fundamental knowledge about Healthy Ageing)

Thank you very much for finding time to fill out this survey!

Providing policymakers like WHO with our vision is very important. This way, we help disseminate information about rejuvenation biotechnologies in our society while we encourage more people to support the researchers and to start using the interventions that are already available.

We would like to thank the International Longevity Alliance for bringing this matter to our attention through its own article on this topic – if you would like to see more versions of answers for inspiration, you are welcome to look at its site.

CategoryAdvocacy, News
About the author
Patrick Deane

Patrick Deane

As an undergraduate of Human Biosciences at Plymouth University, aging research has been Patrick’s passion for a long time now. While he has aspirations to later directly join the research effort, for now, he provides the community with educational articles, spreading knowledge of the biology behind the aging process while he himself learns.
  1. Rhonda Green
    September 30, 2017

    Well done! Thank you.

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