How Mice and Gene-tech May Hold the Solution to the NHS' Funding Crisis
2018 marks the 70th anniversary of the NHS and with it comes a much-needed cash injection of £20 billion. While this significant budget increase is certainly a step in the right direction, many are left wondering where the money for future increases will be found. Raising taxes to fund the health service would be opposed by many in the Conservative party, though recent polls by the BSA show that public opinion is shifting in favour of a new tax channelled directly into the NHS. Wherever it is found it is almost certain that more money will be needed to keep the NHS running due to the increasing demand from the ageing British population.
According to the OBR, the NHS spends five times more caring for an eighty-year-old than for a thirty-year-old per year. What is worrying is that over the next 50 years, the proportion of population aged 85 and over is predicted to treble, from 2.4% to 7.3%. This will undoubtedly create an increased strain on the NHS budget to treat the conditions which inevitably come with growing older; such as heart disease, diabetes and dementia.
But what if this weren’t the case? What if, in the future, we could grow older without ageing? It would certainly increase productivity as everybody would have the capabilities of a young body but could also benefit from years of experience which come with age. Two and a half thousand years since Herodotus first wrote about the Fountain of Youth in his Histories, scientists may have finally discovered it where you'd least expect; inside our genes. A fear of growing old is present across almost all cultures. From the stories of the mythical land of Bimini, whose water was said to have restorative effects, in the folklore of indigenous Caribbean people to J.K. Rowling’s Harry Potter; myths from across the world contain stories about the Elixir of Life which could keep the drinker young forever. The source of eternal life was not found in the New World but we may be closer to it now than ever before.
The initial investment could be paid back in increased tax revenues driven by higher economic growth. By complementing the program with an increase in the age of retirement, the decline in the size of the working age population which threatens many developed economies (most notably Japan, where 21% of the population is over 65) could be reversed. This is, of course, entirely speculation. But it is perhaps not quite as distant as it may first appear.
For many years scientists have been looking into the causes of ageing and it is now believed that, rather than being caused by the natural wear and tear of life, ageing is genetically programmed into our cells. Cells are limited in the number of divisions they can make before they become senescent; ceasing to replicate and declining in function. Ageing is therefore written into our DNA. But as knowledge of the functions of our genes and how they are controlled increases it is becoming easier and easier to create targeted treatments for a whole range of symptoms. A paper published in the Journal of Cell Death and Disease this year, by a team of scientists at the University of Alabama showed how the visible symptoms of ageing could be reversed through gene-focused treatment. By switching off a dysfunctional gene in mice with a mutation leading to wrinkles and hair loss, the scientists were able to completely reverse these signs of ageing.
These images show the dramatic change brought about by the treatment. The mouse on the left is a healthy control. The picture on the right is the mouse in the same mouse as in the centre, one month after it underwent treatment.
But research is not limited to purely aesthetic signs of ageing. Another team of scientists this year published the findings of their research in Cell. They highlighted the changes with age that lead to one of the major causes of age-related diseases; a decline in vascular density (the amount of blood vessels which supply your organs with the oxygen and nutrients required for normal function). By identifying an enzyme (called SIRT1) which is essential for the creation of new capillaries in muscle, an enzyme whose activity also happens to decrease with age, the researchers were able to identify SIRT1 as a possible target for anti-ageing treatments. By using drugs which pharmacologically increased activity in old mice, the team was able to reverse the decline in the endurance and mobility of the mice back to the levels of young mice, as well as protecting younger mice from this decline. This, in theory, could also be applied to humans, keeping us fitter and healthier for longer.
With all these exciting new developments it seems easy therefore to envisage a not-too-far-off future in which ageing is not an inevitability, but a treatable condition. This, however, raises the question of who would be able to access this proverbial fountain of youth. Clearly it would be all too easy for the wealthy to monopolize it, staying fit and youthful while the rest of us are left to wither and decay. Ageing happens to everyone and it would require a huge organised project to bring the benefits to entire populations, as every individual would need to be treated. But what if governments were to offer the ‘Elixir of Life’ in a similar way as vaccines, or even simply subsidize the cost to an individual? It may at first seem like a ridiculous prospect, the amount of money it would cost presumably being very large. However, the Conservative party has a substantial record for being the party of technological progress and scientific advancement; having channeled billions into research and development every year and having championed British breakthroughs from Concorde to Calder Hall. Indeed, in the case of this gene-technology, the rewards surely outweigh the risks, especially in the face of the funding crisis posed by the UK's growing ageing population; making it a fantastic investment for our country.