The Truth About Aging: Longevity Expert Debunks Common Misconceptions w/ Jamie Justice | EP#75

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Eight, ten years ago I started becoming really enamored because I felt like we could do something about it. Let's go back to what we we as humans evolved 100,000 years ago. The last thing you wanted to do to perpetuate your genes and your species was take food from your grandchildren's mouth so you would die.

We know that aging is a primary risk factor for almost every disease, but we know that this can be targeted. The next great idea can come from anyone. These are the things that will improve function and keep people engaged, active, healthy, participating. That's the goal.

Everybody. Peter here. This episode is sponsored by xprize. Imagine a future where aging brings more time with your family and friends, opportunities for continued learning, second or third careers, and actually allows you to fulfill your entire bucket list and go for a second one. A future where healthy aging is not a luxury but a necessity. We designed xprize healthspan to make that future a reality. Xprize healthspan is the world's largest health prize. In fact, it's the largest prize on the planet. It's a seven year, $101 million global competition that incentivizes teams to develop and test therapeutics that target the biology of aging to improve function and extend your healthy lifespan. Now, here's the details on the prize. This radical collaborative effort is going to bring together top scientists, clinicians, policymakers, industry experts, nonprofits, to create a future where aging is something that we're not scared about because we're making 100 years old and U60. We're adding decades onto our health span. So if you'd like to be involved, please join the conversation by following XPRIZE on YouTube, Instagram, LinkedIn, Facebook on X and Discord. Or go to XPRIZE.org and learn more about XPRIZE Healthspan. I cannot tell you how pumped I am about this competition. You know, going to space has been something I wanted to do since a kid. Xprize has really opened up the doors and living to 120 in a healthful fashion. That's what this X Prize is going to do.

Now back to the episode. Welcome, everybody, to Moonshots. This is a special segment for us. For me in particular, this is the launch of the $101 million X Prize healthspan, the largest competition ever in human history. And for me, the X Prize. Hopefully for you, this is an X Prize that's going to change your life, change the life of your family, your friends, your parents. This is about the potential to add 20 healthy years onto your life. Nothing more of value than our health. Our health is our new wealth. And joining me here today to discuss this X Prize is Jamie Justice, Dr. Jamie justice, the head of our healthspan, XPRIZE. Jamie, good morning to you. How are you doing?

Good morning, Peter. It's really good to see you.

It's great to see you, too. We're just back from Riyadh in Saudi Arabia, where we announced this competition to the world. And then on a media blitz, doing TV radio segments around the world, from Washington, D.C. to New York to California, really letting people know about how the future is going to unfold for them in terms of not a longer lifespan per se, but a longer health span.

That's right.

Do you mind if I just do a proper introduction of you? Sure, because people need to know the rock star who's heading this. So Dr. Jamie justice is our executive vice president of the health domain at the xprize, the executive director of XPRIZE healthspan. Our largest prize ever, adjunct professor of internal medicine in gerontology and geriatric medicine at Wake Forest University. What I can say is that I searched and interviewed probably close to 100 individuals. When we finally chose you, Jamie, I had the best verification, people congratulating me. How did you find her? How did you get her? And so super excited. I mean, we're going to go into the details of what this competition means, how it's going to impact individuals, what 20 years of additional help means, how we're going to judge this. But let's begin with the fact that you gave up a tenure track for this competition, which I can say, you know, one is very. I'd say low risk, but this is a big, bold, crazy idea. So what got you to join us at the xprize?

Oh, my gosh, Peter. I think it's a great question. And first, I just want to say how honored I am to be at XPRIZE is that, you know, as an. As an academic, this wasn't anywhere on my radar. As you mentioned, I was actually marching very well towards tenure, had my promotions, materials in, got a new grant, had great things going on. But this opportunity was just incredible. It's like you had gone out and raised funds and pulled together people and ideas. That is exactly what I've been trying to do on the academic side, but with such a much greater expanse and vision, so that I think we can actually make change. And so, you know, that's. I would say it's the beauty of xprize. And I don't think anyone else in the world is doing this in the way that it can be done here. And so, yeah, no, I'm delighted just to give the folks online, you might be a little less familiar with me, but I know, Peter, you and I know each other well. But again, I was an academic investigator. I was working in a new field within aging that really looks at the biology of aging not just as a discipline on its own thing, but really looking at that biology and see if there might be therapeutic opportunities so that we can target not just one disease at a time, which we can talk about what that's gotten us, but really looking at this as an opportunity to make a global shift mindset. And in terms of policy and how we approach, think about, and treat human aging. We know that aging is a primary risk factor for almost every disease, but we know that this can be targeted and that we've been doing this in animals. And my work has really been in Translating that and looking at the effects not just on keeping us less dead and more alive, but how do we actually improve our health? What are we doing not doing great there?

A lot of people think of aging as a disease, right? There's been a big push by Nir Berjalai and David Sinclair and others, and a lot of conversation about, okay, how do we slow this disease, stop it or even reverse it. Speak to that for a moment about the idea of aging as a disease. And the FDA and companies should think about it. How do you think about it?

Yeah, that's a great question. And this has been actually a really active area within the field. I have actually been asked many times to sit on panels to talk about exactly this. I know that there are many people within the field that do categorize it as a disease. I've really been more on the risk factor side, but for a few reasons, and they might not be intuitive. One, is this biology, can it be targeted therapeutically? Is it intervenable? Is it malleable? Absolutely. It is the driving risk factor for every chronic disease, almost every single one that share very few other traditional clinical risk factors. And yet aging is it that we know that really critical work is that we can look at these mechanisms. And this is the other thing that we've learned over the last 10 to 20 years, is that there is a distinct biology. These are some of the frameworks around where this is where people say, yes, is a disease. Because not only does it have this distinct biology, but it has a couple of critical features. One is that this biology is conserved across multiple species. Two, if you do something to these processes to aggravate them, make them worse, turn them up, you can shorten animals lifespan. And this is across many, many species. And then three, if you can do something that you can target, you can block, you can ameliorate, you can actually extend lifespan and also health span. You can look and see how they function, how they thrive within the time that they're alive. And so those are three critical criteria. Now about disease or not disease. I tend to shy away from that. Do I think it can be regulated? Yes. Do I think we can have an indication within the fda? Absolutely. And actually the FDA is willing to play ball. What they need is they need investigators and they need enough groundswell from within the field itself that we bring them something that they can work with. The FDA is not in the business of making determinations like this, but they will absolutely. Whether you call it a disease or not, they also often you can get Approved indications for risk factors for disease. They do this with statins. We do this with many other preventables. And so regardless of what we call it or how we get there, it absolutely is a target for therapeutics, and it absolutely is viable. And I think it's critically important that we pull together, build some consensus and bring something to them so they can create change on our behalf. They just won't hand it to us.

Yeah, well, that's what this XPRIZE is about. For those of you who haven't been following xprize, I'll take a second to give a little bit of background, and then I want to jump into this competition, because one of my goals here is that if you're a team out there that wants to play in this competition, if you're looking for your moonshot and solving aging or extending health span is your moonshot, then you're going to want to play in this X Prize and go for part of that $101 million, if not for the whole thing. So what is it? So X Prize in particular. We're 29 years old. Hard to believe it's 29 years old. It feels like yesterday.

I know, Peter, that's your age. How did you. You were five when it started.

Exactly. So I read the Spirit of St. Louis book that Lindbergh won the Pulitzer prize for in 1994. It was given to me as a present and it got me inspired to create a prize for spaceflight. And I didn't know who was going to put up the money, who was going to be the Pulitzer, the Nobel, the name of the prize. So I used the letter X as a variable to be replaced. And anyway, it took a while. The Ansari family finally put up the $10 million for this first flight for spaceflight, this first prize for spaceflight. And we named that one the Ansari X Prize. On the heels of that success with BURT Rutan building SpaceShipOne and then selling the rights to Richard Branson to create Virgin Galactic, I was able to recruit Elon Musk and Larry Page and Jim Cameron and to our board and many others. And we built it into a platform.

And.

And since then, we raised over $300 million in X Prize competitions. That's driven about 3 to 4 billion dollars in expenditures by all the teams trying to win that 300 million. They're all optimists going after this and super pumped that over the next 90 to 120 days, we're going to be launching a quarter of a billion. Actually just launched $101 million prize and, and we're gonna be launching another $120 million worth of prizes very shortly, so stay tuned for those. But this one, the Healthspan Prize, man, oh man, it's been a journey of about 15 years since the very first conversation here. Five years in earnest. And I feel like I just gave birth with you. I don't wanna call you a surrogate mom or the mom here, but I don't wanna make this.

But we're co parenting, Peter.

Co parenting? Yes, we're co parenting this prize. So let's dive in.

Actually, Peter, before we go on to that, what I'd love to know. So, you know, I love aging. This has been my scientific field, but you're a huge name in aging too. Not, you know, because you've been your passion, your drive, your area. I mean, you have really coalesced quite a group of people to help tackle this with you. So do you mind if I. I know it's your podcast, but how did you get into it?

I love it, Jamie. Thank you. I got into it. I mean, I came from a medical family. I went to medical school years ago, and I tell people, don't ever come to me for anything. I'll offer you a 2 for 1 special on your appendix. But I became enamored in space first, which gave rise to the original Ansari X Prize. And then it's taken so damn long to open up the space frontier. I said, I've got to add 100 years to my lifespan. And it was about eight, 10 years ago I started becoming really enamored because I felt like we could do something about it. I felt like finally the tools existed. The earliest days of AI, but in particular gene therapies and crispr. There was, you know, I tell the story of seeing a long live a television show and long lived sea life that I learned that bowhead whales could live 200 years and Greenland sharks could live 500 years. And I asked the question, if they can live that long, why, why can't we? And my answer was, it's either a software or hardware problem and we're going to be able to solve that. And so I think for me, the biggest business opportunity in the world is longevity. And the biggest gift to humanity would be longevity. When I say longevity, I really mean health. Longevity of health versus life. And we should get into what that, what the difference between lifespan and health span is. But I become just, you know, I've got a new book, Longevity A Practical Playbook, which just came out. I'm focused in on Fountain Life as a company and its sister company Lifeforce. But this prize has been, has been something I've been relentless about, just the same way as the very first prize in spaceflight. It's like, I know there's a there there. I know that if we get the right minds thinking about this and like you said, it's, you know, typically you back one single approach, but here's a chance to approach, to back hundreds or thousands of approaches to solving this challenge. So thank you, thank you for that question. And was there a causative moment in your life that got you excited about this, that steered you towards.

So funny. Peter, I've gotten to know you so well and I didn't realize that your intro to this was actually so shockingly similar to mine. I was in graduate school and had started doing work around looking at function and had just started doing work in aging and looking at some of the common causes for functional decline and disability with aging, really digging into some of the mechanisms and potential treatments. I went to one of the most interesting, it was a point counterpoint discussion about the causes of aging where he had on one side, an investigator named Tom Johnson who talked, talked a lot about sort of different aging genes and some of the early discoveries that had been done around making some sort of these. I think they started in worms and looking at particular mutations.

Our long, long cousins.

Yeah, exactly. Our distant, distant, distant cousins. And that he went through this sort of this really deep, deep approach. And it was coupled by somebody else within the aging field, someone named Leonard Hayflick, who he went up and started talking about these long lived species. And you know, and he also had this sort of non, they call it program, non program. But he. I don't want to get in the weeds, but it was the first time that my attention was just grabbed and it hasn't stopped. I mean, just like, why do we age? How do we age? Is it inevitable? And then you look across just sort of the bestiary, right? And you have, you know, a friend, Steve Alstead, wrote this book called Methuselah Zoo. There's incredibly long lived, really vibrant species and so many lessons to be learned. And then so once I got into it and I started really studying older adults and I started really working with them and you know, that these, it's almost universal and that it can be really terrifying. And it's almost like the problem's like this functional decline, it's almost unseen. We take it for granted, we see it everywhere and we just stop seeing it. And so I think really looking at some of these things, these processes, these new opportunities, is there really something that we could do to drive change and really help a group of, not just group of people. I mean, my goodness, aging is us. It's everywhere. It's success.

For sure. I would say, as I talk to you and George Church and David Sinclair and Eric Verdin and many of the rock stars in this field, it's interesting that the idea of talking about impacting aging, slowing it, stopping it, even potentially reversing it, would have been heresy five or 10 years now. I think it's the hottest topic out there. Would you agree with that?

I would have to agree, absolutely. And that there is in equal parts a lot of champion championing, if I can get that word out. And there is still. It sparks both excitement and I would say still springs a little bit of fear, you know, that there are a lot of people concerned about unintended consequences. And then there's others within the field who just think, you know, poo, poo, can't be done, can't be done.

And also, so much of our society is predicated on aging and dying. Right?

You're right.

I mean, it's the, it's the business plan. It's the business plan of most religions. You know, not gonna get into religious debate here, but you know, it's part of it. Social structure of retirement and Social Security. And I mean, it's just embedded so much into our lives. Most people don't realize that, you know, normal human aging. Let's put, let's go back to what we as humans evolved 100,000 years ago. Normally you would have been pregnant by age 12 or 13, you're a grandparent by 26 or 27. And before we had McDonald's and Whole Food and food was abundant, the last thing you wanted to do to perpetuate your genes and your species was take food from your grandchildren's mouth so you would die. The average human lifespan for most of human history was like 30. And we see that now physiologically from hormone levels from your thymus, from stem cell populations in your body, you're at peak health in your late 20s to 30. And then it's like this slow and steady decline. We want to change that, flatten out that curve.

Yeah, so you're absolutely right. So a couple of really big things that you said, they're really, really important. Right. Is that really critical? So one I'll push back just a little bit is that I know that there's been a lot made of this sort of like this altruism. Right. Is that. Did we evolve towards altruism that we die out so that our kids and grandkids can live? I don't know that that's really where aging comes from. I think that it's almost like a byproduct, is that we have to do to have children. We procreate. Once that natural selection drive goes, then sort of the force declines. And a lot of what we experience of this deterioration, it's limited by, again, the things that used to kill us, which most of those things our aging process directly relied. We call that. That intrinsic capacity for aging. That intrinsic process is directly related to the extrinsic things that used to kill us. And so whether it's predation, illness, injury. I'm a woman. I would have died in childbirth. Like, let's just, you know, let's just go there. That was just too energetically costly to keep this whole system working if I was going to die anyway. And so we've had in the last 100 years just remarkable, remarkable things happen where our traditional medicine and public health. Right. Clean water.

Yep. Sanitation.

Lower infant mortality, Lower maternal pasteurization of milk. Absolutely. Trauma care as well. If you were in an accident, say you're bucked off a horse. 200 years ago, likelihood of death was pretty high. We now keep people less dead.

Let's change the less dead X prize. I like that.

We have done that really well. And even so. And all the public health measures have kept us a little healthier. So, you know, we are living. J. Olshansky calls it this, which. He's another guy if you haven't had him on. Oh, my goodness, Peter. He's a hero of mine. And so he talks a lot about this, like, we're living the longevity revolution. You know, we don't recognize it because it's our lifespan. We don't see it. But, you know, our great grandparents, great, great grandparents lived to 48, early 1900s. Median lifespan was 48 years old. In the U.S. it's now 78. And we just fail to see this huge accomplishment.

And I want to make it 108.

Or more in those years.

Everybody want to take a short break from our episode to talk about a company that's very important to me and could actually save your life or the life of someone that you love. Company is called Fountain Life, and it's a company I started years ago with Tony Robbins and a group of very talented physicians. You know, most of us don't actually know what's going on inside our Body. We're all optimists until that day when you have a pain in your side. You go to the physician in the emergency room and they say, listen, I'm sorry to tell you this, but you have this stage three or four going on and you know, it didn't start that morning. It probably was a problem that's been going on for some time. But because we never look, we don't find out. So what we built at Fountain Life was the world's most advanced diagnostic centers. We have four, four across the US today, and we're building 20 around the world. These centers give you a full body mri, a brain, a brain vasculature, an AI enabled coronary CT looking for soft plaque, DEXA scan, a grail blood cancer test, a full executive blood workup. It's the most advanced workup you'll ever receive. 150 gigabytes of data that then go to our AIs and our physicians to find any disease at the very beginning when it's solvable. You're going to find out eventually. Might as well find out when you can take action. Fountain Life also has an entire side of therapeutics. We look around the world for the most advanced therapeutics that can add 10, 20 healthy years to your life. And we provide them to you at our centers. So if this is of interest to you, please go and check it out. Go to fountainlife.com Peter when Tony and I wrote our New York Times bestseller LifeForce, we had 30,000 people reached out to us for Fountain Life memberships. If you go to fountainlife.com Peter will put you to the top of the list. Really, it's something that is, for me, one of the most important things I offer my Entire family, the CEOs of my companies, my friends. Friends. It's a chance to really add decades onto our healthy lifespans. Go to fountainlife.com Peter it's one of the most important things I can offer to you as one of my listeners. All right, let's go back to our episode. Yeah, agreed. I know. I want to give our listening audience a little bit of insight about what this X prize that you and I.

Both announced, we should have another.

We will. We will for sure. This is a subject that people like. And so if you're a moonshot entrepreneur out there, if you're in biology and health, if you want to go for this largest X prize ever, here it is. $101 million up for grabs. And Jamie, all they have to do to win the money is, oh, my.

Gosh, so if you're out there, my moonshot team, are you ready? Get your pencils. We just launched this, so you better start looking us up online.

Xprize.org that's right.

Go to the site, get registered. We have an intent to compete out. Please sign up for it. Our winning team of the $101 million XPRIZE healthspan. You must demonstrate that your therapeutic treatment restores muscle, cognitive and immune function and that this is a minimum of 10 years, but a goal. Peter's exponential. A goal of 20 years. And you have to show that in persons age 65 to 80. And the therapeutic treatment that you give it has to take a year or less. So we're going to be measuring that function before we're going to be measuring it again at one year. And you have until that time to really move the needle. What we're not going to tell you is what to do. And so you can bring us anything. All right? So this can be a drug that can be a new drug. It can be a repurposed drug. It can be a new combination of either new or repurposed. It could be a biologic. It could be a gene therapy. You could be looking at a cell therapy or a vaccination. You might even have a device. Maybe you're working with some kind of fasting, mimicking diet or other nutritional approach. And you can do one of those alone or in combination. What we're not telling you is what to do. What we're asking you to do is to play by these rules. If you want to be considered for an award and the awarding is indexed right. So we're looking at you have to show an improvement in function, and not one, but all three. Again, that's muscle, cognitive, and immune function.

Let's talk about why those three. And then, if you don't mind, I'll peel the onion on the competition rules so you can explain them a little more in detail. I'll mention muscle. We have a $10 million bonus prize around a muscular dystrophy. FSHD. And I'm going to use this as a digression to tell a little bit about the history of this prize, if that's okay with you, Jamie.

Please do. I'm just so happy that you built this.

Yeah, well. So the very first conversation I had was after the spaceflight prize some 15 years ago. It was a conversation with Aubrey De Grey and Peter Thiel, and it was writing a longevity prize. And we couldn't figure out what the prize would look like if we had to wait 30 years for it to be awarded or 20 years for it to be awarded. So it's difficult. Five years ago, a gentleman by the name of Sergey Young, who is a partner with me in my Bold Longevity venture fund and super proud of what Sergei's built, he put up a half million dollars to try and kick off this idea of a longevity prize again. And that was the money we used to sort of design and develop the prize. And it was a conversation with George Church at Harvard Medical School, who's one of the most prolific and entrepreneurial biotech faculty out there. He's amazing. And he said, rather than longevity, what you really have to look at is functional reversal. Because I don't care what your aging clock says, if you feel better, if your systems are working better, you can measure that in the now. And they're probably FDA approved endpoints. And so we said a true aging therapeutic, if it works in one system, it's likely to work in others. So let's look at three. And I met a guy named Chip Wilson. Many may know Chip's company, it's called Lululemon, he founded it. Amazing entrepreneur and philanthropist. And Chip has this muscular dystrophy fshd. And he became the first major sponsor of this prize. He put up a quarter of the prize money and a $10 million bonus if your therapeutic can impact muscle and help his particular. So we have $101 million for the Health Span X prize, Health Span and 10 million for this FSHD bonus prize, this muscular dystrophy bonus prize. And so we set muscle as one. And one of the biggest issues around aging is sarcopenia, the loss of muscle. And a lot of people, my dad included, fell in his middle 80s, broke his hip, that put him into the hospital, developed pneumonia, and then passed away. And we see this over and over again. If you have muscle wasting and you trip while walking and you break a hip or pelvis, it really is the beginning of the end. It's really challenging. So how do you maintain muscle function? Was one of the biggest things. Where do you want to go next? You want to go to immune or cognition?

Yeah, I want to sort of follow that thought. I think that's really great. So actually that's my intro to aging was exactly around that. I started looking at the neuromuscular determinants of functional decline. That was my graduate work. And then followed that into more systemic multifunction and really focused on physical dysfunction, frailty, disability, and know that those are really incredible drivers. And those are some of the things that are so meaningful to people. So we can do a deep dive in some of these others. One thing I want our audience to know, especially teams out there, which I really, really hope you compete, I will track you down again. So when we're talking about muscle, this is function, but it's also, it's not single dimension. Right. And so we're talking about it can be muscle is kind of broad. So it also means like fitness. So whether that is going to be like a cardiopulmonary kind of thing, like a VO2 max or could be like a six minute walk, something like that that requires that you have to move, you have to walk, it requires endur. We're also looking at strength and power as well as that muscle mass component. So again we're looking at multiple measures of this. So you can't just get one measure and call it good. We're making this hard. Okay, guys, so what we are putting out and you should link to it on the website is you'll go in there, there's going to be a competition guideline that's an initial guideline set, but you can link into it and you can see a menu of suggested tests that we're going to be refining with your input. So please join us in this. So again, muscle physical function is one of those so important.

We'll put the link into the show notes and again, xprize.org or xprize.org healthspan and I think you made an important point. When we launch an xprize, we announce it with a set of guidelines versus the final rules. And we have about a six month period where the world gives you feedback. I'm so happy to have you.

I get to draw the arrows and the praise. Bring them my way, guys. Radically collab.

Yes. It's not me getting the feedback, it's you as the executive director and you have an amazing endpoints committee who are guiding you here. And so then we'll refine it, get the feedback. What did we miss? What did we get right? What did we get wrong? And then we'll announce the final rule set that will guide the agreements we have with the teams. So that's muscle. Everybody who's getting older. I think their biggest fear is cognition. It's losing their mind more than anything else.

Yeah. So I think this is actually the perfect segue so that the three systems. One of the reasons that I was really excited and really made the move to XPRIZE and delete this prize is because it was function forward and that it captured the essence of aging, meaning that it's not one system. I think by making this based on function rather than disease, it really gets to the heart of what health is. Health is more than the absence of disease. We're taking this very holistic look, where we're looking at physical function, what we're calling muscle. Right. We're also looking at cognitive function, because, as Peter said, like the things that worry us and actually lead to disability, these are sort of the three horsemen, right. Is that inability to physically participate in our life, inability to mentally participate in our life, whether that's memory, there's also something we call executive functioning. So that's like, can I keep track of multiple things at the same time? Not just what my memory goes, which we think about with Alzheimer's, but there's also many, many other components of whether it's a general slowing or just a gap, or where I can't do two things at the same time anymore. And so these are some of those really core functions that are really essential in participating in life. And then the third, I don't think I need to tell anybody in the world right now, after going through an international pandemic, how important our immune function is. Is that one of the things we learn through pandemic, where our older adult, those over the age of 60 and 65, or people that had something like comorbidity, we already had some kind of a chronic illness, which is much more frequent in older adults, is that those were the ones that were preferentially targeted by this pandemic. And so what we've really started learning is that we need to do what's called host directed therapies to improve our immune systems. Again, if we target that aging biology, we can improve our immune function and become more resilient in the face of many different challenges, including the next pandemic, whatever it is. And so these are the three most critical pillars, and they're not independently tied to any single disease. So what we're talking about is aging. What we're talking about is health, and that we're developing therapies of any kind. And it can't be just one. It has to be all three, so that we're sure we're not just going after a single process.

Yeah, beautifully said, Jamie. Also remind us that your immune system is not just for an infectious disease. Your immune system protects you against cancer as well.

That's exactly right.

We're all developing cancers all the time. It's just normally our immune system finds it early and zaps it and if your immune system weakens or if you have immune exhaustion as they call it, increases the rate of cancer.

I want to emphasize one other part with this that I think is super, super critical is that these three really go together and they get at something. We haven't talked about the economic impacts yet and I think that's really important. And so when we think about aging is that we often, I think there may be a misperception with this prize. It's like, oh, we're going to launch this prize and we only want rich people to live longer and that they're going to have this huge divide. By setting the price up this way and looking at function. What we're really going after is population level change. Right now in the US for every 10% increase in the fraction of the population over the age of 60, the GDP, the gross domestic product, that it actually goes down just under 6% in the next years, we're actually already had an increase of more than that. We're looking at really major changes. And what they think most of that loss of GDP is due to is actually a loss of labor supply. If we're looking at things that can possibly impact function, we're talking about these are the things that could actually keep people active in their communities. Whether or not they're working in a for profit position or staying at a job per se. But they're still participating, they're still able to take care of their kids, their grandkids, they're working, they're doing something because it's not just whether that individual stays in the labor pool working, but it also means that they're less dependent on a caregiver who might have to leave work to take care of them. A family member, a child, a niece, a nephew. And so this is really critically important is that these are the things that will improve function and keep people engaged, active, healthy, healthy, participating. That's the goal.

Absolutely. You know the numbers, I guess it was, it was, you know, the publication here, David Sinclair is one of the co authors and it was, it was also was supported by Oxford and Harvard here that adding just one year to the global life expectancy on the average is worth $38 trillion to the global economy. And it's like in less, you know, both increased productivity and also decreased spending on medical health. Yeah, I mean it's a massive, massive impact. And I think one of the things that is true for this prize and true for all X prizes is it's around equitable impact globally. Our hope is, and the structure of the competition is that these therapeutics are not going to be million dollar treatments. Eventually, as you offer these treatments to millions, hundreds of millions and billions of people, the price comes down massively and becomes available. And what we truly want is increasing global health span. There's a lot of people who argue and I just want to get to the heart of this one second that say, oh my God, we already have too many people on the planet, we have overpopulation issues. Why do you want to have people live longer? There's a lot of people and we can talk about these individually, but I want to talk about the pro and the con for a second, then come back to the rules here. I mean, I'll just mention off the bat, increasing healthspan is about keeping people in the game or longer. People retire either because they're in pain, they're tired, or they're forced by policy to get out. But imagine at 65, if you are vibrant, you have the most contacts ever, you're excited to contribute and excited to start your next startup or do whatever you want. It is a huge positive impact in society and people who are concerned about population. Let me just give the stats because I know these numbers well. Fifty years ago, the average globally number of children per family was over five children per family. It was like 5.4. The replacement number is 2.1. 2.1 children per family is the average. To keep the population level, we've gone from like 5.4 down to 2.3 right now. And most of the world, China, Japan, most of Europe, the United States is below the replacement level. And so, you know, we're possibly going to have one of the world's, you know, a problem. On the flip side, not enough labor to sustain our global economy.

Actually, that's correct. That's one of the biggest concerns. And so, you know, the U.S. certainly, we're on that trajectory. Other countries are already grappling with it. You know, Japan, many other countries where it's, you know, they have had major demographics changes. And so that's why globally, both the UN and the World Health Organization, they have named this the Decade of Healthy Aging. And it's exactly for this reason is that there are many countries right now that don't have the labor needed, the people within that labor supply to support the number of persons who are actually retired and needing care and support. It's already happening. And this isn't just for really wealthy countries already. The countries that are actually going to see the most change in the next, say 10, 20, 30 years. Those are our lower and middle income countries. We need solutions now that are available to support this really major global demographic shift. We've already seen some of it in our country. Other countries are just coming on board. We have changed what human aging looks like and we need to change it more so that we have support available and options available.

Let me ask you, who can compete for this xprize? Who can register as a team?

Anyone? Anyone? Anyone? I want people from everywhere jumping in this. This is a great opportunity. I mean, it could be from our nonprofit foundations, academic investigators from any country. It could also be commercial for profit companies. So this could be somebody in the biotech space that might already actively be working on therapeutics that think would actually help and benefit aging. This could be from groups working in other disease categories. I know of some folks that working in cancer oncology that may have some things that could be repurposed or reconceptualized toward aging. There are also some active companies and also academic teams that have been working on pieces. As you know, in the US there's been a huge, huge increase, increase in the amount spent for research on Alzheimer's disease trying to find a cure, trying to find a treatment is that there may be opportunities there that maybe some of those drugs, some of those compounds might have effects well beyond cognition and they just need the incentive to actually try them because we need options for aging more holistically and this is a chance to do that. So again, we expect anybody. The important part of X Prize, one of the things that brought me here, and I think it's so central to xprize's mission, and it's really dear to my heart, is it's decentralized. The next great idea could come from anyone.

It could come from anywhere. I love that. You know, one thing important to point out for those is XPRIZE makes no claim on a team's intellectual property. This is non dilutive capital that a team gets. Our job is simply to claim support, promote help. Hopefully hundreds of teams get attention and hopefully as part of this, just like we did with the original spaceflight XPRIZE and we've done with other xprizes also paved the regulatory path. So work with, in this case the FDA and regulators around the world to be supportive of the kinds of strategies and approaches that are coming here.

So that's a really great thing. And so these two actually go hand in hand. So when I just mentioned a little bit ago that, you know, we invite anyone, maybe biotech companies, groups that are out there that are already working in this space Maybe they're developing things around aging. So I'm going to tell you something crazy, Peter. So there are some companies that have been working on aging, developing therapeutics around aging. And I talked to one of them recently, and I was like, well, what would you think? Would you think about competing in the prize? I did this a few months ago before they had an opportunity to start really letting this digest. And one of their founding CEOs said no, because there's no commercial incentive for us to actually do anything towards aging because there's no regulatory pathway. There's nothing there. So we'll just keep developing our drugs and working on them. And this rare disease, that rare disease, this rare disease. Because even though they were at their heart targeting the biology of aging, they saw this as a fool's game, because there's no one here being the champion to bring everyone together to force our, you know, and it's not really forcing the fda. They're receptive, they want to help, but they need us to bring it to them. And it's too large of a challenge for any one company or any one academic group to do it on their own. And so, again, this could be from anyone, anywhere. And the goal is to link these groups together, develop common resources, and actually work together, create change. This is a radically collaborative effort. We're putting out an initial guideline. We're telling you what we think, and we're asking for input. Everybody gets to be part of this with us. We are democratizing science in the field of aging.

Just to remind people, you read about SpaceX and Blue Origin and Relativity Space now and Virgin Galactic and all of these companies, and you say you think about commercial spaceflight and commercial human spaceflight as an everyday activity, and you can go and buy a ticket right now. When the XPRIZE originally got thought up in 94 and announced in May of 1996, that was not the case by any means. The regulations didn't exist. People were not investing in this. It was before all of these companies got started. And the X Prize really lit the fuse on commercial space and, and made it a much more rational investment and created the regulatory framework that has launched this commercial spaceflight. And we want to do the same thing here in the field of health span extension, there's 100. Well, I'm very proud to have raised $141 million for this competition. It's the largest amount of capital ever raised for an X Prize. Yay.

Wow, Peter, that's incredible.

And I believe enough in this that I've put In millions personally into this competition. The first XPRIZE I've backed and as I mentioned, Chip Wilson was our largest first prize sponsor. And then we've had people putting in a million bucks, up to 40 million bucks, and it's our largest group here. Let's talk about how this sort of, how this money gets distributed. 30 million is for operations. There's a lot of testing has to be done. 10 million is up for this FSHD prize.

Small pitch there. 30 million for operations. That might sound like a lot. This is a lot to run. And so any of our partners out there, if anyone's out there, maybe you've got a great idea, a great biomarker, a great system, something you want to ask us about? We're not closed. Feel free to call us for in kind support.

Yeah, we're going to be partnering with companies to do testing in the cognition, immune and muscle space and a whole bunch of biometric testing. Along the way we'll be announcing partners in epigenetic testing and genome testing and blood biomarker testing and so forth. This is a global competition, so we're going to have to be doing this around the world. But there's 101 million up for grabs for the primary segment of this prize. And unlike Winner Take all, which we have done in the past, we're doing this a little bit differently and I'm excited about it. Would you lay out how that 101 million is there for teams to go after?

Okay, so this is great. Again we have the 101 million. This is one of the most common questions that I've had since we've launched, Peter, is people want to know, are we just giving, is it a winner take all? Is it a one prize, one shot? And no, because that's really not the spirit, right, that this is meant to get people in the field and keep them there. And so I think one of the brilliant things that Peter and some of the early developers on this is to find a way to distribute this money. And so again, it is a competition. And so this requires that you have to come into this with some funding on your own to do the earliest stage, those first two years. That's going to be a lot of qualifying submissions. You have to turn in paperwork to us. We have to understand the therapeutics that you're working with and the screening process that you have and we'll do some evaluating based on that. At that point it's going to be in the early about right around two year mark for us, which is going to be in early 2025, we'll look at those qualifying submissions and there's going to be the first 10 million dollar distribution that awarding is going to go to. 40 teams will be given some money. That 10 million will be distributed. So that's about $250,000 a team. And we know that, you know, depending on where you're testing from, that may or may not be a lot for you. But we wanted to make sure that we at least distributed money to encourage people keep them going, keep them invested in this. And it's a token to keep moving. More teams than 40 can continue. But we're only doing the awarding at that point. In another about year and a half ish after that point into 2026, we're going to be distributing again that next milestone award. At this point, teams will have had to go in to do at least some early clinical trials work. This is making sure that they can use the protocols that we're going to recommend, are comfortable and have the regulatory paperwork necessary and a clinical trial center that they can support their work or we can help partner them with folks within our alumni and team network that can help them along the way. Then that's that next $10 million distribution. So again now we've given away 20 million. That next 10 million is given to 10 teams. Those 10 teams will use that $1 million each to at least see their one year clinical trial. The clinical trials will run and again we're going to be asking these teams, they're going to be testing function, that's muscle, cognitive and immune function. We need them at the beginning, at baseline, they'll give whatever that therapeutic intervention, whatever their team solution is. One year later those clinical trials are run again and you have to test those same things again. Muscle, cognitive and immune function. We take that in. Also with some of the safety data that you collect, you know, any kind of event reporting or symptoms, we'll look at dropouts or adherence or anything that's related to that that will support the awarding. But our awarding is based on change in function and that you have to show a functional improvement. And we break down that 101 which remaining at this point is 81 because we've given away 20, now we have the 81. If you can show that the improvements in function in one year are enough to offset, it's equivalent to a 10 year improve or decline. It's enough to offset the 10 year decline. So you have to have an improvement in magnitude. This is equivalent to 10 year. That is the team will be awarded 61 million if you can show a 15 year functional improvement. That's 71 million if you can show again. This is peter. I thought 10 years 3 systems was the most insane thing I could think of. Peter is exponential. This is the exponential goal for 81 million is that you have to show a 20 year. The equivalent of a 20 year improvement in all three systems for 81 million.

And just to be clear the highest level wins the money. So if you showed 10 but someone showed 15, the team who got 15 wins it. And this competition is going to run for seven years from launch. At the end of seven years is hopefully we have a winner by that point.

That's exactly right. 20, 30. Is that our goal period. This gives our teams actually in having that amount of time. Yes. It takes time to run trials. The other thing it takes time to get the regulatory paperwork done and make sure that you have the resources and the network building and that we can actually begin to work and lay that groundwork around what is possible for the future. And so that's why we have this duration is it just takes time to run these trials and it takes time to build the community and lay what we want to make this again. It's not meant to be a prize. A one and done. We give the money away and everyone goes home. Is that this is meant to make global lasting change. We're about an impact.

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Now back to the episode. Yeah. You know one of the things that's important for people to realize is that that we're doing this competition now. Because for the first time ever small teams can do what only the largest corporations and healthcare systems could do before. In fact, I think can do more given the use of AI. And what we'll see before the end of this competition, before 2030, is we'll see quantum chemistry and quantum computation coming online, gene therapies, crispr technologies, gene writing, all kinds of things coming online at exponential rates. And I think the biggest opportunity for impact on the planet is going to be for adding health onto people's life. Let's talk about one second. The definition of lifespan and health span. I think it's important people to realize. Yeah, go for it.

Okay, so what's lifespan? This is a really good point. This is a really, really good point. Okay, so lifespan, right? So this is, you know, a lot of people when we talk about this prize, they see only sort of the lifespan numbers. And lifespan is super important, Right. It's how long you have lived. It's the total duration of your individual life. It's your chronology, it's how many birthday candles you have put on your cake. And it has really not a lot of connection necessarily to your health condition.

Birthday candles, whether or not you can actually count them or not.

Yeah, whether you can blow them out, even see them. Exactly right. So healthspan is different. Okay, so healthspan is the period of life spent in good health. So you know, classically we think about this as when you're free of like major life threatening diseases or disability. So it really, it emphasizes the quality of life rather than just the duration. So again, we want to add life to your years. This is really the key component here. One of the reasons this is such a key component, because this is really where the gap is. Peter, I know you're aware of this and I'm sure that our listeners, if you made it in this far, you probably know this. We talked about that longevity revolution at the beginning of the show. Just drawing a loop back. Did you know? So in the U.S. right, we've gained 30 years in the last 100 years. We're living 30 years longer. Do you know what's happened? So the World Health Organization counts something called the health adjusted life years. Do you know how long we've expanded that? No, no. In the last 20 years? Zero. Right now there's a gap between our health adjusted life years and our lifespan of 12 years, meaning that we've extended life and we might have wiggled health a little bit. But if we actually quantify it, there is a 12 year period that people are living in poor health, low quality of life, poor function and disability. That's staggering.

That's not the goal. That's not the goal. It's not the goal to have you slobbering in a wheelchair, unconscious. How do you have the energy, the cognition, the mobility, the aesthetics, the immunity to enjoy those years of life?

That's right. Yeah. Traditional medicine has made us less dead. We want to make us more alive.

I love that. The less dead X Prize.

You know.

I want to talk about, you know, one more, one more subject for folks here, which is, you know, people complain about extending lifespan or longevity and they bring up a number of things. And I went out to my Twitterverse to get people's objections. I normally, I have a community of folks, many of you here listening, who love this and follow this with me again. I put out my book Longevity A Practical Playbook, which is available for free if you're listening on my diamandis.com longevity or can go to Amazon to get a hard copy copy. But the interesting list of things, and it's going to run through them. The first is boredom. People say, I'm going to be bored. I'm going to be bored if I live to 100 or 120. And I'm like, really? So I think that's interesting. My answer to that is we're going to have AI and VR and BCI and all kinds of, of extraordinary new ways to engage in the world. And hopefully boredom is the last thing you have to worry about. I don't know how you feel about that.

No, I actually, I think that's completely right. You know, and I have talked to others in the field is that, you know, we're going to have to come to terms with this. We are living longer. And I think our current approach has actually left that feeling is that people don't know what to do with those added years. Right. So I think that's where that's like, oh, I'm going to be bored. Oh, I don't know what to do. Or they, you know, even within medicine, there's this sort of palliative approach to care. And it, and it's really, it's. We're looking for things that actually empower people, is you don't have to be bored. Maybe go back to school. Is there an opportunity for lifelong. Is there engagement? There's so many things to, I think.

There'S travel and education. And I think what happens is people conflate being in pain and having low energy with those later years. And the hope is that there'll be increased vitality. Okay. So another thing is the sense of immortal Dictator. So I had this debate with Elon that people need to die in order to make room for new innovation. And if the CEOs and the leaders are still alive and living longer, that we only have change when we have turnover and people die. And I call bullshit for that. I mean, listen, the head of Lockheed Martin and Boeing or General Motors and Toyota didn't have to die for SpaceX and for Tesla to come along. You just need better entrepreneurs and better technology. And I think we have revolution all the time. And we are going to have, without question, the societal checks and balances against evil dictators and tech that doesn't work well.

Yeah. So I mean societal, evil dictators, but I'll clue you in. So there has been a side conversation around this on the academic side around tenure, where there's so Many more new PhD candidates coming up and we can't do anything if nobody retires because of tenure. And so there's all these fear. There's fear, fear, fear, fear, fear. But instead. So we can either do two things. We could either not talk about it, or we can talk about it and just sort of allow a place for engagement. And is this a potential risk? Like, you know, I'm with you, Peter. I certainly don't think so. But I also realize that I am an eternal optimist. But this is a great chance. This is why these prizes are so incredible, is that they take some of these things that might be scaring people in the background about unintended consequences, like the evil dictator syndrome or whatever that may be, which I also don't agree with or I'm going to be bored or any of these things. And. And they allow us to have a public global conversation about them. We can talk about them by doing this prize. You know, bring them out, have pros and cons come to a team summit, come to a biomarker summit. We're going to have a lot of opportunities and channels to communicate and talk about this, is that, you know, we are going to have to talk about reskilling. We're going to have to talk about, you know, whether it's turnover or just new opportunities for engagement. Like, this is an opportunity that we get to have. And I think it's beautiful.

The other side of tenure and evil dictators is till death do us part in marriage. You know, institution of marriage. Was it specifically designed to last for 100 years? I don't know about that. So maybe we are going to have, as people live longer, we're going to have to have change. Right. Whether it's when you retire and Social Security and maybe marriage becomes a renewable contract and maybe tenure goes away. But you know, interesting. Overpopulation. We spoke about the issues of overpopulation. I won't hit on that again. But another is inequality. You know, is this simply for the wealthy? You mentioned this and that's not the objective.

Yeah, no, it's not the objective. But again, this is one of those, we talk about unintended consequences. This is the purpose of having a global prize, rather than have a company or group of companies sort of do this their way, right. Is that we want companies to participate, be a part of a team, be part of the conversation. And I certainly for me the goal is not to. And again, it is not an awarding criteria, but it's part of a judge consideration. As we talk about, we don't call it cost, we're talking about accessibility, right? Because even if you have a cheap drug, if it's not something that can be given and say in other sort of lower and middle income countries that might not have access to the appropriate refrigeration or the blister packs aren't quite right in order to get people can use them or the dosing schedules are too complex. So there's a lot of things that when we think about access, that's really very important. One of those considerations is cost. But I think one of the key features when we think about cost, Peters, you said it sort of two ways, right? So there's the importance is that if we get these out there, the costs will eventually come down. The next thing is that if we actually can go about this the right way and that we can actually go forward and we can get an indication. And again, whether you call aging the disease or not, that's not my dog fight, right? That's not mine. I let other people, people handle that. But the goal is still the same, is that if we can get this through, whether as a disease or a non disease indication, which the FDA is interested in driving forward, that makes health reimbursable, right? And so that automatically is going to start bringing that cost back down so that we can talk about access and delivery and if we can couple this with additional innovations and say, Peter, you and I last month we had some really interesting conversations around decentralized medication, essential medications. Is this an opportunity that we can really drive change in that area? I think one of the other key things is that when we're talking about function, we're automatically going to talk about improving the health and the lives of those who actually experience those declines perhaps earlier, either as accentuated or accelerated aging. And those are the people who really need it. Aging is essentially, it's the great equalizer. Everyone gets here eventually. Some of us might get here a little bit sooner if we make action now. And we actually can work on some of those access issues and work on the regulatory issues collectively. The idea is that we can actually create that level playing field and give innovation and innovative solutions to the populations who need them the most. This could be the great equalizer if we do it correctly and out in the open transparently and with a great global partnership.

So there you have it. Our Healthspan X prize 101 million. Actually, it's 111 million if you include the bonus prize up for grabs. Our mission is stimulate moonshot entrepreneurs. If you're not in the biotech or medical field, maybe you'll organize a team, go and find the smartest people you can pull together a team to compete for this. You know, we had some 6,000 teams pre register for Elon's hundred million dollar Carbon X Prize and then down to some 1400 registered teams. By the way, I have to tell the side story here. Why is it 101 million, not $100 million prize. It was in a conversation with Chip Wilson who put up the first 25 million and then a $10 million FSHD bonus prize and said, huh? Elon's prize is 100 million. How about we make it larger? And I said, you want to kick in an extra million? He said, sure, and it became $101 million prize. I just want to again, go to xprize.org, check out the Xprize Foundation. Go to xprize.org you can get the guidelines there. You can register as a team. You can find out what else we're doing in the XPRIZE world. For me, it's really moonshot heaven for moonshot entrepreneurs. Jamie, what else do you want to add here?

Oh my gosh. All I want to say is come join us. This is us. We're democratizing science. We're encouraging people to rethink about your relationship to aging and the community around you who is aging and that, you know, all I want is for everyone to show up, knock on our doors, actually go onto our website again. That's xprize.org, make sure you go on there. Get that intent to compete. Sign up your team if you need help or access linking up to teams. We're building that global community. Feel free to reach out. This is again, this is a Radically collaborative effort. And I am so excited to have you join me on the journey.

A pleasure. I want to thank hevolution, our largest sponsor, Chip Wilson and Solve fshd, and a myriad of individual sponsors who put in from a million to $10 million each for supporting this XPrize. For our advisors, our, our endpoints committee, the teams who have already registered to compete, we have some amazing individuals top in their fields who are part of this competition. Go and check it out. And Jamie, you and your team, you are playing all out on this and you have an amazing, amazing team.

That's right.

Actually, I think you've got an all female team, which is pretty amazing.

Not intentional, but oh my gosh, we have an incredible, like a powerhouse team of women. So I'm joined. I should have given them a shout out way earlier. In addition to the incredible folks at xprize, which has the most amazing support, prize, design advancement, partnerships, great teams, but my immediate team, I also am joined by a medical deputy, Dr. Laura Goetz. I have a senior epidemiologist and data analyst and her name is Dr. Lirens Lauren Pierpoint. And we have the amazing Dalali, which I recommend anybody who needs information or contact, she's our prize manager. If anything gets done on this prize, she is our get it done gal.

And then of course our CEO Anoushe Ansari, who funded my first XPRIZE back 23 years ago, then flew to the space station as the first private female astronaut and five years ago came back to bless us all. As CEO of the X Prize, I served as executive chairman, which means I get to be her pain in the ass and her partner. And anyway, thank everybody for listening.

She was a sell for me coming out from academia. She's my shero. I just love her.

Yeah, she ra. I love that. All right, that's it. The $101 million Healthspan X prize. Out to change the world. Excited for everybody who's gonna compete and to add 20 healthy years onto my healthspan. I'm looking forward to it. All right, everybody.

Peter, grateful for you. Thank you.

Thank you, Jamie. Take care. Now I wanna take a moment to tell you about abundance360, my year round leadership mastermind for people who wanna go big, create wealth and uplift humanity.

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Sam.