Mastery over biology

A Paper by Jason Crawford

In the bold, ambitious future, we might cure all disease.

We are already making progress against cancer and heart disease, by far the largest causes of death in wealthy countries.⁵ Future progress against cancer might come from early detection via blood or imaging, mRNA cancer “vaccines,” improved CAR-T cell therapy, or even direct editing of cancerous DNA; for heart disease, it might come from advances in surgery, new valve replacement techniques, or drugs such as PCSK9 inhibitors and GLP-1 agonists.⁶ Better gene editing toolkits, and delivery mechanisms to get them to the right cells, might cure genetic diseases such as muscular dystrophy, cystic fibrosis, sickle-cell anemia, or Huntington’s—indeed, treatments for some of these are already approved or in development.⁷ Artificial kidneys grown from our own stem cells might replace diseased ones.⁸ We might cure, or learn how to prevent, Alzheimer’s and other neurodegenerative diseases. We might cure metabolic diseases, and end obesity. We might finally discover the formula for optimal nutrition, creating food that is both delicious and perfectly healthy, and ending the curse of junk food.

We might end pandemics. Far-UVC light might be used to kill airborne pathogens, sanitizing our air the way that chlorine and filtration sanitized our water over a century ago.⁹ Monitoring of wastewater in cities and airports could give early warning of growing threats.¹⁰ CRISPR-based gene drives could eliminate the species of mosquitoes that carry human diseases.¹¹ More ambitiously, biotech founder and sci-fi author Hannu Rajaniemi has proposed an “immune-computer interface,” a way to artificially augment our immune systems.¹² In his novel Darkome, he imagines a wearable device: a miniature mRNA synthesizer with a wi-fi connection, strapped to your arm.¹³ In this world, any time a new pathogen is detected anywhere on the planet, everyone wearing one of these devices can get the vaccine for it before it has time to spread.

We might even cure aging. We rarely think of aging as a disease; we accept it as natural and inevitable. But there is no biological reason why we have to age—why we have to lose strength and muscle mass, suffer worse fractures from weaker bones, face increased risk of cancer and infection, lose our hearing and our eyesight and our energy and our fertility. A new drug, a genetic therapy, or the right cocktail of transcription factors¹⁴ might grant everyone as many years of healthy, vigorous life as they choose.

And to be truly ambitious, we should go beyond eliminating disease, beyond simply maintaining ourselves at a normal, baseline state of health. We might enhance ourselves to levels of functioning far above baseline. We should be able to achieve exceptional strength, endurance, flexibility, and energy. We should all be as attractive as we want to be, with the body composition, skin quality, and hair that we prefer. We should all have exceptional intelligence, creativity, memory, focus, willpower, resilience, and mood. We could all be “short sleepers,” those rare genetic individuals who thrive on four hours of sleep a night; perhaps we will even learn how to eliminate the need for sleep entirely.¹⁵ Almost none of this even requires going beyond demonstrated human limits for these qualities: if we could simply bring the average person up to 99th percentile on all of these axes at once, it would make them effectively superhuman.¹⁶

Nor need we stop at optimizing ourselves. We might optimize our crops and livestock as well: for efficiency, nutrition, taste, and hardiness; for resistance to disease and pests without the need for chemicals.¹⁷ That is, assuming we have livestock in the future—we might not, if we can invent more efficient ways to produce meat, by growing it in a lab, or if someday we can synthesize all our food directly from chemicals, without needing to rely on growing entire organisms that we only eat a part of.¹⁸ We might even invent entirely new types of foods, both meat and vegetable, with undiscovered flavors never found in nature. Nor need we stop at food: bioengineering could give us new materials with novel properties or applications, such as super-strong fibers derived from spider silk.¹⁹