How to enhance humans

Bryan Johnson wants to live for ever. The American businessman pops a hundred pills a day, never eats after 11am, and obsessively monitors dozens of his body’s “biomarkers”. The goal, as he will tell anyone who asks, is not merely to live a few years longer. It is to vanquish death entirely.

Eccentric? Undoubtedly. But as we report this week, Mr Johnson is not alone. He is part of a growing movement that sees the human body as just another piece of hardware to be hacked, optimised and upgraded. In the name of “human enhancement” Mr Johnson and his fellows, who include Peter Thiel and Elon Musk, are exploring life extension, brain implants and drugs that enhance mind and body.

It would be easy to recoil from a project that is filled with cranks and has uncomfortable echoes of the eugenics movement of the early 20th century. But it would be a mistake to dismiss all forms of human enhancement. The idea that medicine should seek to augment the body, not just restore it to health when it goes wrong, has plenty of merit. The key to maximising the benefits and minimising the risks will be to drive out the quacks and bring this rapidly growing project into the scientific mainstream.

A wannabe superhuman has a large menu of techniques to choose from.  Adventurous biohackers can do more than pop pills. They might travel to Próspera, a lightly regulated place in Honduras founded with help from Mr Thiel. There they can have genes inserted into their cells to try to get their body to make more of a protein called follistatin. The clinic says that this will promote muscle growth and lengthen telomeres, chemical caps on the ends of chromosomes that shorten with age.  A still more drastic choice is the brain-computer interface (BCI), a device designed to pass signals directly between biological brains and silicon chips.

The human-enhancement project suffers from two related problems. The first is that it is a baffling mix of cutting-edge science and old-fashioned snake oil. Some of its ideas look genuinely promising, some are honest long shots and many are designed to fleece gullible customers of their money. The second problem is that the poor reputation this quackery produces scares off the sort of large-scale investment that could help move enhancement forward more quickly and safely. The industry is at once dangerous and short of cash.

To fix that, governments should create an environment in which rigorous trials can more easily take place. That will mean rethinking the purpose of medical regulation. For decades, regulators have concentrated on treatments that are designed to restore ill people to a baseline of health. Attempts to improve those who are already healthy, or to fight natural processes, are therefore neglected. Ageing, for instance, is not usually classified as a disease, which makes it harder to run trials designed to “treat” it. That is starting to change: American regulators recently approved a trial of metformin as an anti-ageing medicine. Reform needs to go further and faster.

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