Longevity activism refers to public activities and advocacy directed toward the promotion of healthy longevity of the population, via advancement of biomedical science, promoting education and public health and science policy toward that purpose.
There is now an emerging international social advocacy movement dedicated to promotion of biomedical research and development to alleviate aging-related morbidity, extend healthy period of life, and improve healthy longevity for the elderly population. It is commonly referred to by the activists as the “longevity movement” or “longevity research and advocacy movement,” as well as “healthy life extension movement.” It is a “hybrid” between the aged rights advocacy, patient advocacy, and science advocacy, as it emphasizes the need to implement preventive medicine to improve health care for the elderly around the world via enhanced medical scientific research with a special focus on the mechanisms of biological aging.
To increase public awareness of the plausibility and desirability to bring the processes of aging under medical control, thus extending healthy human life span, delaying the manifestation of age-related diseases, and improving health in the older age
To foster the improvement of the local and global legislation concerning health across the life course, aging, health and well-being of the elderly, and medical research with a special focus on the mechanisms of aging
To allocate more public funding to fundamental and translational research on the mechanisms of aging and age-related diseases
To increase the interest of the investment industry in supporting biotechnology companies developing innovative drugs and therapies targeting the underlying mechanisms of aging and thus able to prevent, delay, or cure age-related diseases
To promote clinical implementation of the evidence-based medical and lifestyle means to extend healthy human life span
The movement embraces the recent advances of biomedical science proving the possibility to intervene into the degenerative processes of aging to slow down, delay, prevent, and reverse age-related damage accumulation (de Grey et al. 2001; López-Otín et al. 2013) and seeks to enhance and accelerate such advances. The movement is still young and emerging and is not yet strongly related to other forms of health-care advocacy. But a stronger relation is hoped for.
The variety of the longevity movement’s goals is one of the reasons of its heterogeneity. The movement is also not well organized or coordinated. Many groups are united by the idea of the need to improve healthy longevity thanks to increasing biomedical research in the field of aging and aging-related diseases. Some groups emphasize that the education of the public is crucial and that the resources of the movement should be used to run large-scale information campaigns. Another direction of activism focuses on and advocates for the promotion of clinical trials (institutional or patient-organized) of the most promising medical and lifestyle interventions targeting the mechanisms of aging. But the actions of each group and even of each individual activist in the movement are mostly independent and autonomous, conditional on the context and possibilities at hand. The actions may include content creation (publications, movies, video recordings, and lectures), meetings and public events, street actions, social media promotions, participation in the public discussions of local legislation, schools for journalists and collaborations with the media, support of particular research projects, and also fundraising, sometimes involving “crowdfunding” and “crowd-sourcing.”
Researchers of aging and longevity (geneticists, biologists, gerontologists, physiologists, dietologists, demographers, etc.)
Experts in investment (VCs, angel investors, family and private funds, representatives of biotechnology accelerators)
Medical specialists (general practitioners, geriatricians, oncologists, cardiologists, neurologists, endocrinologists, nurses, etc.)
Public health experts, representatives of patient organizations
Longevity advocates (members of advocacy organizations and individual activists that can be full-timers, part-timers, or volunteers)
Early adopters (adherents of putative longevity-promoting lifestyle and other health and therapeutic regimens)
Longevity supporters (people who are not taking part in advocacy activities but who are following the news on aging research and express interest and support)
Lately, there have been efforts to capture the landscape of the longevity movement in several reports, position papers, and roadmaps, illustrating the extensive growth of the movement (Longevity International 2018).
The Main Achievements of the Longevity Movement in the Recent Years
Even though still relatively recent, the longevity movement has already achieved significant milestones in terms of public outreach, dissemination, and adoption of its goals.
International Policies on Aging
The effort to emphasize the need to strengthen biomedical research of aging was undertaken at the WHO Consultation on the Global Strategy and Action Plan on Aging and Health (GSAP) in October 2015 (World Health Organization 2015).
In November 2017, the WHO published a draft of its 13th Work Programme, which did not include propositions that would address the problems emerging due to population aging. The longevity advocacy organizations, such as the International Society on Aging and Disease, International Federation on Aging, International Association of Gerontology and Geriatrics, Vetek (Seniority) Association, Life Extension Advocacy Foundation, International Longevity Alliance (ILA), Biogerontology Research Foundation (BGRF), and others, formed a coalition (Stambler et al. 2018) that took part in the public consultation on the Work Programme to promote a number of improvements. Two of the most important changes achieved were the introduction into the WHO Work Programme of healthy life expectancy as a way to measure the effectiveness of public health programs and the commitment to implement the activities included in the WHO Global Strategy and Action Plan on Ageing and Health, which include a call for enhanced clinical research on the etiology of and treatments for age-related diseases and conditions (World Health Organization 2018).
Another significant project of the movement is the introduction of the special extension code “Ageing-related” into the ICD-11 (The L.D.E. 2018). The proposed code, jointly developed by the experts of BGRF, ILA, and the Council for Public Health and the Problems of Demography (CPHD), can be used for relevant conditions listed in ICD-11 as well as applied to newly recognized conditions in the future. ICD codes are mandatory for the registration of all new drugs and therapies, and the recognition of aging as a pathogenic process is a big step forward in removing the regulatory obstacles and promoting the development of interventions targeting aging and age-related diseases.
Local Policies on Aging
The goal of increasing governmental support and public funding for fundamental and translational research on the mechanisms of aging and age-related diseases is not easy to achieve, first of all, because the process of lobbying the related changes to the local legislation requires participation and active support of multiple stakeholders, each of which has to be properly informed.
Several higher-level advocacy initiatives were undertaken, such as the “Longevity Dividend” initiative in the USA, since around 2006 (Olshansky et al. 2006) and the ongoing efforts to lobby for biomedical aging research in the US congress.
In Israel, there have been persistent advocacy efforts to emphasize the importance of enhancing biomedical research of aging to improve healthy longevity for the population. The advocacy for the “Law Proposal for the Establishment of the National Advisory Committee for the Promotion of Longevity and Quality of Life for the Elderly Population” in Israel has been ongoing since July 2012. Several national conferences entitled “Pathways to Healthy Longevity” were held since 2013. With a strong contribution from such efforts, there have been issued governmental calls for research proposals specifically addressing this issue, such as the Israel Ministry of Science and Technology’s program to enhance the scientific and technological infrastructure for the elderly (since 2014), the Britain-Israel Research and Academic Exchange Partnership on Ageing – BIRAX Ageing in 2018, the Prime Minister’s Innovation Prize with a focus on medical technologies for healthy aging in 2018, and others. As a part of preparation of the Knesset National Masterplan on Aging, a special section was proposed for “Enhancing the research, development, and education for the promotion of healthy longevity and prevention of aging-related diseases” in 2018. Organizations like Vetek (Seniority) – the Movement for Longevity and Quality of Life, Israeli Longevity Alliance, and Disabled Not Half a Person – have been at the forefront of longevity advocacy in Israel (Vetek 2019).
In 2015 in Russia, the experts from CPHD took part in the preparation of the State Strategy of Action in the Interest of the Older Generation. Their participation allowed to include several propositions promoting research on the mechanisms of aging and age-related diseases and public education programs about the potential and advances of gerontology and geriatrics.
In 2016, there took place the initiatives by the American Federation for Aging Research (AFAR), Alliance for Aging Research (AAR), and Global Health Policy Institute (GHPI) to support the organization of the clinical trial of metformin, a promising geroprotective drug, for the FDA-approved study entitled “Targeting Aging with Metformin: TAME” (Hall 2015; Newman et al. 2016). Metformin was one of the very first drugs that was found to positively affect human life span (Bannister et al. 2014). However, the absence of explicit regulatory frameworks to recognize degenerative aging as a diagnosable and treatable medical condition (Stambler 2017a) represents a barrier for testing such interventions with the aim of a healthy life extension. The success of the campaign in support of TAME set a precedent for more clinical trials of interventions targeting the mechanisms of aging to prevent, postpone, and eventually cure age-related diseases.
Education and Outreach Programs
Longevity advocacy organizations are educating the public by generating and spreading the educational content (articles, interviews, explanatory videos, recorded webinars, talks and streams, educational games). There are several niche newsmakers covering aging and longevity research (with different ranges of outreach): Lifespan.io, FightAging, LongLongLife, Longevity Reporter, Longevity Technologies, Geroscience, LongevityForAll, and others. Most of longevity advocacy organizations have their own monthly newsletter with a rather modest following. There are several websites that work as scientific encyclopedias focused on aging and longevity research, for instance, the Russian project Nestarenie.ru and Senescence.info in the UK.
The community is promoting its ideas through different events that range from completely scientific in nature to edutainment and entertainment. Several significant conferences with a strong focus on promoting the development of biotechnologies to bring aging under medical control included Undoing Aging (jointly organized by SENS Research Foundation and Forever Healthy Foundation in Berlin, Germany), Genetics of Aging and Longevity (traditionally organized in Russia), the International Conference on Aging and Disease of the International Society on Aging and Disease (held since 2014 in China, the USA, and France), Eurosymposium on Healthy Ageing (organized by Healthy Life Extension Society – HEALES – in Brussels, Belgium), Ending Age-Related Diseases (organized by Lifespan.io in New York City, USA), and many others.
Even though the projects of longevity activists are mostly autonomous, several concerted international actions, dedicated to the promotion of biomedical and biological research of aging and longevity, have been undertaken by various groups of advocates. The method of organization is usually via personal contacts and joint consultations of longevity research activists, as well as public calls to actions. The importance of taking personal responsibility for the organization and personal contacts cannot be overestimated.
Some of the concerted actions, involving longevity activists groups from several countries, included the “Future of Longevity” campaign around the “Future Day” on March 1, 2013, and the “Metchnikoff Day” – around May 15, 2015 – in honor of the anniversary of the founder of gerontology, Elie Metchnikoff. Yet, perhaps the most successful and wide-reaching is the so-called “International Longevity Day” campaign, which has been organized since 2013, around October 1 – the UN “International Day of Older Persons.” Perhaps unintentionally, “the day of older persons” may appear value-neutral and indifferent toward the “older persons,” while the “longevity day” celebrating and aspiring to healthy longevity for all may be more uplifting. Yet, as this is the officially recognized “UN International Day of Older Persons,” this has provided the longevity research activists a good opportunity to emphasize the importance of aging and longevity research for the development of effective health care for the elderly, in the wide public as well as among decision-makers. In 2013, events during or around that day – ranging from small meetings of friends to seminars and rather large conferences, alongside special publications, distributions of outreach materials (petitions and flyers), and media appearances – were held in over 30 countries, in 2014 in over 20 countries, and in 2015 in over 40 countries (Longevity for All 2018).
Diverse educational and promotional materials have been created by longevity activists and included in discussions, distributions, and promotions. Among many other resources, the position paper by the International Society on Aging and Disease (ISOAD) on the “Critical need to promote research of aging and aging-related diseases to improve health and longevity of the elderly population” briefly describes the rationales, technologies, and policies needed to promote this research (Jin et al. 2015). The position paper has been translated by activists and is now available in 12 languages: with full texts in 9 languages and partial translations in 3 more languages. It has served as a “universal advocacy paper” both for the grassroots discussions and promotions and for the outreach to officials in several countries. Also, some frequently asked questions and topics of discussion on longevity research promotion, regarding both scientific and social aspects, have been summarized (Stambler 2017b).
Several groups of scientists have published position papers and manifestos, with different emphases, yet united by the appeal to enhance biomedical research of aging to enable treating the root causes of aging-related ill health (Olshansky et al. 2006; Rae et al. 2010; Goldman et al. 2013; Fontana et al. 2014; Anisimov and Sidorenko 2018).
Factors Influencing Public Support for Longevity Extension
One of the main reasons why the idea to target the mechanisms of aging in order to prevent, delay, or cure age-related damage is not yet widely accepted is its relative novelty. Even though the coverage of aging research in mass media is increasing over time, surveys show that only a small share of population in the developed countries is aware of the scientific advances in this field. This is the reason why most longevity advocacy groups put a significant effort into outreach and education programs.
The communication of this idea, however, requires a thoughtful approach, as it can be accepted or rejected depending solely on the framing and specific words used by the activist.
If asking people how long they would like to live, most of them will likely add a few years to the current life expectancy in a given country, while the number of people expressing the desire for a significantly longer life will be very small. Yet, when the question is formulated differently and implies longevity achieved through the extension of a healthy and productive period of life, around one third of participants express the desire to extend their lives by several decades or even several times compared to a normal human life (Smol’kin et al. 2018). The desirability of radical life extension is estimated to range from 32% to 79% of the participants (Donner et al. 2016), and the main predictor of support is the general interest in science (Dragojlovic 2013).
Particular words and expressions have to be avoided as they are interpreted by the general public in a wrong way. Paradoxically, “longevity” and “life extension” seem to be interpreted as the extension of life in older ages with a respective ill health. The fear of the extension of an unhealthy period of life is so strong that it tops the list of longevity-related concerns even if the survey is focused on the attitude to the extension of healthy life span (Partridge et al. 2009). The possibility to enhance humans with innovative medical technologies is provoking rejection, while the usage of the same technologies to cure diseases is found acceptable (Partridge et al. 2011). The notion of immortality, which is often brought to the table by longevity activists when the possibility to bring aging under medical control is discussed, can also provoke repulsion, because the pop culture most often depicts the immortals as morally inferior, cruel, and insane (Underwood 2014).
Choosing the message is a difficult task for an advocate, and even if the explanation is successful, there is a number of concerns that usually emerge and have to be addressed before the audience will turn into supporters. The main concerns found in the surveys are inequality, burden on social and health-care systems, burden on the environment, etc. (Partridge et al. 2009). As some of these concerns, like inequality, stem from the existing socioeconomic issues, they can be difficult to deal with. A study performed in Russia in 2015 found that avoiding deviations from the discussion of health improvement by the interventions targeting aging can make the overall discussion more productive (Smol’kin et al. 2018).
As has been exemplified above, diverse longevity advocacy-related actions have been intensifying around the world. The actions can be scaled to almost any dimensions, from a local meeting of friends to international campaigns. The main message of these actions is rather simple: “Increase support for biomedical research of aging to improve healthy longevity.” The main message implies the realization that biomedical interventions into degenerative aging processes can provide the best foundations for combating aging-related ill health at its root and thus for attaining healthy longevity. Yet, not enough is known about these processes and their countermeasures to provide truly effective means of combat. Hence “More Research is Needed!” This simple realization and the wish to induce this realization in others have proven to give enough motivation for longevity research activists to step up to participate in actions, study groups, and campaigns. It should be noted that the vast majority of the groups and activities so far have been entirely voluntary.
Despite their still rather limited extents, such actions may be considered as exercises for the longevity movement building. They provide a demonstration that massive grassroots actions for biomedical research of aging are possible. Yet, much remains to be aspired to even begin to think of approaching the level of public involvement and influence that has been achieved by the campaigns of other movements, such as the “green movement,” or other forms of health advocacy. The activists often express the hope that this fledging movement will gradually approach such levels and become a truly integral and involved part of the global health movement. The recent successes in reaching out to and influencing both international and national public opinion and policy frameworks attest to the growing strength of the movement and the potential for the realization of its goals.
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