Preface

An algorithm led Packt to me in January 2019.

This was life Before COVID (BC). I got a message on LinkedIn: "Would you author a book on health tech? It would be something looking at AI in the NHS, and maybe the AI hospital."

Like many people who use LinkedIn, I get a lot of messages from people I don't know. This was one of them and I thought it was harmless spam. I whizzed back a slightly flippant message:

"Thanks for the idea but probably not for me right now as just too busy!"

Well, after a few more exchanges, I realized it was a serious approach by a leading international tech publisher. Within a week, we had agreed terms. And that was the same week I was invited to 10 Downing Street for breakfast, to talk about the Ageing Society Grand Challenge with the Secretary of State for Health and Care (for non-Brits, Number 10 is where the UK Prime Minister lives). Two days before that, I had published my first article on Forbes.com: 'Longevity' Could Reach Billions In 2019 - And Is No Longer Just The Preserve of Billionaires.

Fast-forward to April 2020—at the height of the global COVID-19 pandemic. We put a freeze on the book's publication because it wasn't right to talk about living longer when the entire world was grappling with how to deal with the worst public health crisis in our lifetime.

We are now living and experiencing this murky, strange period of a patchwork "new normal." We have moved from BC, but have absolutely no idea when we will reach After the Disease (AD). COVID-19 has changed everything: our lives, our plans, our hopes, and our future. And there is still no end in sight.

But we are learning a huge number of lessons that will form part of an enduring legacy AD. For one thing, the pandemic has brought renewed attention to how humanity's destruction of biodiversity may have created the conditions for new viruses and diseases such as COVID-19. The discipline of "planetary health," the intricate and finely balanced ecosystem of humans and all other living things, has been put into the limelight.

I have tried to capture some of the lessons we're learning in the pages ahead.

So, first, back to January 2019. How did this algorithm identify me? What criteria was it using? Was it using the right criteria?

After the algorithm found me, a human being did, of course, check me out before approaching me. The one thing everyone should know about algorithms is that, for now, they are only as good as the data they draw from, and the rules that humans set (at least until AGI—artificial general intelligence—hits us; that is, when machines take over what humans do. But that's still a little way off. More on this later).

On the face of it, I am hardly an "AI expert" at a technical level. I speak to many who are, and certainly now have enough experience to know when so-called "AI experts" really have no clue at all (knowing what you don't know is a very underrated skill, but I use it all the time!). What I am becoming an expert in is how AI will affect society and drive change.

As you will see in this book, artificial intelligence is influencing, and indeed driving, far more things in our lives than most of us realize. And technology is moving fast, and far faster than many C-suite industry executives, think tank leaders, or policymakers realize.

But the entrepreneurs and the scientists do realize it. I spend a lot of time with these people. And it is thanks to them and their knowledge that I find myself in the privileged position of writing this book. I've interviewed some of them, but I didn't interview the two people I'm about to mention. Without them, I would not have been found by that algorithm over a year ago.

Melissa Ream is the first one. She is an AI and digital expert in healthcare, and that's why I asked her to help me with this book. She gave me my first big opportunity to work in AI—with the Academic Health Science Network AI program, then with the Department of Health and Care and NHS England, and more recently with NHSX, helping to build the UK's AI ecosystem for health. I talk about this in Chapter 4, Moving Sickcare to Well-being, Through Prevention.

Eric Kihlstrom is the second one. We met about five years ago and we've collaborated on many projects involving our shared interests in data innovation and longevity. He invited me to help build an ecosystem of "unusual suspects," companies to come together in transformational bids for the Healthy Ageing Industrial Strategy Challenge Fund (backed with £98 million of government money), when he was interim director for the fund at Innovate UK.

There is a famous quote (that Eric uses a lot!) by the writer William Gibson: "The future is already here—it's just not very evenly distributed."

The future is definitely not evenly distributed at the moment.

In many ways, prosperity in the Western world has become more accessible to wider sections of society, with better cars, better-quality housing, and high-quality healthcare. Consumer technology has become ubiquitous, and many of the most deprived people in both the developed and developing world have a smartphone. However, we have seen rather alarmingly that despite growing economies and the many developments in science, technology, and medicine, life expectancies have been dropping in the USA and stalling in the UK. Inequalities in health are increasing.

Something is going wrong. And it has to do with inequality, the uneven, unfair ways we are sharing the benefits of the future. The COVID-19 pandemic has brutally exposed this.

I was invited to speak at a recent event run by the UK chapter of Singularity University, a hotbed of exponential thinking in California. I imagine many attendees expected me to speak about how science is getting us a step closer to achieving immortality, but I started with a question—why aren't we fixing this problem of health inequality? How can we share the benefits of longevity democratically, so that we can all benefit from the "longevity dividend?"

Why is it that the treatment we receive in hospitals (accounting for a mere 10% of what keeps us healthy) gets the most attention and budget, when it is the 90% of the other determinants of our health (including the environment, genomics, and socio-economic factors) that matter far more?

This conundrum is what I have been trying to unpack with many experts in The Health of the Nation: A Strategy for Healthier Longer Lives, a strategy we created on behalf of the All-Party Parliamentary Group for Longevity. The strategy was published in February 2020 with proposed actions on how all UK citizens can gain five extra years of healthy life expectancy by 2035, while minimizing health inequalities between the richest and poorest. This goal is part of the current government's manifesto but was initially drawn up by Theresa May, the former prime minister, in 2018. May's deputy prime minister at the time was Damian Green. Damian, who is still an MP, chairs the All-Party Parliamentary Group for Longevity, which is now getting international attention. There is so much to thank him for in terms of his hard work in getting the Health of the Nation strategy to where it is now.

Many of those involved in the strategy have been interviewed for this book. But this strategy would not have been possible without the extraordinary expertise and energy of Lord Geoffrey Filkin CBE, who, among his many other accomplishments, set up the Centre for Ageing Better. Together, Geoff and I have led the strategy, and it has been a terrific partnership of social entrepreneurship since we first spoke in March 2019.

The strategy is focused on closing the health inequality gap. When we emerge from COVID-19's massive impact on society and the economy, the priorities and recommendations we have set out will only become more urgent and more pressing. And with all the work I have been doing in AI, data, healthy aging, and now in longevity, one key thing keeps coming up over and over again: our citizens.

The public will shape the future. Ordinary people need to be brought more into the debate on how technology could be more powerfully deployed as a force for good, to cope far better when the next pandemic hits, and until then, to help us live longer better. We all need to participate in decisions that could ultimately shape a better society—at all levels—whether individually for personal reasons, at a community level for civic duty, or through votes at a national level. And I think we need a societal system more focused on social capital, on the value of human contribution.

We also need to scale solutions at an international level. That's especially true when it comes to sharing knowledge in science and harnessing data, but also to learn what is working best to engage communities, prevent ill health, and care for our most vulnerable.

At the time of writing, Ipsos Mori published a poll showing that scientists are the most trusted profession in the world (politicians come last). It is no surprise that politicians have insisted on being "guided by the science" during this devastating pandemic.

It is clear we need to involve scientists in decisions affecting our future. And there seems to be an appetite for it. A public program I ran before the pandemic on the science of aging for How To Academy was a sell-out, and had to move to a bigger venue. I invited four leading scientists (two of whom were interviewed for this book) to speak and the audience couldn't have been more mixed (as were the questions asked afterwards)—young students, middle aged, and older people—all interested and curious to know more.

My curiosity about science began as early as I can remember in childhood, when I first started asking the questions most kids ask, like "where do we come from?" This curiosity propelled me to Cornell University, where I studied genetics at the time that the Human Genome Project was first being conceived—30 years ago. Now in my mid-50s, I am starting to ask many more questions about how we can harness science to help us live a good life, not just from the beginning, but right through to the very end, aided by technology that was unimaginable just a few years ago.

So, starting with the science of "our beginning," let's start answering some of those questions.

Get in touch with Packt

Feedback from our readers is always welcome.

General feedback: Email [email protected], and mention the book's title in the subject of your message. If you have questions about any aspect of this book, please email us at [email protected].

Errata: Although we have taken every care to ensure the accuracy of our content, mistakes do happen. If you have found a mistake in this book, we would be grateful if you would report this to us. Please visit http://www.packtpub.com/submit-errata, selecting your book, clicking on the Errata Submission Form link, and entering the details.

Piracy: If you come across any illegal copies of our works in any form on the Internet, we would be grateful if you would provide us with the location address or website name. Please contact us at [email protected] with a link to the material.

If you are interested in becoming an author: If there is a topic that you have expertise in and you are interested in either writing or contributing to a book, please visit http://authors.packtpub.com.

Reviews

Please leave a review. Once you have read and used this book, why not leave a review on the site that you purchased it from? Potential readers can then see and use your unbiased opinion to make purchase decisions, we at Packt can understand what you think about our products, and our authors can see your feedback on their book. Thank you!

For more information about Packt, please visit packtpub.com.