gohome scenario of the future

In 2005 the Institute for Alternative Futures (IAF) published a report on The 2029 Project: Achieving an Ethical Future for Biomedical R&D. Based on interviews with dozens of scientists, the report provides a preview of the greatest advances coming through biomedical R&D until the year 2029. Interestingly the study has been supported financially and intellectually by Pfizer, the largest pharmaceutical company in the world. The complete report can be found on the IAF web site.

I think this is a fascinating study, not because all predictions are right or even attractive, but because it looks over the borders of technology to ethics, collaboration, and perspectives on disease and health. I see this study as a signal of a shift in thinking, a shift that deserves much more attention and discussion. Also the developments and ideals that are being described, are worthwhile to discuss, because they concern everyone and reflect — despite the futuristic content — not science fiction but reality.

From the executive summary of the report

The report forecasts that a wide array of achievements in science will be enabled by an ethical evolution. After scanning the scientific literature, interviewing dozens of scientists and holding meetings focused on 2029, IAF anticipates a culture change. An emerging ethical concern for global health will create the context for medical science to realize its full potential, which will culminate in a Health Advocate Avatar.
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Health Advocate Avatar

Basically the Avatar is a knowledge interface that can mediate interactions between individuals and the world of medical knowledge. The Health Advocate Avatar is envisioned as a secure and discreet agent for the individual that also represents a highly ethical learning technology for collective knowledge. A variety of developments and new technologies will be required to provide components for the Avatar, including natural language search engines, truly effective voice recognition, haptic devices and high resolution displays. The Avatar is envisioned to be a coach, educator and health manager that draws on the experience of large populations. The Avatar can provide individuals with control and personalized advice while serving health worldwide. More than just a technological wonder, the Avatar is an ethical development that can facilitate the health of both individuals and society.

Four Timelines

The promise of the Health Advocate Avatar is supported by a large number of forecasts IAF arrayed along four timelines. They anticipate short term (2005-2010), mid term (2011-2020) and long term (2021-2029) developments in biomedical R&D. Each timeline is thematically distinct, yet they flow together to offer patterns of opportunity that the Avatar can synthesize into a growing capability to achieve health. The four timelines are:
1. Turning Data into Information, Knowledge and Wisdom
Knowledge is power, and more people will gain access to this power. Over the next five years, the flood of data from genetics, proteomics and electronic medical records will be converted into an overwhelming amount of health information. Scientists will use new knowledge tools, such as intelligent agents, to create the context that converts this information into knowledge. By the mid-term the accelerating spread of knowledge will include biomarkers that illuminate cellular pathways. Systems biology will take these pathways into new assessments of individual health potential based on signals of pre-disease. By the 2020s, a prognostic system will emerge and begin to replace the diagnostic systems of the past. Remarkable knowledge tools, such as immersive interactive environments and virtual brains will support the creation and dissemination of knowledge. By 2029 more people will be looking beyond knowledge and asking how to create wisdom.

2. The Union between East and West
Wisdom can arise from different cultures that will bring their particular gifts together in the decades ahead. Over the next five years Eastern philosophies and practices will be further adopted in the West, complemented by a growing base of Asian scientists bringing their worldview to biomedical R&D. By 2020, this combined knowledge will merge science and ancient beliefs into a new understanding of health that recognizes subtle effects, chaos theory and energy fields. At all levels prevention will become the favored intervention, with predisease displacing disease as the focal point for research. Death will become another focal point, bringing the idea of spiritual health to the fore. By 2029, systems biology with advanced models and simulations will fuse with Eastern philosophies to achieve a unifying theory of biology no less significant than the breakthroughs in physics of the early 20th century.

3. Moving Beyond Boundaries
Learning will accelerate worldwide over the next twenty-four years as networks grow across such divisions as country, sector, institution and discipline. By 2010, boundaries will blur as open source networks rapidly create and spread knowledge. Fed by a major short-term success against malaria, grid communities and distributed research projects will help open source science create continuous risk assessment for individuals, families and communities. By 2029, complete connectivity between researchers and patients who actively collaborate in science will reinforce a global ethic. The political impact of this ethic will be clear in new intellectual property rules negotiated to speed innovation and diffusion. Biomedical R&D will serve the poor as well as the rich, worldwide. Healthcare can be fully personalized by 2029 to achieve gains in individual and population health that will also create greater wealth.

4. Shift from Disease to Health Potential
When more disease can be prevented, interest will grow in how health can be created. The shift starts in the near term with regulators accepting the validity of surrogate markers and suites of biomarkers that individuals will use for continuous risk monitoring. As more people learn to interpret biological signals, prevention will take center stage. A low-dose combination therapy will prove successful against heart disease by 2010. This success will lead to a “predict and prevent” approach that fosters global learning cooperatives as people with shared risk factors pool their knowledge. By 2020, risk research will identify indicators for families, communities and societies showing their health potential. Healthy communities will grow in number, and will focus on the role of compassion in creating health. The global health agenda created by these healthy communities will be supported by science and ethics.


The report goes on to review expected and possible developments in medical, technological and ethical areas. At the end seven steps are defined to promote the most ethical advances from biomedical R&D, expand knowledge of health and disease, and improve health for everyone.

Acknowledgement

Institute for Alternative Futures, The 2029 Project: Achieving an Ethical Future in Biomedical R&D.
Alexandria, Virginia, 2005, © the Institute for Alternative Futures.
http://www.altfutures.com.
Used with permission.
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