With contributions from James Smith, a recent Oxford University graduate and current SENS Research Foundation Summer Scholar working at the Harvard Stem Cell Institute.
Assume a single bacterium weighs one thousand billionth of a gram. If it, and each of its progeny, divides once every 20 minutes then the population will reach approximately 4000 times the mass of the earth in two days. Such is the power of exponential change.
In 1976, the first digital camera was invented. It could capture images at a resolution of 0.01 mega pixels, it weighed nearly 4lbs and cost around $10,000. In 2014, a digital camera with more than 10 mega pixels weighs 0.03lbs and can cost as little is $10. Trends like this are a result of exponential improvement in technology, described by Moore’s law. It explains how vast numbers of technologies can now be combined into a single portable device (your mobile) that 20 years ago would have required several large suitcases and considerable physical stamina to transport. Understanding exponential change and its role in technology formed a large portion of the keynote speech by Peter Diamandis on the final day of the Rejuvenation Biotechnology conference (read earlier blogs here and here).
Figure 1: Linear growth is steady, exponential growth becomes explosive (http://www.thethirdsource.org)
One might, and Diamandis does, consider exponential change as an empowering force; it allows paradigm shifting technologies to rapidly advance and overtake current platforms. Think Facebook, YouTube, WhatsApp, Dropbox. All went from idea to billion-dollar company in a matter of years. Can the same occur in the cell therapy industry?
In another panel session, Bob Clay, Chief Regulatory Officer at Kinapse, noted that in the last 40 years, approximately 30 new drugs have been approved each year by the FDA. This linear change seems to be in stark contrast with that discussed above. But the above picture is incomplete – eventually change must plateau as some theoretical maximum is reached.
With health care, this maximum might be an entirely disease-free population. As we get closer to the limit – as we certainly are – it inevitably becomes more difficult to produce innovations that cause significant change. As an example, small pox has been eradicated entirely. Therefore, there is one less space in which innovation can take place.
It should be clear from this that a great potential to achieve the desired exponential change occurs if we change the theoretical limit. Cell therapy could be a tool that allows us to do this. It permits thinking about medicine in an entirely different way, thus providing new avenues through which change can take place. Lab-grown organs are one example. Before the advent of regenerative medicine, this potential path for medical innovation and intervention did not exist.
One might counter that cell therapy as an industry seems to be advancing slowly. However, the industry is young, and it may be that we have simply not yet reached the ‘knee’ of the exponential curve. If technology does indeed increase explosively, then a comparable explosion in the need for translational research will emerge. Medical innovation, unlike technological innovation, requires stringent tests of safety and efficacy. Addressing this need could allow us to match exponential technological advances with exponential patient benefit.
The picture for cell therapy is not, we think, as simple as might be hoped. But the potential to fundamentally change the limitations of medicine and open new avenues for explosive growth to occur are promising and real.
For health, the challenge will be to rapidly translate new technologies into patient outcomes. For industry, enabling this translation will be critical to commercial success. The interests of both are closely aligned.
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