Raphael Thys
Welcome back to the "Life in 2050" series. In previous installments, we looked at how technological advancements, climate change, and changes in the geopolitical landscape will alter the nature of warfare, economics, living at home, education, transportation, and space exploration (in two installments) in the coming decades.
Today, we will look at how these same changes and advancements will revolutionize medicine by the middle of this century. As with all the other aspects of life we've explored, this revolution is already well underway, but will accelerate dramatically as we get closer to 2050. This will present new opportunities for healthier living, but also new hazards.
While it is safe to say that more people will be able to live longer, healthier lives in the future, it's also likely that future generations will face health threats that are less common, or even unknown, today. To break it down, the field of medicine will be impacted by developments in the five following categories:
- Big data, biometrics, and the internet of things
- Machine learning, AI, and advanced analytics
- Climate change and environmental health hazards
- "Internals," robotics, nanorobotics, and bionics
- Genetic engineering and bioprinting
Big data & personalized health care
"If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." These words were uttered by Hippocrates, one of the most influential figures in the field of medicine. Today, this reasoning is the very foundation of self-care and health monitoring, something that is getting easier with time.
This is due in no small part to the explosion in wearable technology, coupled with the growth of wireless internet connections. From apps on your smartphone to fitness tracking devices, people are able to measure their heart rate, blood pressure, eating habits, the number of calories they've burned, and the number of steps they've taken in a day.
By mid-century, this trend will have become the norm for most of the world as internet access becomes near-universal. According to a 2018 report by the UN's International Telecommunication Union (ITU), 90% of the world's population (estimated to be 9.73 billion people in 2050) will have access to internet services by 2050, whereas somewhere over 4 billion people have access today (out of an estimated 7.9 billion).
In addition to more than four billion new users, the number of wireless devices connected to the internet will increase exponentially by 2050. Between 2016 and 2021, the number of devices connected to a wireless local area network (WLAN) rose from 8.36 to 22.2 billion (or by 265%). By mid-century, this number is projected to reach over 100 billion.
Combined with the hundreds of billions of cameras, sensors, homes, and entire cities that will be connected, the resulting explosion in data will create what is known as the "Internet of Things." The resulting amount of data produced on a daily basis will be enormous, and a sizeable portion will be medical in nature.
In future "smart homes," all of this data will be at a person's fingertips. As soon as they wake up, health diagnostics and/or recommendations will be available. People will be told how they are doing in terms of achieving or maintaining certain health goals. And if there's a problem, they will be alerted and told to notify their doctor immediately — or perhaps, their doctor will be automatically notified.
AI-assisted medicine
With the massive volumes of medical data health authorities and practitioners will have to contend with, advanced analytics and machine learning (aka. AI) will be relied on to monitor it all. On the more localized end of things, AIs will be used to analyze patient data for signs of possible health conditions and predict future ones.
This will give health care practitioners the ability to detect problems in advance and diagnose cases with greater speed and efficiency (and with less risk of misdiagnosis). Patient histories will also be much more up-to-date and detailed, and real-time patient monitoring will be readily available for the elderly and people who are at-risk for stroke, heart attack, etc.
On the macro end of things, AIs will also be responsible for analyzing worldwide health patterns to track pandemics and the spread of disease. The ability to track disease vectors and anticipate mutations in existing viruses will be all the more important as climate change leads to an increase in the spread of deadly viruses worldwide.
Last, but hardly least, AI-assisted research will lead to the development of new treatments and cures for diseases. Ordinarily, producing new drugs and vaccines is a cost-intensive and time-consuming process that involves a lot of experimentation, which is why major pharmaceutical companies are already turning to AI platforms to aid in drug discovery.
As these platforms become more sophisticated and advanced, the development process will become much more rapid and cost-effective. Even before 2050 arrives, vaccines for HIV, some types of cancer, and malaria are expected, meaning they could be joining smallpox on the list of eradicated diseases.
More lives & living longer
Beyond the eradication of diseases, health will also improve by mid-century in two profound ways. On the one hand, increased access to medical services in the developing world will result in a substantial drop in the rate of infant mortality and in the number of women who die during childbirth. Meanwhile, longevity treatments in the developed world will allow people to live longer, healthier lives.
Between 1990 and 2019, the number of children who died before they reached age five dropped by 59%, going from 93 deaths per 1,000 live births in 1990 to 38 in 1,000 by 2019. Much of this was due to improved access to health care and basic services in the developing world, where infant mortality dropped from 1 in 10 (10%) to 1 in 20 (less than 5%) between 1990 and 2015.
By 2030, the average rate of infant mortality worldwide is projected to reach 2%. While this trend is expected to continue, improvements in medical care and increased access will have to contend with emerging health threats caused by climate change (more on that below). Meanwhile, life expectancy will increase in the developed world thanks to treatments that delay and reverse aging.
As of 2019, the average life expectancy worldwide was 72.6 years, representing a two-fold increase since 1900. By 2050, that could increase to 115 years or longer for people with access to premium medical care. Aside from personalized medicine and improved data analysis, a major driver will be the development of nanorobotics (more on that below).
In the normal aging process, repetitive nucleotide sequences at the ends of linear chromosomes (called "telomeres") shorten over time. This eventually results in cell damage and death (aka. aging) and the onset of age-related diseases. But with machines small enough to access chromosomes, telomeres could be lengthened periodically, to slow aging down and extend a person's life.
There are those who believe that these types of medical procedures will allow for clinical immortality, where human beings can prolong their lives indefinitely through medical intervention. While this may be a farfetched notion, by 2050 the combination of advanced medicine, bionics, and other advances is likely to increase average life expectancies around the world.
Environmental threats
Between now and 2050, one of the greatest threats facing the global population is the way climate change will affect the social and environmental determinants of health. These include air quality, drinking water, food security, and shelter, all of which will be compromised to an extent by increases in global temperature, flooding, extreme weather, and drought.
For starters, rising temperatures will lead to an increased risk of diseases like Lyme disease, Zika, West Nile, Ebola, dengue fever, and other warm-weather viruses spreading to cooler regions of the world. Similarly, the growth of cities and urban populations will mean an increased risk of respiratory and cardiovascular disease.
According to "World Population Prospects 2019," a report compiled by the UN Department of Economic and Social Affairs, by 2050 about 68% of the world's population (6.6 billion people) will live in urban areas (compared to 55% today). With increases in temperature, disease, resource depletion, and rising sea levels, people in urban centers will be subject to multiple health hazards.
"In urban areas climate change is projected to increase risks for people, assets, economies, and ecosystems, including risks from heat stress, storms, and extreme precipitation, inland and coastal flooding, landslides, air pollution, drought, water scarcity, sea-level rise and storm surges (very high confidence). These risks are amplified for those lacking essential infrastructure and services or living in exposed areas."
In rural areas, increased drought, extreme weather, and disease will have a major impact on food security and the agricultural industry. All told, the vulnerable populations will include those living on small islands, coastal regions, megacities, and in mountainous and polar regions. However, the most vulnerable people will be those in the developing world, particularly children and the elderly.
In fact, the WHO anticipates that between 2030 and 2050, climate change will cause approximately 250,000 additional deaths per year. Of these, an estimated 38,000 will be elderly people who die from heat exposure, 48,000 will be due to dysentery (predominantly caused by tainted drinking water), 60,000 will be due to malaria, and 95,000 will be due to childhood undernutrition.
Mitigating the impact this will have on human populations will require international cooperation and multilateral efforts to resettle migrants, distribute medicine and medical services, and build the necessary infrastructure to deal with the crisis.
Mental illness is the new pandemic
While many fatal and degenerative diseases will be (or will be well on their way to being) eliminated by 2050, other ailments will arise to take their place. And whereas improvements in medicine and drug delivery will extend average lifespans, environmental issues will lead to elevated levels of health issues and threats.
By the 2030s, depression and mental illness are expected to overtake heart disease to become the greatest health concern worldwide. Contributing factors will include debt, unemployment, domestic violence, war, the stresses of living in an urban environment, environmental degradation, and disasters.
Changing demographics will also play a role, specifically where age is concerned. According to the World Health Organization (WHO), between 2015 and 2050, the proportion of the world's population aged 60 or older will nearly double — from about 900 million to 2 billion (12% to 20%). Of these individuals, approximately 20% will suffer from a cognative disorder (i.e., dementia, Alzheimer's, Parkinson's, etc.)
The issue of "lost years"
While improvements in diagnostics and treatment will address these health concerns with greater efficiency, depression will remain a leading cause of "lost years" (i.e., years lived in a state of poor health). Fortunately, a greater understanding of neurology and improvements in drug discovery will also mean that people suffering from depression will be able to get effective treatment.
Also, in recent years, an increase in public awareness (which may or may not be due to increased prevalence) has led to increasing destigmatization. According to a survey conducted by the HealthPartners Institute, between 2017 and 2019, the percentage of people who felt comfortable talking about their mental illness increased from 66% to 71%.
The same survey noted an increase in people willing to talk to friends about their mental illness (34% to 41%), as well as a decrease in reluctance to seek help (50% to 46%). Clearly, increased prevalence leads to increased awareness and healthier attitudes. So, while depression may be more common by 2050, public perceptions and medical science will be more accomodating.
From wearables to "internals"
Health monitoring is also expected to advance by leaps and bounds as embedded electronics (aka. "internals") become commercially available. These will consist of flexible electronic patches that can be grafted directly to muscles and organs to monitor heart rate, liver function, kidney function, digestion, respiration, and brain activity for signs of irregularities.
These same devices could also release medication as needed, which would be especially helpful for patients suffering from diabetes or neurological disorders. Between internal sensors that provide regular health monitoring and those that can administer medications, people will be able to personalize their health care in a way that was never before possible.
While these devices will assist in the rise of personalized medicine, they are sure to become a regular feature in hospitals as well. Rather than monitoring patients' vital signs and biometrics with pads that connect via wires to bulky equipment, everything doctors and nurses need to know will be transmitted wirelessly from wearable sensors directly to a patient monitoring system.
"Internals" will also take the form of nanomachines, tiny robots that measure only a few microns in diameter — or ~4×10-5 inches (1×10-6 meters). Between 2009 and 2025, the global market value for nanomedicine is projected to grow from $53 billion to $334 billion USD — an average of 17.5% growth per year. At this rate of increase, the market will be valued at over $19 trillion by 2050.
Nanomedicine will come in many forms by mid-century, including nanosensors, nanoparticles, and nanorobots. Nanosensors will take the form of tiny machines equipped with miniscule radio/microwave emitters, and/or spectrometers. These will be taken internally and scan the user's blood and soft tissue for signs of chemical imbalances, bacteria, viruses, HIV, or cancer cells.
For years, nanoparticles have been investigated for their potential medical applications and are likely to become the predominant means of medication delivery in the coming years. For instance, nanoparticles containing bee venom have been proven to be very effective at killing cancer and HIV cells, while leaving surrounding tissue unharmed.
In this respect, medical nanoparticles could cure fatal diseases without the harmful side effects typical of chemotherapy or antiviral drugs. Meanwhile, nanorobots could be fashioned that would be introduced into the bloodstream and tasked with clearing plaque and blockages from arteries, improving circulation, repairing ulcers, aneurysms, and other health issues.
Employed by hospitals and emergency medical teams (EMTs), medical nanorobots could eliminate the need for exploratory surgery and the old-fashioned diagnostic approach. Simply inject a patient with a culture of nanorobots, and doctors or first responders will have all the data they need to administer life-saving treatment.
Virtual checkups and doctors
Thanks to the growth of broadband internet access, it's also possible that doctors and patients won't even need to meet in person by mid-century. While face-to-face consultations will still exist and will be the preferred method in serious cases, "teleconsultations" will replace regular checkups to a large extent.
Using their household sensors, wearables, and internals, patients could simply send their health care data to a doctor who would interpret it (possibly with help from an AI) and dispatch medical advice in return. Over time, these consultations will likely become more sophisticated, moving from a reliance on devices and apps like Skype or Zoom, to eventually include the use of immersive virtual reality.
When paired with advancements in machine learning and AI, patients may not even need a flesh and blood doctor to dispense advice at all. In fact, more people worldwide may entrust their health information to an artificial intelligence (a virtual practitioner, or "VP") who will let them know what could be wrong, based on their symptoms.
With advancements in robotics, sensory feedback (aka. haptics), and virtual reality, doctors will also be able to perform surgery on patients halfway around the world — "teleoperations". While robotic surgery suites, connected to the internet, will perform the actual operations, it will likely be the job of a human surgeon (using a full-body VR suit) to control the procedure.
Robotics and bionics
Advances in robotics and bionics will also be at the forefront of medical innovation as 2050 approaches. We have already seen how robotic exoskeletons can assist people recovering from injuries and dealing with partial paralysis. But by 2050, exoskeletons — which will likely be lighter, smaller, and made of flexible materials — will be the tip of the iceberg!
As we explored in a previous installment, robotics and cybernetics will become a regular feature for soldiers by 2050 — both on and off the battlefield. But it will be the commercial market where these advancements will be the most impactful, particularly for patients recovering from severe accidents and injuries.
For example, ocular implants will be available for patients who have suffered a loss of vision, offering restored (or even enhanced sight) while artificial cochlea and ear bones could correct hearing loss. Optogenetic stimulators, which rely on pulses of light to stimulate muscles, could treat soft tissue injuries that would otherwise require years of surgery, physiotherapy, and pain medication.
Another major innovation (which we are already seeing today in the form of Neuralink) is neural implants, which are expected to become commonplace by mid-century. In addition to enabling brain-to-machine and brain-to-brain interfacing (BMI and BBI), soft and flexible implants could also be used to address brain injuries and cure neurological diseases.
There's also the burgeoning field of bionics, where electronics mimic biology in order to enhance human abilities. While elective and military enhancements are inevitable, medical applications — like artificial organs and replacement limbs — will arguably be the most common by 2050.
In recent years, prosthetics have become commercially available that use electrodes to connect to the user's nerve channels, allowing them to control the limbs the way they would their own arms or legs. In addition, there are prosthetics today that can provide sensory feedback using electrodes that stimulate specific nerves (pressure, vibration, temperature, pleasure/pain).
By 2050, these advances could culminate in the development of bionic enhancements that are indistinguishable from the real thing — at least in terms of appearance. As this technology becomes more readily available and accessible, it will also mean the difference between life and death for more and more people.
Gene editing & bioprinting
In 2012, one of the most significant findings in the history of biology and medicine was made when Jennifer Doudna and Emmanuelle Charpentier published research that indicated that the Cas9 protein (CRISPR-associated protein 9) could be programmed using RNA. This opened the door to CRISPR-Cas9 genomic editing, where the very structure of DNA can be altered to remove or add sequences.
In the coming decades, improvements in genome editing are expected to lead to "drag and drop" genetic engineering and the elimination of many genetic diseases. Meanwhile, gene therapies are anticipated to become commercially available that will be able to restore sight and hearing loss, and cure Alzheimer's, Parkinson's, paralysis, and other conditions and degenerative diseases.
Other treatment options that will become commonplace by mid-century include stem cell therapy. In fact, stem cell pharmacies, which dispense tissue therapies, are expected to become commercially available in the developed world by the early 2030s, offering affordable, personalized, and targeted treatments for regenerating body parts, organs, and restoring abilities.
The growing availability of stem cells will also have drastic implications when it comes to bioprinting. As a medical application of 3D printing (additive manufacturing), bioprinting involves using stem cells to manufacture biological materials, including replacement skin, bones, organs, and replacement body parts.
As bioprinting becomes more readily available, it will be possible for people to walk into a clinic or hospital, provide a DNA sample, and have a culture of stem cells based on their genome prepared in no time. These stem cells could then be used to fashion whatever the person needs, be it a new kidney, a skin graft, or new blood vessels.
There are many metrics for measuring human growth and development. For some, progress is a matter of creating bigger, shinier, and more elaborate structures. For others, it's the number of people (and other living beings) in our society we are willing to extend basic rights and privileges to. Some even think progress can be measured in how efficiently we kill one another.
But most people would probably agree that the state of medicine and how we care for our sick and injured is the most worthy metric for measuring how far we've come. By 2050, we will have made incredible advances, cured some of the most deadly diseases, and improve the quality of life for billions of people worldwide.
These advances will be tested thoroughly as new health threats, many of which will be the result of climate change, push our infrastructure and our means to the limit. As with all other aspects of life that we have explored with this series, the way we treat the sick and injured is yet another way that humanity will find itself being pulled in two directions at once by mid-century.
How will it all play out? It's difficult to say. But from our current vantage point, two possibilities are clear — either things will eventually get better, or they will continue to get worse. Luckily, everyone alive today either has or will have a hand in making sure it's the former. The only question is, are we up to the task?