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> almost impossible to get FDA approval for drugs that "improve" or "enhance" human biology

What is the rationale for this?




You can only make drugs to treat medical problems of some sort. I think the argument is that the cost/benefit is never positive for drugs that aren't attempting to just bring you back to baseline.

Basically imagine you are perfectly healthy, and you take a drug that has a 99.9% chance of increasing your IQ by 20 points, or a 0.1% chance of reducing your IQ by 5 points.

The FDA would basically say "no way in fucking hell, you don't need the extra IQ points to cure any problem, and there is a risk of brain damage".

Now if that same drug was instead marketed towards helping people with traumatic brain injuries heal, then it could maybe get approval.

There was a petition a few years back to the FDA to change this to allow research into life extending drugs, but AFAIK it didn't go anywhere.


International competition will eventually force the US to change rules like this.

When everyone in China lives till 200 years old and they all have IQs of 130+, the FDA will be pushed aside.


The entire drug research sphere outside of the US is miniscule. Unless you can sell the drug in the US there's very little point to investing in the large scale research needed to truly determine efficacy. Yeah there's some minimal state sponsored stuff outside of the US. BUt it's like comparing Little League to the MLB.


Where do you get this idea from? More than half of all major drug companies are based in Europe and Asia.

https://en.wikipedia.org/wiki/List_of_largest_biomedical_com...


Ok, I think your list, and the fact that HALF are in 1 Country VS the entire rest of the world qualifies my statement. As well Roche, ASZ, and GSK do the bulk of their research in the US.

On top of that the largest outside of the US is China and there is very little trust of data coming from there in the Western World.


Maybe from the fact that half of all pharmaceutical revenues come from the US (and likely a much higher share of the profits). Single-payer systems are more cost-effective but definitely provide less revenue to pharmaceutical companies.


“We can overcharge patients” in no way leads to the logical conclusion that “more medicine is developed here.”

It just means your pharma companies can get away with higher profit margins.


The Chinese government ran a huge research effort to try and determine the genes for intelligence. From what I understand it was a failure, as the genetic causes of intelligence are too spread out and varied to be easily isolated.

I'm pretty sure if the project had succeeded that the Chinese government would have had no moral qualms about gene-engineering a population with an IQ of 130+ and the US would be permanently behind in every field forever after.


> the Chinese government would have had no moral qualms about gene-engineering a population with an IQ of 130+ and the US would be permanently behind in every field forever after.

The US is already a key brain-drain destination for Chinese elites, why would that change?


I think all sorts of assumptions are baked into that statement. Would the CCP even survive if the population IQ was 130+?


It would be a worthy ultimate sacrifice


> Chinese government would have had no moral qualms about gene engineering

Anyone cares to shed a tear for IQ 85/90 people that have to navigate increasingly complex world?

Look at the amount of legal documents, EULA’s, software, and complex corporate structures that an average Joe has to deal with today vs 50 years ago. How long u till average person can no longer cope?


If this great science fiction scenario were to come to pass, I’m pretty confident that it wouldn’t be only the FDA that would be pushed to the side.

The impact of a population in an organised, technologically advanced society being one standard deviation of intelligence higher than a strategic rival population … would be immense.

Even if just temporarily boosting intelligence, something like a militarised Flowers for Algernon scenario is pretty terrifying.


Someone I know pointed out that there’s a feedback effect: groups where everyone is smarter do better not just because of the first order effect but also because they can cooperate better. There’s a roughly quadratic effect on productivity.

Mass enhancement of the general population would have far reaching consequences.


Why? It will only result in more and harder dictatorship, more direct terror and fear, and even more unhappy society. Democracy works best when people are easy to manipulate through mass media. Smart people will need to be coerced by force. Maybe in fact, to a degree this is what already happening. Superior education in China makes democratic transition next to impossible.

Maybe the observation that countries with the best education tend to be authoritarian is not because "dictators are good at educating people" but other way around - because it's a natural selection and if a highly educated country tries to transition to democracy, it either ruins democracy, or education, or country itself.

Any model of governance mainly solves the problem of "how to satisfy interests of the stakeholders - i.e. the elite - without ruining things"; there are many ways to ruin things (even elite itself can bring about it's own downfall), but the one everyone fears most is when people get too angry. Democracy is a good way to shift responsibility back to people itself, thus defusing this threat. But it requires people being sufficiently dumb to bite it.


> Democracy works best when people are easy to manipulate through mass media

This is a huge statement that seems wrong to me. Democracy works best when the population are engaged and hard to manipulate.

Also the "observation that countries with the best education are authoritarian" seems wrong to me too. The data I see has the top 10 entirely filled with democracies, with Singapore as the first nondemocracy coming in at 11th place. Check the economist democracy index, the correlation between democracy and education is imperfect but strong.

And those are arguments based on data. There are also arguments based on logic. Authoritarianism and education are fundamentally opposed, because authoritarians hate the teaching of things that disagree with their own specific viewpoint and suppress it.


>countries with the best education tend to be authoritarian

On what basis are you making this claim?


> Democracy works best when people are easy to manipulate through mass media. Smart people will need to be coerced by force.

Been there done that, it’s called Russia.

I don’t agree with your worldview, but if I was presented with the choice is between dumb, fake democracy and clever competent dictatorship, I might as well choose the latter. At least trains will run on time.


The clever, competent dictatorship is quite rare, though.


And short-lived


There's an assumption here that such drugs will exist. They might not.


Death is a medical problem, terminal disease really. Stopping aging stops death.


We can give a lab mouse any form of cancer and cure it. We can reverse their aging symptoms... yet we've only been able to extend their lifespan by a measly third at best. It's safe to say we're very far away from getting anywhere close to solving aging in humans if we can't even make an immortal mouse despite a century of throwing every possible thing at them without holding back.


I think the point was that the opposite would be true if it weren't for it government intervention.


I agree, but the pedant in me wants to point out that

> despite a century of throwing every possible thing at them without holding back

is incorrect. IACUCs exist for a reason. We do hold back.


Also, a century? What did we have a century ago?

MRI was only invented in 1977, first commercial CT scanner came out in 1970’s, same for ultrasound. Before 1970’s we didn’t have antiviral drugs or DNA sequencing

Medicine a hundred years ago was brutal and medieval


Believe it or not, lab mice have been used for medical research for over 150 years.

We're all high and mighty with our moderns scanners, yet we still do surgery with chisels and hammers, drill teeth, put broken bones in plaster, have sick people congregate all in one place so they get infected with each other's diseases plus get some antibiotic resistant bacteria or two on top. And well, whatever the hell they do in the ER. Medicine is still pretty brutal when it comes down to it.


That may be so, but it's absolutely fundamental to know where to cut, and to cut in the right place. How are you going to diagnose cancer at an early stage if you have no way to scan and detect anything? Exploratory surgery?


This wasn't necessarily an informed opinion.

Note their "layman's opinion" qualification.


I recently spoke with someone in biotechnology who was doing a deep dive on "exercise pills". she told me that it would only be approved if it treated a specific disease, like muscular dystrophy, because the FDA views any potential negative side effect as too risky to approve for healthy people. Long term negative side effects are tolerable in Duchenne muscular dystrophy because those people are going to die without intervention. Once people with DMD show the safety profile it can be evaluated for more conditions.




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