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Moving Our Preemptive Health and Medicine Initiative Forward

At Flagship Pioneering, we constantly challenge ourselves to imagine a different future. Our Preemptive Health and Medicine Initiative asks: what if we could create a world largely free from disease? Our ambition is to help people to live disease free for longer, not only adding years to our lives but life into our years. It is our belief that true health security—the ability to live our lives free from sickness—can and must be achieved for all.

Our healthcare systems are, in fact, sickcare systems. They are focused on diagnosing and treating sickness. This observation is not meant to denigrate their importance; they are essential to the good functioning of a civilized society. But sickcare by its nature focuses on the already-sick rather than on securing the health of those who are healthy. Yet the rising tide of chronic disease—many the result of modern lifestyles—means those systems are under sustained financial pressure. Indeed, our projections find that if healthcare costs in the US grow at the same pace for the next 30 years as they have for the past 30 years, then healthcare will account for 32 per cent of the US economy by 2050.

We believe the extraordinary advances in the biological and computational sciences should make it possible to detect predisease states far earlier, and to preempt disease, so symptoms never manifest. Such an approach has the potential to enable us to live healthier lives for longer, free of sickness—adding life into our years. That means more time for family and friends, for work or study, or to contribute to our communities. From an economic perspective, it means high levels of workforce participation, improved productivity, and reduced healthcare costs. After all, keeping people healthy by preempting disease is the best kind of healthcare cost containment.

We believe the extraordinary advances in the biological and computational sciences should make it possible to detect predisease states far earlier, and to preempt disease, so symptoms never manifest.

The Covid-19 pandemic – which has revealed our individual and collective health vulnerability—has accelerated our efforts in this area. That’s why we have launched new companies that are aimed at uncovering novel biomarkers and discovering new interventions that can stop, delay, or reverse disease. From companies such as Harbinger Health that aims to detect cancer at its earliest stages to FL77 that is focused on protecting the world from fast-mutating viruses, we have invested more than $100 million in this area, with more capital already committed in the coming years. We are set to announce more companies in this area this year.

Established companies within the wider Flagship ecosystem are also pursuing new preemptive health and medicine efforts. The most well-known example is, of course, Moderna which was founded in 2010 and achieved the miracle of mRNA vaccines in the pandemic. Other companies such as Generate Biomedicines are designing novel monoclonal antibodies or Axcella Therapeutics that is developing new interventions to help our bodies preserve or restore proper biological self-regulation, including for the millions of patients suffering from chronic fatigue associated with long-Covid.

Such a future is possible. But it will require a paradigm leap in our thinking to achieve it. It will require policy changes by governments, new regulatory frameworks that enable innovation to flourish, supportive market access approaches, and shifts in focus and priorities by R&D funders – public, private and philanthropic. This new paradigm is necessarily global, so these shifts will need to occur across multiple countries over time.

Forging the preemptive health and medicine paradigm will require a public conversation where everyone’s voice is heard and everyone’s contribution is valued. At Flagship, we try to ask provocative questions while recognizing that many others will possess the answers. Such a public conversation will take place in the wake of a global pandemic, about how we can better value our health and the steps that we as a society can take to protect it.

Forging the preemptive health and medicine paradigm will require a public conversation where everyone’s voice is heard and everyone’s contribution is valued.

We have begun to convene those conversations, together with partners who share our passion about preempting disease. Today, in Washington DC, we are convening eminent experts and thought leaders to begin that conversation at a policy roundtable co-hosted with the Milken Institute. This follows on from a recent series of conversations and events we held in London, England, at the famed Royal Society and at Imperial College’s Institute for Global Health Innovation.

Whenever we try to imagine humankind in the far future, we envisage a world where scientific and technological advances transform the human experience. From overcoming challenges such as climate change to allowing our descendants to travel freely to the stars, we conceive of those futures that are free from disease. If we believe that future is possible, then the only question that remains is not whether, but when. Our Preemptive Health and Medicine Initiative aims to bring that far future into the here and now, and to set all of us free to lead our best lives, liberated from imminent disease.

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