This week I want to tell you about an experimental surgical procedure that’s helping people have babies. Specifically, it’s helping people who have had treatment for bowel or rectal cancer.
Radiation and chemo can have pretty damaging side effects that mess up the uterus and ovaries. Surgeons are pioneering a potential solution: simply stitch those organs out of the way during cancer treatment. Once the treatment has finished, they can put the uterus—along with the ovaries and fallopian tubes—back into place.
It seems to work! Last week, a team in Switzerland shared news that a baby boy had been born after his mother had the procedure. Baby Lucien was the fifth baby to be born after the surgery and the first in Europe, says Daniela Huber, the gyno-oncologist who performed the operation. Since then, at least three others have been born, adds Reitan Ribeiro, the surgeon who pioneered the procedure. They told me the details.
Huber’s patient was 28 years old when a four-centimeter tumor was discovered in her rectum. Doctors at Sion Hospital in Switzerland, where Huber works, recommended a course of treatment that included multiple medications and radiotherapy—the use of beams of energy to shrink a tumor—before surgery to remove the tumor itself.
This kind of radiation can kill tumor cells, but it can also damage other organs in the pelvis, says Huber. That includes the ovaries and uterus. People who undergo these treatments can opt to freeze their eggs beforehand, but the harm caused to the uterus will mean they’ll never be able to carry a pregnancy, she adds. Damage to the lining of the uterus could make it difficult for a fertilized egg to implant there, and the muscles of the uterus are left unable to stretch, she says.
In this case, the woman decided that she did want to freeze her eggs. But it would have been difficult to use them further down the line—surrogacy is illegal in Switzerland.
Huber offered her an alternative.
She had been following the work of Ribeiro, a gynecologist oncologist formerly at the Erasto Gaertner Hospital in Curitiba, Brazil. There, Ribeiro had pioneered a new type of surgery that involved moving the uterus, fallopian tubes, and ovaries from their position in the pelvis and temporarily tucking them away in the upper abdomen, below the ribs.
Ribeiro and his colleagues published their first case report in 2017, describing a 26-year-old with a rectal tumor. (Ribeiro, who is now based at McGill University in Montreal, says the woman had been told by multiple doctors that her cancer treatment would destroy her fertility and had pleaded with him to find a way to preserve it.)
Huber remembers seeing Ribeiro present the case at a conference at the time. She immediately realized that her own patient was a candidate for the surgery, and that, as a surgeon who had performed many hysterectomies, she’d be able to do it herself. The patient agreed.
Huber’s colleagues at the hospital were nervous, she says. They’d never heard of the procedure before. “When I presented this idea to the general surgeon, he didn’t sleep for three days,” she tells me. After watching videos from Ribeiro’s team, however, he was convinced it was doable.
So before the patient’s cancer treatment was started, Huber and her colleagues performed the operation. The team literally stitched the organs to the abdominal wall. “It’s a delicate dissection,” says Huber, but she adds that “it’s not the most difficult procedure.” The surgery took two to three hours, she says. The stitches themselves were removed via small incisions around a week later. By that point, scar tissue had formed to create a lasting attachment.
The woman had two weeks to recover from the surgery before her cancer treatment began. That too was a success—within months, her tumor had shrunk so significantly that it couldn’t be seen on medical scans.
As a precaution, the medical team surgically removed the affected area of her colon. At the same time, they cut away the scar tissue holding the uterus, tubes, and ovaries in their new position and transferred the organs back into the pelvis.
Around eight months later, the woman stopped taking contraception. She got pregnant without IVF and had a mostly healthy pregnancy, says Huber. Around seven months into the pregnancy, there were signs that the fetus was not growing as expected. This might have been due to problems with the blood supply to the placenta, says Huber. Still, the baby was born healthy, she says.
Ribeiro says he has performed the surgery 16 times, and that teams in countries including the US, Peru, Israel, India, and Russia have performed it as well. Not every case has been published, but he thinks there may be around 40.
Since Baby Lucien was born last year, a sixth birth has been announced in Israel, says Huber. Ribeiro says he has heard of another two births since then, too. The most recent was to the first woman who had the procedure. She had a little girl a few months ago, he tells me.
No surgery is risk-free, and Huber points out there’s a chance that organs could be damaged during the procedure, or that a more developed cancer could spread. The uterus of one of Ribeiro’s patients failed following the surgery. Doctors are “still in the phase of collecting data to [create] a standardized procedure,” Huber says, but she hopes the surgery will offer more options to young people with some pelvic cancers. “I hope more young women could benefit from this procedure,” she says.
Ribeiro says the experience has taught him not to accept the status quo. “Everyone was saying … there was nothing to be done [about the loss of fertility in these cases],” he tells me. “We need to keep evolving and looking for different answers.”
This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.
For the last couple of years, I’ve been following the progress of a group of individuals who believe death is humanity’s “core problem.” Put simply, they say death is wrong—for everyone. They’ve even said it’s morally wrong.
Vitalism is more than a philosophy, though—it’s a movement for hardcore longevity enthusiasts who want to make real progress in finding treatments that slow or reverse aging. Not just through scientific advances, but by persuading influential people to support their movement, and by changing laws and policies to open up access to experimental drugs.
And they’re starting to make progress.
Vitalism was founded by Adam Gries and Nathan Cheng—two men who united over their shared desire to find ways to extend human lifespan. I first saw Cheng speak back in 2023, at Zuzalu, a pop-up city in Montenegro for people who were interested in life extension and some other technologies. (It was an interesting experience—you can read more about it here.)
Zuzalu was where Gries and Cheng officially launched Vitalism. But I’ve been closely following the longevity scene since 2022. That journey took me to Switzerland, Honduras, and a compound in Berkeley, California, where like-minded longevity enthusiasts shared their dreams of life extension.
It also took me to Washington, DC, where, last year, supporters of lifespan extension presented politicians including Mehmet Oz, who currently leads the Centers for Medicare & Medicaid Services, with their case for changes to laws and policies.
The journey has been fascinating, and at times weird and even surreal. I’ve heard biohacking stories that ended with smoking legs. I’ve been told about a multi-partner relationship that might be made possible through the cryopreservation—and subsequent reanimation—of a man and the multiple wives he’s had throughout his life. I’ve had people tell me to my face that they consider themselves eugenicists, and that they believe that parents should select IVF embryos for their propensity for a long life.
I’ve been shouted at and threatened with legal action. I’ve received barefoot hugs. One interviewee told me I needed Botox. It’s been a ride.
My reporting has also made me realize that the current interest in longevity reaches beyond social media influencers and wellness centers. Longevity clinics are growing in number, and there’s been a glut of documentaries about living longer or even forever.
At the same time, powerful people who influence state laws, giant federal funding budgets, and even national health policy are prioritizing the search for treatments that slow or reverse aging. The longevity community was thrilled when longtime supporter Jim O’Neill was made deputy secretary of health and human services last year. Other members of Trump’s administration, including Oz, have spoken about longevity too. “It seems that now there is the most pro-longevity administration in American history,” Gries told me.
I recently spoke to Alicia Jackson, the new director of ARPA-H. The agency, established in 2022 under Joe Biden’s presidency, funds “breakthrough” biomedical research. And it appears to have a new focus on longevity. Jackson previously founded and led Evernow, a company focused on “health and longevity for every woman.”
“There’s a lot of interesting technologies, but they all kind of come back to the same thing: Could we extend life years?” she told me over a Zoom call a few weeks ago. She added that her agency had “incredible support” from “the very top of HHS.” I asked if she was referring to Jim O’Neill. “Yeah,” she said. She wouldn’t go into the specifics.
Gries is right: There is a lot of support for advances in longevity treatments, and some of it is coming from influential people in positions of power. Perhaps the field really is poised for a breakthrough.
And that’s what makes this field so fascinating to cover. Despite the occasional weirdness.
This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.
“Who here believes involuntary death is a good thing?”
Nathan Cheng has been delivering similar versions of this speech over the last couple of years, so I knew what was coming. He was about to try to convince the 80 or so people in the audience that death is bad. And that defeating it should be humanity’s number one priority—quite literally, that it should come above all else in the social and political hierarchy.
“If you believe that life is good and there’s inherent moral value to life,” he told them, “it stands to reason that the ultimate logical conclusion here is that we should try to extend lifespan indefinitely.”
Solving aging, he added, is “a problem that has an incredible moral duty for all of us to get involved in.”
It was the end of April, and the crowd—with its whoops and yeahs—certainly seemed convinced. They’d gathered at a compound in Berkeley, California, for a three-day event called the Vitalist Bay Summit. It was part of a longer, two-month residency (simply called Vitalist Bay) that hosted various events to explore tools—from drug regulation to cryonics—that might be deployed in the fight against death. One of the main goals, though, was to spread the word of Vitalism, a somewhat radical movement established by Cheng and his colleague Adam Gries a few years ago.
No relation to the lowercase vitalism of old, this Vitalism has a foundational philosophy that’s deceptively simple: to acknowledge that death is bad and life is good. The strategy for executing it, though, is far more obviously complicated: to launch a longevity revolution.
Interest in longevity has certainly taken off in recent years, but as the Vitalists see it, it has a branding problem. The term “longevity” has been used to sell supplements with no evidence behind them, “anti-aging” has been used by clinics to sell treatments, and “transhumanism” relates to ideas that go well beyond the scope of defeating death. Not everyone in the broader longevity space shares Vitalists’ commitment to actually making death obsolete. As Gries, a longtime longevity devotee who has largely become the enthusiastic public face of Vitalism, said in an online presentation about the movement in 2024, “We needed some new word.”
“Vitalism” became a clean slate: They would start a movement to defeat death, and make that goal the driving force behind the actions of individuals, societies, and nations. Longevity could no longer be a sideshow. For Vitalism to succeed, budgets would need to change. Policy would need to change. Culture would need to change. Consider it longevity for the most hardcore adherents—a sweeping mission to which nothing short of total devotion will do.
“The idea is to change the systems and the priorities of society at the highest levels,” Gries said in the presentation.
To be clear, the effective anti-aging treatments the Vitalists are after don’t yet exist. But that’s sort of the point: They believe they could exist if Vitalists are able to spread their gospel, influence science, gain followers, get cash, and ultimately reshape government policies and priorities.
For the past few years, Gries and Cheng have been working to recruit lobbyists, academics, biotech CEOs, high-net-worth individuals, and even politicians into the movement, and they’ve formally established a nonprofit foundation “to accelerate Vitalism.” Today, there’s a growing number of Vitalists (some paying foundation members, others more informal followers, and still others who support the cause but won’t publicly admit as much), and the foundation has started “certifying” qualifying biotech companies as Vitalist organizations. Perhaps most consequentially, Gries, Cheng, and their peers are also getting involved in shaping US state laws that make unproven, experimental treatments more accessible. They hope to be able to do the same at the national level.
VITALISMFOUNDATION.ORG
VITALISMFOUNDATION.ORG
Vitalism cofounders Nathan Cheng and Adam Gries want to launch a longevity revolution.
All this is helping Vitalists grow in prominence, if not also power. In the past, people who have spoken of living forever or making death “optional” have been dismissed by their academic colleagues. I’ve been covering the broader field of aging science for a decade, and I’ve seen scientists roll their eyes, shrug their shoulders, and turn their backs on people who have talked this way. That’s not the case for the Vitalists.
Even the scientists who think that Vitalist ideas of defeating death are wacky, unattainable ones, with the potential to discredit their field, have shown up on stage with Vitalism’s founders, and these serious researchers provide a platform for them at more traditionally academic events.
I saw this collegiality firsthand at Vitalist Bay. Faculty members from Harvard, Stanford, and the University of California, Berkeley, all spoke at events. Eric Verdin, the prominent researcher who directs the Buck Institute for Research on Aging in Novato, California, had also planned to speak, although a scheduling clash meant he couldn’t make it in the end. “I have very different ideas in terms of what’s doable,” he told me. “But that’s part of the [longevity] movement—there’s freedom for people to say whatever they want.”
Many other well-respected scientists attended, including representatives of ARPA-H, the US federal agency for health research and breakthrough technologies. And as I left for a different event on longevity in Washington, DC, just after the Vitalist Bay Summit, a sizable group of Vitalist Bay attendees headed that way too, to make the case for longevity to US lawmakers.
The Vitalists feel that momentum is building, not just for the science of aging and the development of lifespan-extending therapies, but for the acceptance of their philosophy that defeating death should be humanity’s top concern.
This, of course, sparks some pretty profound questions. What would a society without death look like—and would we even want it? After all, death has become an important part of human culture the world over. And even if Vitalists aren’t destined to realize their lofty goal, their growing influence could still have implications for us all. As they run more labs and companies, and insert themselves into the making of laws and policy, perhaps they will discover treatments that really do slow or even reverse aging. In the meantime, though, some ethicists are concerned that experimental and unproven medicines—including potentially dangerous ones—are becoming more accessible, in some cases with little to no oversight.
Gries, ultimately, has a different view of the ethics here. He thinks that being “okay with death” is what disqualifies a person from being considered ethical. “Death is just wrong,” he says. “It’s not just wrong for some people. It’s wrong for all people.”
The birth of a revolution
When I arrived at the Vitalist Bay Summit on April 25, I noticed that the venue was equipped with everything a longevity enthusiast might need: napping rooms, a DEXA body-composition scanner, a sauna in a bus, and, for those so inclined, 24-hour karaoke.
I was told that around 300 people had signed up for that day’s events, which was more than had attended the previous week. That might have been because arguably the world’s most famous longevity enthusiast, Bryan Johnson, was about to make an appearance. (If you’re curious to know more about what Johnson was doing there, you can read about our conversation here.)
The key to Vitalism has always been that“death is humanity’s core problem, and aging its primary agent,” cofounder Adam Gries told me. “So it was, and so it has continued, as it was foretold.”
But Gries, another man in his 40s who doesn’t want to die, was the first to address the audience that day. Athletic and energetic, he bounded across a stage wearing bright yellow shorts and a long-sleeved shirt imploring people to “Choose Life: VITALISM.”
Gries is a tech entrepreneur who describes himself as a self-taught software engineer who’s “good at virality.” He’s been building companies since he was in college in the 2000s, and grew his personal wealth by selling them.
As with many other devotees to the cause, his deep interest in life extension was sparked by Aubrey de Grey, a controversial researcher with an iconic long beard and matching ponytail. He’s known widely both for his optimistic views about “defeating aging” and for having reportedly made sexual comments to two longevity entrepreneurs. (In an email, de Grey said he’s “never disputed” one of these remarks but denied having made the other. “My continued standing within the longevity community speaks for itself,” he added.)
In an influential 2005 TED Talk (which has over 4.8 million views), de Grey predicted that people would live to 1,000 and spoke of the possibility of new technologies that would continue to stave off death, allowing some to avoid it indefinitely. (In a podcast recorded last year, Cheng described a recording of this talk as “the OG longevity-pilling YouTube video.”)
Many Vitalists have been influenced by controversial longevity researcher Aubrey de Grey. Cheng called his 2005 TED Talk “the OG longevity-pilling YouTube video.”
PETER SEARLE/CAMERA PRESS/REDUX
“It was kind of evident to me that life is great,” says Gries. “So I’m kind of like, why would I not want to live?”
A second turning point for Gries came during the early stages of the covid-19 pandemic, when he essentially bet against companies that he thought would collapse. “I made this 50 [fold] return,” he says. “It was kind of like living through The Big Short.”
Gries and his wife fled from San Francisco to Israel, where he grew up, and later traveled to Taiwan, where he’d obtained a “golden visa” and which was, at the time, one of only two countries that had not reported a single case of covid. His growing wealth afforded him the opportunity to take time from work and think about the purpose of life. “My answer was: Life is the purpose of life,” he says. He didn’t want to die. He didn’t want to experience the “journey of decrepitude” that aging often involves.
So he decided to dedicate himself to the longevity cause. He went about looking up others who seemed as invested as he was. In 2021 his search led him to Cheng, a Chinese-Canadian entrepreneur based in Toronto. He had dropped out of a physics PhD a few years earlier after experiencing what he describes on his website as “a massive existential crisis” and shifted his focus to “radical longevity.” (Cheng did not respond to email requests for an interview.)
The pair “hit it off immediately,” says Gries, and they spent the following two years trying to figure out what they could do. The solution they finally settled on: revolution.
After all, Gries reasons, that’s how significant religious and social movements have happened in the past. He says they sought inspiration from the French and American Revolutions, among others. The idea was to start with some kind of “enlightenment,” and with a “hardcore group,” to pursue significant social change with global ramifications.
“We were convinced that without a revolution,” Gries says, “we were as good as dead.”
A home for believers
Early on, they wrote a Vitalist declaration, a white paper that lists five core statements for believers:
Life and health are good. Death is humanity’s core problem, and aging its primary agent.
Aging causes immense suffering, and obviating aging is scientifically plausible.
Humanity should apply the necessary resources to reach freedom from aging as soon as possible.
I will work on or support others to work on reaching unlimited healthy human lifespan.
I will carry the message against aging and death.
While it’s not an explicit part of the manifesto, it was important to them to think about it as a moral philosophy as well as a movement. As Cheng said at the time, morality “guides most of the actions of our lives.” The same should be true of Vitalism, he suggested.
Gries has echoed this idea. The belief that “death is morally bad” is necessary to encourage behavior change, he told me in 2024. It is a moral drive, or moral purpose, that pushes people to do difficult things, he added.
Revolution, after all, is difficult. And to succeed—to “get unlimited great health to the top of the priority list,” as Gries says—the movement would need to infiltrate the government and shape policy decisions and national budgets. The Apollo program got people to the moon with less than 1% of US GDP; imagine, Gries asks, what we could do to human longevity with a mere 1% of GDP?
It makes sense, then, that Gries and Cheng launched Vitalism in 2023 at Zuzalu, a “pop-up city” in Montenegro that provided a two-month home for like-minded longevity enthusiasts. The gathering was in some ways a loose prototype for what they wanted to accomplish. Cheng spoke there of how they wanted to persuade 10,000 or so Vitalists to move to Rhode Island. Not only was it close to the biotech hub of Boston, but they believed it had a small enough population for an influx of new voters sharing their philosophy to influence local and state elections. “Five to ten thousand people—that’s all we need,” he said. Or if not Rhode Island, another small-ish US state, where they could still change state policy from the inside.
The ultimate goal was to recruit Vitalists to help them establish a “longevity state”—a recognized jurisdiction that “prioritizes doing something about aging,” Cheng said, perhaps by loosening regulations on clinical trials or supporting biohacking.
Bryan Johnson, who is perhaps the world’s most famous longevity enthusiast, spoke at Vitalist Bay and is trying to start a Don’t Die religion.
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This idea is popular among many vocal members of the Vitalism community. It borrows from the concept of the “network state” developed by former Coinbase CTO Balaji Srinivasan, defined as a new city or country that runs on cryptocurrency; focuses on a goal, in this case extending human lifespan; and “eventually gains diplomatic recognition from preexisting states.”
Some people not interested in dying have made progress toward realizing such a domain. Following the success of Zuzalu, one of the event’s organizers, Laurence Ion, a young cryptocurrency investor and self-proclaimed Vitalist, joined a fellow longevity enthusiast named Niklas Anzinger to organize a sequel in Próspera, the private “special economic zone” on the Honduran island of Roatán. They called their “pop-up city” Vitalia.
I visited shortly after it launched in January 2024. The goal was to create a low-regulation biotech hub to fast-track the development of anti-aging drugs, though the “city” was more like a gated resort that hosted talks from a mix of respected academics, biohackers, biotech CEOs, and straight-up eugenicists. There was a strong sense of community—many attendees were living with or near each other, after all. A huge canvas where attendees could leave notes included missives like “Don’t die,” “I love you,” and “Meet technoradicals building the future!”
But Vitalia was short-lived, with events ending by the start of March 2024. And while many of the vibes were similar to what I’d later see at Vitalist Bay, the temporary nature of Vitalia didn’t quite match the ambition of Gries and Cheng.
Patri Friedman, a 49-year-old libertarian and grandson of the economist Milton Friedman who says he attended Zuzalu, Vitalia, and Vitalist Bay, envisions something potentially even bolder. He’s the founder of the Seasteading Institute, which has the goal of “building startup communities that float on the ocean with any measure of political autonomy” and has received funding and support from the billionaire Peter Thiel. Friedman also founded Pronomos Capital, a venture capital fund that invests in projects focused on “building the cities of tomorrow.”
His company is exploring various types of potential network states, but he says he’s found that medical tourism—and, specifically, a hunger for life extension—dominates the field. “People do not want this ‘10 years and a billion dollars to pass a drug’ thing with the FDA,” says Friedman. (While he doesn’t call himself a Vitalist, partly because he’s “almost never going to agree with” any kind of decree, Friedman holds what you might consider similarly staunch sentiments about death, which he referred to as “murder by omission.” When I asked him if he has a target age he’d like to reach, he told me he found the question “mind-bogglingly strange” and “insane.” “How could you possibly be like: Yes, please murder me at this time?” he replied. “I can always fucking shoot myself in the head—I don’t need anybody’s help.”)
But even as Vitalists and those aligned with their beliefs embrace longevity states, Gries and Cheng are reassessing their former ambitions. The network-state approach has limits, Gries tells me. And encouraging thousands of people to move to Rhode Island wasn’t as straightforward as they’d hoped it might be.
Not because he can’t find tens of thousands of Vitalists, Gries stresses—but most of them are unwilling to move their lives for the sake of influencing the policy of another state. He compares Vitalism to a startup, with a longevity state as its product. For the time being, at least, there isn’t enough consumer appetite for that product, he says.
The past year shows that it may in fact be easier to lobby legislators in states that are already friendly to deregulation. Anzinger and a lobbying group called the Alliance for Longevity Initiatives (A4LI) were integral to making Montana the first US hub for experimental medical treatments, with a new law to allow clinics to sell experimental therapies once they have been through preliminary safety tests (which don’t reveal whether a drug actually works). But Gries and his Vitalist colleagues also played a role—“providing feedback, talking to lawmakers … brainstorming [and] suggesting ideas,” Gries says.
The Vitalist crew has been in conversation with lawmakers in New Hampshire, too. In an email in December, Gries and Cheng claimed they’d “helped to get right-to-try laws passed” in the state—an apparent reference to the recent expansion of a law to make more unapproved treatments accessible to people with terminal illnesses. Meanwhile, three other bills that expand access even further are under consideration.
Ultimately, Gries stresses, Vitalism is “agnostic to the fixing strategies” that will help them meet their goals. There is, though, at least one strategy he’s steadfast about: building influence.
Only the hardcore
To trigger a revolution, the Vitalists may need to recruit only around 3% or 4% of “society” to their movement, Gries believes. (Granted, that does still mean hundreds of millions of people.) “If you want people to take action, you need to focus on a small number of very high-leverage people,” he tells me.
That, perhaps unsurprisingly, includes wealthy individuals with “a net worth of $10 million or above,” he says. He wants to understand why (with some high-profile exceptions, including Thiel, who has been investing in longevity-related companies and foundations for decades) most uber-wealthy people don’t invest in the field—and how he might persuade them to do so. He won’t reveal the names of anyone he’s having conversations with.
These “high-leverage” people might also include, Gries says, well-respected academics, leaders of influential think tanks, politicians and policymakers, and others who work in government agencies.
A revolution needs to find its foot soldiers. And at the most basic level, that will mean boosting the visibility of the Vitalism brand—partly through events like Vitalist Bay, but also by encouraging others, particularly in the biotech space, to sign on. Cheng talks of putting out a “bat signal” for like-minded people, and he and Gries say that Vitalism has brought together people who have gone on to collaborate or form companies.
There’s also their nonprofit Vitalism International Foundation, whose supporters can opt to become “mobilized Vitalists” with monthly payments of $29 or more, depending on their level of commitment. In addition, the foundation works with longevity biotech companies to recognize those that are “aligned” with its goals as officially certified Vitalist organizations. “Designation may be revoked if an organization adopts apologetic narratives that accept aging or death,” according to the website. At the time of writing, that site lists 16 certified Vitalist organizations, including cryopreservation companies, a longevity clinic, and several research companies.
One of them is Shift Bioscience, a company using CRISPR and aging clocks—which attempt to measure biological age—to identify genes that might play a significant role in the aging process and potentially reverse it. It says it has found a single gene that can rejuvenate multiple types of cells.
Shift cofounder Daniel Ives, who holds degrees in mitochondrial and computational biology, tells me he was also won over to the longevity cause by de Grey’s 2005 TED Talk. He now has a countdown on his computer: “It’s my days till death,” he says—around 22,000 days left. “I’m using that to keep myself focused.”
Ives calls himself the “Vitalist CEO” of Shift Bioscience. He thinks the label is important first as a way for like-minded people to find and support each other, grow their movement, and make the quest for longevity mainstream. Second, he says, it provides a way to appeal to “hardcore” lifespan extensionists, given that others in the wellness and cosmetics industry have adopted the term “longevity” without truly applying themselves to finding rejuvenation therapies. He refers to unnamed companies and individuals who claim that drinking juices, for example, can reverse aging by five years or so.
“You don’t have to convince the mainstream,” says ARPA-H science and engineering advisor Mark Hamalainen. Though “kind of a terrible example,”he notes, Stalinism started small. “Sometimes you just have to convince the right people.”
“Somebody will make these claims and basically throw legitimate science under the bus,” he says. He doesn’t want spurious claims made on social media to get lumped in with the company’s serious molecular biology. Shift’s head of machine learning, Lucas Paulo de Lima Camillo, was recently awarded a $10,000 prize by the well-respected Biomarkers of Aging Consortium for an aging clock he developed.
Another out-and-proud Vitalist CEO is Anar Isman, the cofounder of AgelessRx, a telehealth provider that offers prescriptions for purported longevity drugs—and a certified Vitalist organization. (Isman, who is in his early 40s, used to work at a hedge fund but was inspired to join the longevity field by—you guessed it—de Grey.)
During a panel session at Vitalist Bay, he stressed that he too saw longevity as a movement—and a revolution—rather than an industry. But he also claimed his company wasn’t doing too badly commercially. “We’ve had a lot of demand,” he said. “We’ve got $60 million plus in annual revenue.”
Many of his customers come to the site looking for treatments for specific ailments, he tells me. He views each as an opportunity to “evangelize” his views on “radical life extension.” “I don’t see a difference between … dying tomorrow or dying in 30 years,” he says. He wants to live “at least 100 more” years.
CHRIS LABROOY
Vitalism, though, isn’t just appealing to commercial researchers. Mark Hamalainen, a 41-year-old science and engineering advisor at ARPA-H, describes himself as a Vitalist. He says he “kind of got roped into” Vitalism because he also works with Cheng—they founded the Longevity Biotech Fellowship, which supports new entrants to the field through mentoring programs. “I kind of view it as a more appealing rebranding of some of the less radical aspects of transhumanism,” he says. Transhumanism—the position that we can use technologies to enhance humans beyond the current limits of biology—covers a broad terrain, but “Vitalism is like: Can we just solve this death thing first? It’s a philosophy that’s easy to get behind.”
In government, he works with individuals like Jean Hébert, a former professor of genetics and neuroscience who has investigated the possibility of rejuvenating the brain by gradually replacing parts of it; Hébert has said that “[his] mission is to beat aging.” He spoke at Zuzalu and Vitalist Bay.
Andrew Brack, who serves as the program manager for proactive health at ARPA-H, was at Vitalist Bay, too. Both Brack and Hébert oversee healthy federal budgets—Hébert’s brain replacement project was granted $110 million in 2024, for example.
Neither Hébert nor Brack has publicly described himself as a Vitalist, and Hébert wouldn’t agree to speak to me without the approval of ARPA-H’s press office, which didn’t respond to multiple requests for an interview with him or Brack. Brack did not respond to direct requests for an interview.
Gries says he thinks that “many people at [the US Department of Health and Human Services], including all agencies, have a longevity-positive view and probably agree with a lot of the ideas Vitalism stands for.” And he is hoping to help secure federal positions for others who are similarly aligned with his philosophy. On both Christmas Eve and New Year’s Eve last year, Gries and Cheng sent fundraising emails describing an “outreach effort” to find applicants for six open government positions that, together, would control billions of dollars in federal funding. “Qualified, mission-aligned candidates we’d love to support do exist, but they need to be found and encouraged to apply,” the pair wrote in the second email. “We’re starting a systematic search to reach, screen, and support the best candidates.”
Hamalainen supports Gries’s plan to target high-leverage individuals. “You don’t have to convince the mainstream,” he says. Though “kind of a terrible example,” Hamalainen notes, Stalinism started small. “Sometimes you just have to convince the right people.”
One of the “right” people may be the man who inspired Gries, Hamalainen, Ives, Isman, and so many others to pursue longevity in the first place: de Grey. He’s now a paid-up Vitalist and even spoke at Vitalist Bay. Having been in the field for over 20 years, de Grey tells me, he’s seen various terms fall in and out of favor. Those terms now have “baggage that gets in the way,” he says. “Sometimes it’s useful to have a new term.”
The sometimes quiet (sometimes powerful, sometimes influential) Vitalists
Though one of the five principles of Vitalism is a promise to “carry the message,” some people who agree with its ideas are reluctant to go public, including some signed-up Vitalists. I’ve asked Gries multiple times over several years, but he won’t reveal how many Vitalists there are, let alone who makes up the membership.
Even some of the founders of Vitalism don’t want to be public about it. Around 30 people were involved in developing the movement, Gries says—but only 22 are named as contributors to the Vitalism white paper (with Gries as its author), including Cheng, Vitalia’s Ion, and ARPA-H’s Hamalainen. Gries won’t reveal the names of the others. He acknowledges that some people just don’t like to publicly affiliate with any organization. That’s certainly what I’ve found when I’ve asked members of the longevity community if they’re Vitalists. Many said they agreed with the Vitalist declaration, and that they liked and supported what Gries was doing. But they didn’t want the label.
Some people worry that associating with a belief system that sounds a bit religious—even cult-like, some say—won’t do the cause any favors. Others have a problem with the specific wording of the declaration.
For instance, Anzinger—the other Vitalia founder—won’t call himself a Vitalist. He says he respects the mission, but that the declaration is “a bit poetic” for his liking.
And Dylan Livingston, CEO of A4LI and arguably one of the most influential longevity enthusiasts out there, won’t describe himself as a Vitalist either.
Many other longevity biotech CEOs also shy away from the label—including Emil Kendziorra, who runs the human cryopreservation company Tomorrow Bio, even though that’s a certified Vitalist organization. Kendziorra says he agrees with most of the Vitalist declaration but thinks it is too “absolutist.” He also doesn’t want to imply that the pursuit of longevity should be positioned above war, hunger, and other humanitarian issues. (Gries has heard this argument before, and counters that both the vast spending on health care for people in the last years of their life and the use of lockdown strategies during the covid pandemic suggest that, deep down, lifespan extension is “society’s revealed preference.”)
Still, because Kendziorra agrees with almost everything in the declaration, he believes that “pushing it forward” and bringing more attention to the field by labeling his company a Vitalist organization is a good thing. “It’s to support other people who want to move the world in that direction,” he says. (He also offered Vitalist Bay attendees a discount on his cryopreservation services.)
“There’s a lot of closeted scientists working in our field, and they get really excited about lifespans increasing,” explains Ives of Shift Bioscience. “But you’ll get people who’ll accuse you of being a lunatic that wants to be immortal.” He claims that people who represent biotech companies tell him “all the time” that they are secretly longevity companies but avoid using the term because they don’t want funders or collaborators to be “put off.”
Ultimately, it may not really matter how much people adopt the Vitalist label as long as the ideas break through. “It’s pretty simple. [The Vitalist declaration] has five points—if you agree with the five points, you are a Vitalist,” says Hamalainen. “You don’t have to be public about it.” He says he’s spoken to others about “coming out of the closet” and that it’s been going pretty well.
Gries puts it more bluntly: “If you agree with the Vitalist declaration, you are a Vitalist.”
And he hints that there are now many people in powerful positions—including in the Trump administration—who share his views, even if they don’t openly identify as Vitalists.
Jim O’Neill, the deputy secretary of health and human services, is one of the highest-profile longevity enthusiasts serving in government. Gries says, “It seems that now there is the most pro-longevity administration in American history.”
AMY ROSSETTI/DEPARTMENT OF HEALTH AND HUMAN SERVICES VIA AP
O’Neill has long been interested in both longevity and the idea of creating new jurisdictions. Until March 2024, he served on the board of directors of Friedman’s Seasteading Institute. He also served as CEO of the SENS Research Foundation, a longevity organization founded by de Grey, between 2019 and 2021, and he represented Thiel as a board member there for many years. Many people in the longevity community say they know him personally, or have at least met him. (Tristan Roberts, a biohacker who used to work with a biotech company operating in Próspera, tells me he served O’Neill gin when he visited his Burning Man camp, which he describes as a “technology gay camp from San Francisco and New York.” Hamalainen also recalls meeting O’Neill at Burning Man, at a “techy, futurist” camp.) (Neither O’Neill nor representatives from the Department of Health and Human Services responded to a request to comment about this.)
O’Neill’s views are arguably becoming less fringe in DC these days. The day after the Vitalist Bay Summit, A4LI was hosting its own summit in the capital with the goal of “bringing together leaders, advocates, and innovators from around the globe to advance legislative initiatives that promote a healthier human lifespan.” I recognized lots of Vitalist Bay attendees there, albeit in more formal attire.
The DC event took place over three days in late April. The first two involved talks by longevity enthusiasts across the spectrum, including scientists, lawyers, and biotech CEOs. Vitalia’s Anzinger spoke about the success he’d had in Próspera, and ARPA-H’s Brack talked about work his agency was doing. (Hamalainen was also there, although he said he was not representing ARPA-H.)
But the third day was different and made me think Gries may be right about Vitalism’s growing reach. It began with a congressional briefing on Capitol Hill, during which Representative Gus Bilirakis, a Republican from Florida, asked, “Who doesn’t want to live longer, right?” As he explained, “Longevity science … directly aligns with the goals of the Make America Healthy Again movement.”
“There’s a lot of closeted scientists working in our field, and they get really excited about lifespans increasing,” says Daniel Ives of Shift Bioscience. “But you’ll get people who’ll accuse you of being a lunatic that wants to be immortal.”
Bilirakis and Representative Paul Tonko, a New York Democrat, were followed by Mehmet Oz, the former TV doctor who now leads the Centers for Medicare and Medicaid Services; he opened with typical MAHA talking points about chronic disease and said US citizens have a “patriotic duty” to stay healthy to keep medical costs down. The audience was enthralled as Oz talked about senescent cells, the zombie-like aged cells that are thought to be responsible for some age-related damage to organs and tissues. (The offices of Bilirakis and Tonko did not respond to a request for comment; neither did the Centers for Medicare and Medicaid Services.)
And while none of the speakers went anywhere near the concept of radical life extension, the Vitalists in the audience were suitably encouraged.
Gries is too: “It seems that now there is the most pro-longevity administration in American history.”
The fate of “immortality quests”
Whether or not Vitalism starts a revolution, it will almost always be controversial in some quarters. While believers see an auspicious future, others are far less certain of the benefits of a world designed to defeat death.
Gries and Cheng often make the case for deregulation in their presentations. But ethicists—and even some members of the longevity community—point out that this comes with risks. Some question whether it is ever ethical to sell a “treatment” without some idea of how likely it is to benefit the person buying and taking it. Enthusiasts counter with arguments about bodily autonomy. And they hope Montana is just the start.
Then there’s the bigger picture. Is it really that great not to die … ever? Some ethicists argue that for many cultures, death is what gives meaning to life.
Sergio Imparato, a moral philosopher and medical ethicist at Harvard University, believes that death itself has important moral meaning. We know our lives will end, and our actions have value precisely because our time is limited, he says. Imparato is concerned that Vitalists are ultimately seeking to change what it means to be human—a decision that should involve all members of society.
Alberto Giubilini, a philosopher at the University of Oxford, agrees. “Death is a defining feature of humanity,” he says. “Our psychology, our cultures, our rituals, our societies, are built around the idea of coping with death … it’s part of human nature.”
CHRIS LABROOY
Imparato’s family is from Naples, Italy, where poor residents were once laid to rest in shared burial sites, with no headstones to identify them. He tells me how the locals came to visit, clean, and even “adopt” the skulls as family members. It became a weekly ritual for members of the community, including his grandmother, who was a young girl at the time. “It speaks to what I consider the cultural relevance of death,” he says. “It’s the perfect counterpoint to … the Vitalist conception of life.”
Gries seems aware of the stigma around such “immortality quests,” as Imparato calls them. In his presentations, Gries shares lists of words that Vitalists should try to avoid—like “eternity,” “radical,” and “forever,” as well as any religious terms.
He also appears to be dropping, at least publicly, the idea that Vitalism is a “moral” movement. Morality was “never part of the Vitalist declaration,” Gries told me in September. When I asked him why he had changed his position on this, he dismissed the question. “Our point … was always that death is humanity’s core problem, and aging its primary agent,” he told me. “So it was, and so it has continued, as it was foretold.”
But despite these attempts to tweak and control the narrative, Vitalism appears to be opening the door to an incredibly wide range of sentiments in longevity science. A decade ago, I don’t think there would have been any way that the views espoused by Gries, Anzinger, and others who support Vitalist sentiments would have been accepted by the scientific establishment. After all, these are people who publicly state they hope to live indefinitely and who have no training in the science of aging, and who are open about their aims to find ways to evade the restrictions set forth by regulatory agencies like the FDA—all factors that might have rendered them outcasts not that long ago.
But Gries and peers had success in Montana. Influential scientists and policymakers attend Vitalism events, and Vitalists are featured regularly at more mainstream longevity events. Last year’s Aging Research and Drug Discovery (ARDD) conference in Copenhagen—widely recognized as the most important meeting in aging science—was sponsored in part by Anzinger’s new Próspera venture, Infinita City, as well as by several organizations that are either certified Vitalist or led by Vitalists.
“I was thinking that maybe what I was doing was very fringe or out there,” Anzinger, the non-Vitalist supporter of Vitalism, admits. “But no—I feel … loads of support.”
There was certainly an air of optimism at the Vitalist Bay Summit in Berkeley. Gries’s positivity is infectious. “All the people who want a fun and awesome surprise gift, come on over!” he called out early on the first day. “Raise your voice if you’re excited!” The audience whooped in response. He then proceeded to tell everyone, Oprah Winfrey–style, that they were all getting a free continuous glucose monitor. “You get a CGM! You get a CGM!” Plenty of attendees actually attached them to their arms on the spot.
Every revolution has to start somewhere, right?
This piece has been updated to clarify a quote from Mark Hamalainen.
When Elon Musk was at Davos last week, an interviewer asked him if he thought aging could be reversed. Musk said he hasn’t put much time into the problem but suspects it is “very solvable” and that when scientists discover why we age, it’s going to be something “obvious.”
Not long after, the Harvard professor and life-extension evangelist David Sinclair jumped into the conversation on X to strongly agree with the world’s richest man. “Aging has a relatively simple explanation and is apparently reversible,” wrote Sinclair. “Clinical Trials begin shortly.”
“ER-100?” Musk asked.
“Yes” replied Sinclair.
ER-100 turns out to be the code name of a treatment created by Life Biosciences, a small Boston startup that Sinclair cofounded and which he confirmed today has won FDA approval to proceed with the first targeted attempt at age reversal in human volunteers.
The company plans to try to treat eye disease with a radical rejuvenation concept called “reprogramming” that has recently attracted hundreds of millions in investment for Silicon Valley firms like Altos Labs, New Limit, and Retro Biosciences, backed by many of the biggest names in tech.
The technique attempts to restore cells to a healthier state by broadly resetting their epigenetic controls—switches on our genes that determine which are turned on and off.
“Reprogramming is like the AI of the bio world. It’s the thing everyone is funding,” says Karl Pfleger, an investor who backs a smaller UK startup, Shift Bioscience. He says Sinclair’s company has recently been seeking additional funds to keep advancing its treatment.
Reprogramming is so powerful that it sometimes creates risks, even causing cancer in lab animals, but the version of the technique being advanced by Life Biosciences passed initial safety tests in animals.
But it’s still very complex. The trial will initially test the treatment on about a dozen patients with glaucoma, a condition where high pressure inside the eye damages the optic nerve. In the tests, viruses carrying three powerful reprogramming genes will be injected into one eye of each patient, according to a description of the study first posted in December.
To help make sure the process doesn’t go too far, the reprogramming genes will be under the control of a special genetic switch that turns them on only while the patients take a low dose of the antibiotic doxycycline. Initially, they will take the antibiotic for about two months while the effects are monitored.
Executives at the company have said for months that a trial could begin this year, sometimes characterizing it as a starting bell for a new era of age reversal. “It’s an incredibly big deal for us as an industry,” Michael Ringel, chief operating officer at Life Biosciences, said at an event this fall. “It’ll be the first time in human history, in the millennia of human history, of looking for something that rejuvenates … So watch this space.”
The technology is based on the Nobel Prize–winning discovery, 20 years ago, that introducing a few potent genes into a cell will cause it to turn back into a stem cell, just like those found in an early embryo that develop into the different specialized cell types. These genes, known as Yamanaka factors, have been likened to a “factory reset” button for cells.
But they’re dangerous, too. When turned on in a living animal, they can cause an eruption of tumors.
That is what led scientists to a new idea, termed “partial” or “transient” reprogramming. The idea is to limit exposure to the potent genes—or use only a subset of them—in the hope of making cells act younger without giving them complete amnesia about what their role in the body is.
In 2020, Sinclair claimed that such partial reprogramming could restore vision to mice after their optic nerves were smashed, saying there was even evidence that the nerves regrew. His report appeared on the cover of the influential journal Nature alongside the headline “Turning Back Time.”
Not all scientists agree that reprogramming really counts as age reversal. But Sinclair has doubled down. He’s been advancing the theory that the gradual loss of correct epigenetic information in our cells is, in fact, the ultimate cause of aging—just the kind of root cause that Musk was alluding to.
“Elon does seem to be paying attention to the field and [is] seemingly in sync with [my theory],” Sinclair said in an email.
Reprogramming isn’t the first longevity fix championed by Sinclair, who’s written best-selling books and commands stratospheric fees on the longevity lecture circuit. Previously, he touted the longevity benefits of molecules called sirtuins as well as resveratrol, a molecule found in red wine. But some critics say he greatly exaggerates scientific progress, pushback that culminated in a 2024 Wall Street Journal story that dubbed him a “reverse-aging guru” whose companies “have not panned out.”
Life Biosciences has been among those struggling companies. Initially formed in 2017, it at first had a strategy of launching subsidiaries, each intended to pursue one aspect of the aging problem. But after these made limited progress, in 2021 it hired a new CEO, Jerry McLaughlin, who has refocused its efforts on Sinclair’s mouse vision results and the push toward a human trial.
The company has discussed the possibility of reprogramming other organs, including the brain. And Ringel, like Sinclair, entertains the idea that someday even whole-body rejuvenation might be feasible. But for now, it’s better to think of the study as a proof of concept that’s still far from a fountain of youth. “The optimistic case is this solves some blindness for certain people and catalyzes work in other indications,” says Pfleger, the investor. “It’s not like your doctor will be writing a prescription for a pill that will rejuvenate you.”
Life’s treatment also relies on an antibiotic switching mechanism that, while often used in lab animals, hasn’t been tried in humans before. Since the switch is built from gene components taken from E. coli and the herpes virus, it’s possible that it could cause an immune reaction in humans, scientists say.
“I was always thinking that for widespread use you might need a different system,” says Noah Davidsohn, who helped Sinclair implement the technique and is now chief scientist at a different company, Rejuvenate Bio. And Life’s choice of reprogramming factors—it’s picked three, which go by the acronym OSK—may also be risky. They are expected to turn on hundreds of other genes, and in some circumstances the combination can cause cells to revert to a very primitive, stem-cell-like state.
Other companies studying reprogramming say their focus is on researching which genes to use, in order to achieve time reversal without unwanted side effects. New Limit, which has been carrying out an extensive search for such genes, says it won’t be ready for a human study for two years. At Shift, experiments on animals are only beginning now.
“Are their factors the best version of rejuvenation? We don’t think they are. I think they are working with what they’ve got,” Daniel Ives, the CEO of Shift, says of Life Biosciences. “But I think they’re way ahead of anybody else in terms of getting into humans. They have found a route forward in the eye, which is a nice self-contained system. If it goes wrong, you’ve still got one left.”
This week marked a rather unpleasant anniversary: It’s a year since Texas reported a case of measles—the start of a significant outbreak that ended up spreading across multiple states. Since the start of January 2025, there have been over 2,500 confirmed cases of measles in the US. Three people have died.
As vaccination rates drop and outbreaks continue, scientists have been experimenting with new ways to quickly identify new cases and prevent the disease from spreading. And they are starting to see some success with wastewater surveillance.
After all, wastewater contains saliva, urine, feces, shed skin, and more. You could consider it a rich biological sample. Wastewater analysis helped scientists understand how covid was spreading during the pandemic. It’s early days, but it is starting to help us get a handle on measles.
Globally, there has been some progress toward eliminating measles, largely thanks to vaccination efforts. Such efforts led to an 88% drop in measles deaths between 2000 and 2024, according to the World Health Organization. It estimates that “nearly 59 million lives have been saved by the measles vaccine” since 2000.
Still, an estimated 95,000 people died from measles in 2024 alone—most of them young children. And cases are surging in Europe, Southeast Asia, and the Eastern Mediterranean region.
Last year, the US saw the highest levels of measles in decades. The country is on track to lose its measles elimination status—a sorry fate that met Canada in November after the country recorded over 5,000 cases in a little over a year.
Public health efforts to contain the spread of measles—which is incredibly contagious—typically involve clinical monitoring in health-care settings, along with vaccination campaigns. But scientists have started looking to wastewater, too.
Along with various bodily fluids, we all shed viruses and bacteria into wastewater, whether that’s through brushing our teeth, showering, or using the toilet. The idea of looking for these pathogens in wastewater to track diseases has been around for a while, but things really kicked into gear during the covid-19 pandemic, when scientists found that the coronavirus responsible for the disease was shed in feces.
This led Marlene Wolfe of Emory University and Alexandria Boehm of Stanford University to establish WastewaterSCAN, an academic-led program developed to analyze wastewater samples across the US. Covid was just the beginning, says Wolfe. “Over the years we have worked to expand what can be monitored,” she says.
Two years ago, for a previous edition of the Checkup, Wolfe told Cassandra Willyard that wastewater surveillance of measles was “absolutely possible,” as the virus is shed in urine. The hope was that this approach could shed light on measles outbreaks in a community, even if members of that community weren’t able to access health care and receive an official diagnosis. And that it could highlight when and where public health officials needed to act to prevent measles from spreading. Evidence that it worked as an effective public health measure was, at the time, scant.
Since then, she and her colleagues have developed a test to identify measles RNA. They trialed it at two wastewater treatment plants in Texas between December 2024 and May 2025. At each site, the team collected samples two or three times a week and tested them for measles RNA.
Over that period, the team found measles RNA in 10.5% of the samples they collected, as reported in a preprint paper published at medRxiv in July and currently under review at a peer-reviewed journal. The first detection came a week before the first case of measles was officially confirmed in the area. That’s promising—it suggests that wastewater surveillance might pick up measles cases early, giving public health officials a head start in efforts to limit any outbreaks.
There are more promising results from a team in Canada. Mike McKay and Ryland Corchis-Scott at the University of Windsor in Ontario and their colleagues have also been testing wastewater samples for measles RNA. Between February and November 2025, the team collected samples from a wastewater treatment facility serving over 30,000 people in Leamington, Ontario.
These wastewater tests are somewhat limited—even if they do pick up measles, they won’t tell you who has measles, where exactly infections are occurring, or even how many people are infected. McKay and his colleagues have begun to make some progress here. In addition to monitoring the large wastewater plant, the team used tampons to soak up wastewater from a hospital lateral sewer.
They then compared their measles test results with the number of clinical cases in that hospital. This gave them some idea of the virus’s “shedding rate.” When they applied this to the data collected from the Leamington wastewater treatment facility, the team got estimates of measles cases that were much higher than the figures officially reported.
Their findings track with the opinions of local health officials (who estimate that the true number of cases during the outbreak was around five to 10 times higher than the confirmed case count), the team members wrote in a paper published on medRxiv a couple of weeks ago.
There will always be limits to wastewater surveillance. “We’re looking at the pool of waste of an entire community, so it’s very hard to pull in information about individual infections,” says Corchis-Scott.
Wolfe also acknowledges that “we have a lot to learn about how we can best use the tools so they are useful.” But her team at WastewaterSCAN has been testing wastewater across the US for measles since May last year. And their findings are published online and shared with public health officials.
In some cases, the findings are already helping inform the response to measles. “We’ve seen public health departments act on this data,” says Wolfe. Some have issued alerts, or increased vaccination efforts in those areas, for example. “[We’re at] a point now where we really see public health departments, clinicians, [and] families using that information to help keep themselves and their communities safe,” she says.
McKay says his team has stopped testing for measles because the Ontario outbreak “has been declared over.” He says testing would restart if and when a single new case of measles is confirmed in the region, but he also thinks that his research makes a strong case for maintaining a wastewater surveillance system for measles.
McKay wonders if this approach might help Canada regain its measles elimination status. “It’s sort of like [we’re] a pariah now,” he says. If his approach can help limit measles outbreaks, it could be “a nice tool for public health in Canada to [show] we’ve got our act together.”
This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.
Earlier this week, MIT Technology Review published its annual list of Ten Breakthrough Technologies. As always, it features technologies that made the news last year, and which—for better or worse—stand to make waves in the coming years. They’re the technologies you should really be paying attention to.
This year’s list includes tech that’s set to transform the energy industry, artificial intelligence, space travel—and of course biotech and health. Our breakthrough biotechnologies for 2026 involve editing a baby’s genes and, separately, resurrecting genes from ancient species. We also included a controversial technology that offers parents the chance to screen their embryos for characteristics like height and intelligence. Here’s the story behind our biotech choices.
A base-edited baby!
In August 2024, KJ Muldoon was born with a rare genetic disorder that allowed toxic ammonia to build up in his blood. The disease can be fatal, and KJ was at risk of developing neurological disorders. At the time, his best bet for survival involved waiting for a liver transplant.
Then he was offered an experimental gene therapy—a personalized “base editing” treatment designed to correct the specific genetic “misspellings” responsible for his disease. It seems to have worked! Three doses later, KJ is doing well. He took his first steps in December, shortly before spending his first Christmas at home.
KJ’s story is hugely encouraging. The team behind his treatment is planning a clinical trial for infants with similar disorders caused by different genetic mutations. The team members hope to win regulatory approval on the back of a small trial—a move that could make the expensive treatment (KJ’s cost around $1 million) more accessible, potentially within a few years.
Others are getting in on the action, too. Fyodor Urnov, a gene-editing scientist at the University of California, Berkeley, assisted the team that developed KJ’s treatment. He recently cofounded Aurora Therapeutics, a startup that hopes to develop gene-editing drugs for another disorder called phenylketonuria (PKU). The goal is to obtain regulatory approval for a single drug that can then be adjusted or personalized for individuals without having to go through more clinical trials.
It was a big year for Colossal Biosciences, the biotech company hoping to “de-extinct” animals like the woolly mammoth and the dodo. In March, the company created what it called “woolly mice”—rodents with furry coats and curly whiskers akin to those of woolly mammoths.
The company made an even more dramatic claim the following month, when it announced it had created three dire wolves. These striking snow-white animals were created by making 20 genetic changes to the DNA of gray wolves based on genetic research on ancient dire wolf bones, the company said at the time.
Whether these animals can really be called dire wolves is debatable, to say the least. But the technology behind their creation is undeniably fascinating. We’re talking about the extraction and analysis of ancient DNA, which can then be introduced into cells from other, modern-day species.
Analysis of ancient DNA can reveal all sorts of fascinating insights into human ancestors and other animals. And cloning, another genetic tool used here, has applications not only in attempts to re-create dead pets but also in wildlife conservation efforts. Read more here.
Embryo scoring
IVF involves creating embryos in a lab and, typically, “scoring” them on their likelihood of successful growth before they are transferred to a person’s uterus. So far, so uncontroversial.
Recently, embryo scoring has evolved. Labs can pinch off a couple of cells from an embryo, look at its DNA, and screen for some genetic diseases. That list of diseases is increasing. And now some companies are taking things even further, offering prospective parents the opportunity to select embryos for features like height, eye color, and even IQ.
This is controversial for lots of reasons. For a start, there are many, many factors that contribute to complex traits like IQ (a score that doesn’t capture all aspects of intelligence at any rate). We don’t have a perfect understanding of those factors, or how selecting for one trait might influence another.
Some critics warn of eugenics. And others note that whichever embryo you end up choosing, you can’t control exactly how your baby will turn out (and why should you?!). Still, that hasn’t stopped Nucleus, one of the companies offering these services, from inviting potential customers to have their “best baby.” Read more here.
This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.
Here at MITTechnology Review we’ve been writing about the gene-editing technology CRISPR since 2013, calling it the biggest biotech breakthrough of the century. Yet so far, there’s been only one gene-editing drug approved. It’s been used commercially on only about 40 patients, all with sickle-cell disease.
It’s becoming clear that the impact of CRISPR isn’t as big as we all hoped. In fact, there’s a pall of discouragement over the entire field—with some journalists saying the gene-editing revolution has “lost its mojo.”
So what will it take for CRISPR to help more people? A new startup says the answer could be an “umbrella approach” to testing and commercializing treatments. Aurora Therapeutics, which has $16 million from Menlo Ventures and counts CRISPR co-inventor Jennifer Doudna as an advisor, essentially hopes to win approval for gene-editing drugs that can be slightly adjusted, or personalized, without requiring costly new trials or approvals for every new version.
The need to change regulations around gene-editing treatments was endorsed in November by the head of the US Food and Drug Administration, Martin Makary, who said the agency would open a “new” regulatory pathway for “bespoke, personalized therapies” that can’t easily be tested in conventional ways.
Aurora’s first target, the rare inherited disease phenylketonuria, also known as PKU, is a case in point. People with PKU lack a working version of an enzyme needed to use up the amino acid phenylalanine, a component of pretty much all meat and protein. If the amino acid builds up, it causes brain damage. So patients usually go on an onerous “diet for life” of special formula drinks and vegetables.
In theory, gene editing can fix PKU. In mice, scientists have already restored the gene for the enzyme by rewriting DNA in liver cells, which both make the enzyme and are some of the easiest to reach with a gene-editing drug. The problem is that in human patients, many different mutations can affect the critical gene. According to Cory Harding, a researcher at Oregon Health Sciences University, scientists know about 1,600 different DNA mutations that cause PKU.
There’s no way anyone will develop 1,600 different gene-editing drugs. Instead, Aurora’s goal is to eventually win approval for a single gene editor that, with minor adjustments, could be used to correct several of the most common mutations, including one that’s responsible for about 10% of the estimated 20,000 PKU cases in the US.
“We can’t have a separate clinical trial for each mutation,” says Edward Kaye, the CEO of Aurora. “The way the FDA approves gene editing has to change, and I think they’ve been very understanding that is the case.”
A gene editor is a special protein that can zero in on a specific location in the genome and change it. To prepare one, Aurora will put genetic code for the editor into a nanoparticle along with a targeting molecule. In total, it will involve about 5,000 gene letters. But only 20 of them need to change in order to redirect the treatment to repair a different mutation.
“Over 99% of the drug stays the same,” says Johnny Hu, a partner at Menlo Ventures, which put up the funding for the startup.
The new company came together after Hu met over pizza with Fyodor Urnov, an outspoken gene-editing scientist at the University of California, Berkeley, who is Aurora’s cofounder and sits on its board.
In 2022, Urnov had written a New York Times editorial bemoaning the “chasm” between what editing technology can do and the “legal, financial, and organizational” realities preventing researchers from curing people.
“I went to Fyodor and said, ‘Hey, we’re getting all these great results in the clinic with CRISPR, but why hasn’t it scaled?” says Hu. Part of the reason is that most gene-editing companies are chasing the same few conditions, such as sickle-cell, where (as luck would have it) a single edit works for all patients. But that leaves around 400 million people who have 7,000 other inherited conditions without much hope to get their DNA fixed, Urnov estimated in his editorial.
Then, last May, came the dramatic demonstration of the first fully “personalized” gene-editing treatment. A team in Philadelphia, assisted by Urnov and others, succeeded in correcting the DNA of a baby, named KJ Muldoon, who had an entirely unique mutation that caused a metabolic disease. Though it didn’t target PKU, the project showed that gene editing could theoretically fix some inherited diseases “on demand.”
It also underscored a big problem. Treating a single child required a large team and cost millions in time, effort, and materials—all to create a drug that would never be used again.
That’s exactly the sort of situation the new “umbrella” trials are supposed to address. Kiran Musunuru, who co-led the team at the University of Pennsylvania, says he’s been in discussions with the FDA to open a study of bespoke gene editors this year focusing on diseases of the type Baby KJ had, called urea cycle disorders. Each time a new patient appears, he says, they’ll try to quickly put together a variant of their gene-editing drug that’s tuned to fix that child’s particular genetic problem.
Musunuru, who isn’t involved with Aurora, does not think the company’s plans for PKU count as fully personalized editors. “These corporate PKU efforts have nothing whatsoever to do with Baby KJ,” he says. He says his center continues to focus on mutations “so ultra-rare that we don’t see any scenario where a for-profit gene-editing company would find that indication to be commercially viable.”
Instead, what’s occurring in PKU, says Musunuru, is that researchers have realized they can assemble “a bunch” of the most frequent mutations “into a large enough group of patients to make a platform PKU therapy commercially viable.”
While that would still leave out many patients with extra-rare gene errors, Musunuru says any gene-editing treatment at all would still be “a big improvement over the status quo, which is zero genetic therapies for PKU.”
The new year has barely begun, but the first days of 2026 have brought big news for health. On Monday, the US’s federal health agency upended its recommendations for routine childhood vaccinations—a move that healthassociations worry puts children at unnecessary risk of preventable disease.
There was more news from the federal government on Wednesday, when health secretary Robert F. Kennedy Jr. and his colleagues at the Departments of Health and Human Services and Agriculture unveiled new dietary guidelines for Americans. And they are causing a bit of a stir.
That’s partly because they recommend products like red meat, butter, and beef tallow—foods that have been linked to cardiovascular disease, and that nutrition experts have been recommending people limit in their diets.
These guidelines are a big deal—they influence food assistance programs and school lunches, for example. So this week let’s look at the good, the bad, and the ugly advice being dished up to Americans by their government.
The government dietary guidelines have been around since the 1980s. They are updated every five years, in a process that typically involves a team of nutrition scientists who have combed over scientific research for years. That team will first publish its findings in a scientific report, and, around a year later, the finalized Dietary Guidelines for Americans are published.
The last guidelines covered the period 2020 to 2025, and new guidelines were expected in the summer of 2025. Work had already been underway for years; the scientific report intended to inform them was published back in 2024. But the publication of the guidelines was delayed by last year’s government shutdown, Kennedy said last year. They were finally published yesterday.
Nutrition experts had been waiting with bated breath. Nutrition science has evolved slightly over the last five years, and some were expecting to see new recommendations. Research now suggests, for example, that there is no “safe” level of alcohol consumption.
We are also beginning to learn more about health risks associated with some ultraprocessed foods (although we still don’t have a good understanding of what they might be, or what even counts as “ultraprocessed”.) And some scientists were expecting to see the new guidelines factor in environmental sustainability, says Gabby Headrick, the associate director of food and nutrition policy at George Washington University’s Institute for Food Safety & Nutrition Security in Washington DC.
They didn’t.
Many of the recommendations are sensible. The guidelines recommend a diet rich in whole foods, particularly fresh fruits and vegetables. They recommend avoiding highly processed foods and added sugars. They also highlight the importance of dietary protein, whole grains, and “healthy” fats.
But not all of them are, says Headrick. The guidelines open with a “new pyramid” of foods. This inverted triangle is topped with “protein, dairy, and healthy fats” on one side and “vegetables and fruits” on the other.
USDA
There are a few problems with this image. For starters, its shape—nutrition scientists have long moved on from the food pyramids of the 1990s, says Headrick. They’re confusing and make it difficult for people to understand what the contents of their plate should look like. That’s why scientists now use an image of a plate to depict a healthy diet.
“We’ve been using MyPlate to describe the dietary guidelines in a very consumer-friendly, nutrition-education-friendly way for over the last decade now,” says Headrick. (The UK’s National Health Service takes a similar approach.)
And then there’s the content of that food pyramid. It puts a significant focus on meat and whole-fat dairy produce. The top left image—the one most viewers will probably see first—is of a steak. Smack in the middle of the pyramid is a stick of butter. That’s new. And it’s not a good thing.
While both red meat and whole-fat dairy can certainly form part of a healthy diet, nutrition scientists have long been recommending that most people try to limit their consumption of these foods. Both can be high in saturated fat, which can increase the risk of cardiovascular disease—the leading cause of death in the US. In 2015, on the basis of limited evidence, the World Health Organization classified red meat as “probably carcinogenic to humans.”
Also concerning is the document’s definition of “healthy fats,” which includes butter and beef tallow (a MAHA favorite). Neither food is generally considered to be as healthy as olive oil, for example. While olive oil contains around two grams of saturated fat per tablespoon, a tablespoon of beef tallow has around six grams of saturated fat, and the same amount of butter contains around seven grams of saturated fat, says Headrick.
“I think these are pretty harmful dietary recommendations to be making when we have established that those specific foods likely do not have health-promoting benefits,” she adds.
Red meat is not exactly a sustainable food, and neither are dairy products. And the advice on alcohol is relatively vague, recommending that people “consume less alcohol for better overall health” (which might leave you wondering: Less than what?).
There are other questionable recommendations in the guidelines. Americans are advised to include more protein in their diets—at levels between 1.2 and 1.6 grams daily per kilo of body weight, 50% to 100% more than recommended in previous guidelines. There’s a risk that increasing protein consumption to such levels could raise a person’s intake of both calories and saturated fats to unhealthy levels, says José Ordovás, a senior nutrition scientist at Tufts University. “I would err on the low side,” he says.
Some nutrition scientists are questioning why these changes have been made. It’s not as though the new recommendations were in the 2024 scientific report. And the evidence on red meat and saturated fat hasn’t changed, says Headrick.
In reporting this piece, I contacted many contributors to the previous guidelines, and some who had led research for 2024’s scientific report. None of them agreed to comment on the new guidelines on the record. Some seemed disgruntled. One merely told me that the process by which the new guidelines had been created was “opaque.”
“These people invested a lot of their time, and they did a thorough job [over] a couple of years, identifying [relevant scientific studies],” says Ordovás. “I’m not surprised that when they see that [their] work was ignored and replaced with something [put together] quickly, that they feel a little bit disappointed,” he says.
This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.
The Italian neurosurgeon Sergio Canavero has been preparing for a surgery that might never happen. His idea? Swap a sick person’s head—or perhaps just the brain—onto a younger, healthier body.
Canavero caused a stir in 2017 when he announced that a team he advised in China had exchanged heads between two corpses. But he never convinced skeptics that his technique could succeed—or to believe his claim that a procedure on a live person was imminent. The Chicago Tribune labeled him the “P.T. Barnum of transplantation.”
Canavero withdrew from the spotlight. But the idea of head transplants isn’t going away. Instead, he says, the concept has recently been getting a fresh look from life-extension enthusiasts and stealth Silicon Valley startups.
Career path
It’s been rocky. After he began publishing his surgical ideas a decade ago, Canavero says, he got his “pink slip” from the Molinette Hospital in Turin, where he’d spent 22 years on staff. “I’m an out-of-the-establishment guy. So that has made things harder, I have to say,” he says.
Why he persists
No other solution to aging is on the horizon. “It’s become absolutely clear over the past years that the idea of some incredible tech to rejuvenate elderly people—happening in some secret lab, like Google—is really going nowhere,” he says. “You have to go for the whole shebang.”
The whole shebang?
He means getting a new body, not just one new organ. Canavero has an easy mastery of English idioms and an unexpected Southern twang. He says that’s due to a fascination with American comics as a child. “For me, learning the language of my heroes was paramount,” he says. “So I can shoot the breeze.”
Cloned bodies
Canavero is now an independent investigator and has advised entrepreneurs who want to create brainless human clones as a source of DNA-matched organs that wouldn’t get rejected by a recipient’s immune system. “I can tell you there are guys from top universities involved,” he says.
What’s next
Combining the necessary technologies, like reliably precise surgical robots and artificial wombs to grow the clones, is going to be complex and very, very expensive. Canavero lacks the funds to take his plans further, but he believes “the money is out there” for a commercial moonshot project: “What I say to the billionaires is ‘Come together.’ You will all have your own share, plus make yourselves immortal.”
At first glance, it looks like the start of a human pregnancy: A ball-shaped embryo presses gently into the receptive lining of the uterus and then grips tight, burrowing in as the first tendrils of a future placenta appear.
This is implantation—the moment that pregnancy officially begins.
Only none of it is happening inside a body. These images were captured in a Beijing laboratory, inside a microfluidic chip, as scientists watched the scene unfold.
This transparent microfluidic chip is used to grow an organoid that mimics the lining of a uterus.
COURTESY OF THE RESEARCHERS
In three papers published this week by Cell Press, scientists are reporting what they call the most accurate efforts yet to mimic the first moments of pregnancy in the lab. They’ve taken human embryos from IVF centers and let these merge with “organoids” made of endometrial cells, which form the lining of the uterus.
The reports—two from China and a third involving a collaboration among researchers in the United Kingdom, Spain, and the US—show how scientists are using engineered tissues to better understand early pregnancy and potentially improve IVF outcomes.
“You have an embryo and the endometrial organoid together,” says Jun Wu, a biologist at the University of Texas Southwestern Medical Center, in Dallas, who contributed to both Chinese reports. “That’s the overarching message of all three papers.”
According to the papers, these 3D combinations are the most complete re-creations yet of the first days of pregnancy and should be useful for studying why IVF treatments often fail.
In each case, the experiments were stopped when the embryos were two weeks old, if not sooner. That is due to legal and ethical rules that typically restrict scientists from going any further than 14 days.
In your basic IVF procedure, an egg is fertilized in the lab and allowed to develop into a spherical embryo called a blastocyst—a process that takes a few days. That blastocyst then gets put into a patient’s uterus in the hope it will establish itself there and ultimately become a baby.
Two blastoids, or artificial embryos (circles), grow inside an organoid.
COURTESY OF THE RESEARCHERS
But that’s a common failure point. Many patients will learn that their IVF procedure didn’t work because an embryo never attached.
In the new reports, it’s that initial bond between mother and embryo that is being reproduced in the lab. “IVF means in vitro fertilization, but now this is the stage of in vitroimplantation,” says Matteo Molè, a biologist at Stanford University whose results with collaborators in Europe are among those published today. “Considering that implantation is a barrier [to pregnancy], we have the potential to increase the success rate if we can model it in the laboratory.”
Normally implantation is entirely hidden from view because it occurs in someone’s uterus, says Hongmei Wang, a developmental biologist at the Beijing Institute for Stem Cell and Regenerative Medicine, who co-led the effort there. Wang often studies monkeys because she can interrupt their pregnancies to collect the tissues she needs to see. “We’ve always hoped to understand human embryo implantation, but we have lacked a way to do so,” she says. “It’s all happening in the uterus.”
In the Beijing study, researchers tested about 50 donated IVF embryos, but they also ran a thousand more experiments using so-called blastoids. The latter are mimics of early-stage human embryos manufactured from stem cells. Blastoids are easy to make in large numbers and, since they aren’t true embryos, don’t have as many ethical rules on their use.
“The question was, if we have these blastoids, what can we use them for?” says Leqian Yu, the senior author of the report from the Beijing Institute. “The obvious next step was implantation. So how do you do that?”
For the Beijing team, the answer was to build a soft silicone chamber with tiny channels to add nutrients and a space to grow the uterine organoid. After that, blastoids—or real embryos—could be introduced through a window in the device, so the “pregnancy” could start.
“The key question we want to try to answer is what is the first cross-talk between embryo and mother,” says Yu. “I think this is maybe the first time we can see the entire process.”
Medical applications
This isn’t the first time researchers have tried using organoids for this kind of research. At least two startup companies have raised funds to commercialize similar systems—in some cases presenting the organoids as a tool to predict IVF success. In addition toDawn Bio, a startup based in Vienna, there is Simbryo Technologies, in Houston, which last month said it would begin offering “personalized” predictions for IVF patients using blastoids and endometrial organoids.
To do that test, doctors will take a biopsy of a patient’s uterine lining and grow organoids from it. After that, blastoids will be added to the organoids to gauge whether a woman is likely to be able to support a pregnancy or not. If the blastoids don’t start to implant, it could mean the patient’s uterus isn’t receptive and is the reason IVF isn’t working.
The Beijing team thinks the pregnancy organoids could also be used to identify drugs that might help those patients. In their paper, they describe how they made organoids out of tissue taken from women who’ve had repeated IVF failures. Then they tested 1,119 approved drugs on those samples to see if anything improved.
Several seemed to have helpful effects. One chemical, avobenzone, an ingredient in some types of sunblock, increased the chance that a blastoid would start implanting from just 5% of the time to around 25% of the time. Yu says his center hopes to eventually start a clinical trial if they can find the right drug to try.
Artificial womb?
The Beijing group is working on ways to improve the organoid system so that it’s even more realistic. Right now, it lacks important cell types, including immune cells and a blood supply. Yu says a next step he’s working on is to add blood vessels and tiny pumps to his chip device, so that he can give the organoids a kind of rudimentary circulation.
This means that in the near future, blastoids or embryos could likely be grown longer, raising questions about how far scientists will be able to take pregnancy in the lab. “I think this technology does raise the possibility of growing things longer,” says Wu, who says some view the research as an initial step toward creating babies entirely outside the body.
However, Wu says incubating a human to term in the laboratory remains impossible, for the time being. “This technology is certainly related to ectogenesis, or development outside the body,” he says. “But I don’t think it’s anywhere near an artificial womb. That’s still science fiction.”
