We stand at a very interesting juncture in the ongoing development of medicine, travel, and communication. The world is becoming a small place, in which geographically dispersed interest groups can find one another, talk, and organize. The cost of either a round trip by air to a different continent or a cruise that covers a dozen countries is considerably less than the cost of many of the new classes of stem cell therapy or gene therapy. These treatments have been or soon will be available via medical tourism. They are not available or are only just starting to become available in countries such as the US due to the incredible cost and time required to comply with US regulatory requirements in comparison to those elsewhere. Stem cell treatments were the important class of new treatment available via medical tourism over the past decade and in the decade to come will be joined by elective gene therapies, such as myostatin knockout for muscle growth. You'll recall that the analogous follistatin gene therapy was undertaken in an overseas clinic as a proof of concept by the CEO of startup BioViva not so long ago. In a year or two anyone with the money and the insider connections will be able to do the same, and five years from now a competitive international marketplace will offer this gene therapy at a comparatively low cost.

The next decade of therapies available via medical tourism will also include the first narrowly focused rejuvenation therapies. Those already technically possible include the senescent cell clearance approach of Oisin Biotechnologies and the transthyretin amyloid clearance trialed by Pentraxin and GlaxoSmithKline. I expect to see these joined by glucosepane cross-link clearance and perhaps allotopic expression of all mitochondrial genes in the years ahead. Senescent cell clearance is certainly very close, close enough, I think, to that we should be planning how we can help to place these therapies into clinics as soon as possible.

I put down a few thoughts on this topic earlier in the month, focused on how rejuvenation therapies might follow the trail blazed by the stem cell research and development community fifteen years ago, producing widespread and cost-effective availability of treatments - and data on patient outcomes - long before regulators in the US were willing to approve these therapies. Today I'll talk about a different approach to gaining access to therapies for early adopters, one that looks a lot like the organization of group buys or vacations. If you look at what BioViva organized for one person's gene therapy, it is fairly easy to imagine organizing it for a dozen people willing to put up $20,000 and fly to the very same clinic to undertake the very same treatment on the same day. Or get on a cruise and head out to international waters with a staffed clinic on board. The economics will scale as the number of people involved grows: if we can organize a conference in which hundred of people fly to a distant city, or if the "anti-aging" marketplace can organize their large conferences, can we not also organize a hundred people paying $10,000 for a myostatin gene therapy or for the Oisin Biotechnologies senescent cell clearance technology? At that scale, the potential revenue per event becomes large enough to make this worth trying for a startup company - it is comparable to the size of early fundraising rounds.

Of course you or I can't just call up a hundred people and get them on board for a five figure payment and a trip on a given date, for all that I'm very certain that a hundred people in our extended community are up for early access to gene therapy or senescent cell clearance. Gathering this crowd, both for the first time and for later organized medical tourism group buys, would require a small organization devoted to the purpose: web site, a phone line, outreach, marketing, staff to do the work implied by all of the above, and so forth. Fortunately there is no shortage of small organizations in our neck of the woods, and one might reasonably expect advocates to create another if none of the existing groups wanted to take this on. This sounds like a good fit for Lifespan.io or Longecity, for example, if they chose to head in that direction. The entrepreneurs at either BioViva or Oisin Biotechnologies should certainly consider playing their parts in such a plan if provided solid evidence that the market is there and people are willing to pay.

How do you prove a market? Well, the traditional method is that you register an organization, put up a website and phone line, and collect expressions of interest of one form or another: people willing to sign up, people willing to put down a refundable deposit, that sort of thing. If you have a few hundred people willing to do this, well: there you go. Companies have been launched with less proof. This is not to say that I think this will all be straightforward and smooth sailing. Ask anyone who organizes conferences for a living about the challenges inherent in putting a few hundred people in one distant building at one given time. Or ask a cruise line operator about the analogous portions of their business. That said, group buys, medical tourism, and group vacations such as cruises are all established practices. There are people who know how to run these things, and none of the potential problems are surprises in and of themselves. This seems to me a logical evolution of the present medical tourism industry. It doesn't exist today because the sort of treatments that people travel to undertake are highly individual. But given the advent of enhancement and rejuvenation therapies that everyone can benefit from, a whole different dynamic emerges.

So for the community at large, as we ask ourselves how we can best help the rapid development and clinical availability of rejuvenation therapies, I think that the approach I sketched here is worth thinking on. It is something that many of us could help bring about: few specialized skills are required for the mundane tasks of advocacy or assembling an organization to put together group buys. Many of us could help in meaningful ways, and a great many people are motivated to bring about the end result, including those who are presently working on the biotechnology side of the house.