From 0 to 1 – Saudi Arabia’s Technology Dream

I visited Saudi Arabia (KSA) for the first time in my life in July, 2022. It broke all stereotypes and reminded me of visiting Shenzhen in 2002. There is no religious police on the streets, high-tech construction all around, women with PhDs in top leadership roles, and Uber drivers listening to HRH MBS speeches promoting tolerance, innovation, and vision of technology-augmented clean energy future. Recently, CNN did a great job describing the transformation of Saudi Arabia. Of course, this rapid transformation from 0 to 1 was not easy for MBS and was met with substantial resistance from inside and outside the country and required gargantuan efforts. But it is happening and now he has even more ambitious plans that, if properly executed, will benefit everyone on the planet. He decided to focus on extending healthy longevity in KSA.

Longevity as a National Priority

Increasing productive longevity may be the most altruistic cause anyone can pursue in order to generate the most number of Quality Adjusted Life Years (QALY), a central metric in healthcare economics, during their lifetime. Imagine that an average surgeon performs around 400 surgeries per year. Working for 30 years, he or she generates on average two quality-adjusted life years per patient. That is 24 thousand QALYs. Now, imagine that you prove that a safe drug in use today, for example, Rapamycin, adds a few years of life if taken once a week. Adjusted for quality of life, this results in just one additional year of quality life. If everyone starts taking this drug, you can generate roughly 8 billion QALYs, not even accounting for future generations. Now imagine that you discover an absolutely new drug that can be developed for a specific disease but also works to combat aging and adds 10 years of life to everyone’s quality productive life – that is 80 Billion QALY. It is estimated that there are around 1.1 million specialist surgeons in the world today. A dual-purpose therapeutic for treating aging and disease could generate three times more quality life than all the surgeons in the world during their entire careers.

But the development of just one drug using traditional methods takes over a decade, costs over 2 billion dollars, and the process fails over 90% of the time. Most productive pharmaceutical companies produce one or even fewer approved drugs per year out of their own R&D efforts. And only a few of these drugs may serve a dual purpose – extend longevity when used as a prophylactic and address a disease or loss of function. Examples that come to mind include Metformin, Aspirin, Rapamycin, and a just a handful of others. The era of pharmaceuticals intelligently designed to target aging and disease simultaneously is still in its infancy with less than a handful of examples of novel targets and/or molecules discovered using aging research.

Discovering a blockbuster therapeutic that could work in aging and disease from scratch is a high-stakes effort with massive financial returns and benefits to society when successful. It requires a substantial amount of funding, expert leadership, and a multi-year commitment. Visionary leaders with a long-term outlook recognize this opportunity and there are several large-scale efforts globally dedicated to extending human longevity.

In 2021 the US life expectancy has fallen to 76.6 years, far behind China’s 78.2 years for a variety of reasons and is expected to remain reasonably flat. But the media largely ignored this fact. The only significant mention of this new disparity I could find was in a short mention by Vice. However, I do not see any major political figure advocating for substantial longevity increases or setting ambitious goals for life expectancy. Compared to abortion, gay issues, and geopolitical influence, longevity is not even on the news or on the agenda. In a democratic society longevity is not a popular political platform. Life expectancy in Saudi Arabia was 75.37 years in 2021 over a year lower than in the US. Recent advances in longevity biotechnology suggest that it may be possible to rapidly close this gap and substantially increase life expectancy. The beauty of biomedical research is that a drug found in Saudi Arabia or founded using Saudi capital would quickly propagate globally and benefit everyone on the planet. Therefore, recent announcements and policy changes by the progressive HRH Mohammed bin Salman bin Abdulaziz Al Saud where he intends to prioritize longevity research and sustainable energy as the two main research priorities may be comparable to the unexpected bets on electronics in Japan and Korea in the 1970s.


How Significant is $1 Billion per Year for Aging Research?

In 2013, Google launched their secretive anti-aging company Calico with billions of dollars in funding. Fast forward eight years, and we can only find one Phase I early trial in ALS and two early cancer trials sponsored by Calico, using Abbvie compounds.

The annual budget of the National Institute on Aging (NIA) in the US exceeded $1 billion in 2013, grew to over $3 billion in 2019, and reached $3.89 Billion in 2021. The request for 2023 is over $4 Billion. The total budget of the National Institutes of Health (NIH) in the US exceeded $45 billion in 2022.

In 2010, our team started tracking the funding going into aging research (currently tracking over $2 trillion). To understand where all this funding is going and its effectiveness better, we developed a non-profit resource (not actively supported) called the International Aging Research Portfolio (IARP). In 2013, we noticed that only about $635 million, or 7% of total funding spent on individual protein targets, is spent on projects implicated in aging and longevity. If the $1 billion that Hevolution has committed to direct towards aging research will be spent on these dual-purpose aging- and disease-related targets, it will be more than the NIH spent on these targets in the context of aging in the past 30+ years! Even if it disperses the funds across the industry, it will result in a significant increase in total funding globally.

When Hevolution came out of stealth in June 2022, the entire aging research community stood up and cheered, and many other funding bodies took notice. In the past, several other emerging countries with visionary long-term leadership have prioritized futuristic technologies and succeeded (think Japan or Korea). But nobody expected Saudi Arabia to announce such a visionary plan and become a substantial player in this important field.

Saudi Push into Longevity – Hevolution

One of the most credible management consultants in the pharmaceutical industry is Dr. Michael Ringel of Boston Consulting Group. He is well known in longevity circles and helped to grow Life Biosciences, a longevity company founded by the most famous scientist in the longevity business, David Sinclair and Tristan Edwards, Australian biotechnology entrepreneur. In March 2019, it was announced that Dr. Mehmood Khan joined Life Biosciences as CEO.

In early 2019, BCG reached out to me and we conducted a couple of “longevity landscaping” calls for an unnamed client in the Middle East. I thought that this initiative was driven by the secretive AI company in the UAE called Group42 which also had expressed some ambitions in longevity in the past. They were exploring several for-profit and non-profit business models for a national longevity initiative. Having participated in similar initiatives for several countries, I readily agreed. The group was quietly doing the work in 2020 and 2021. When the word “Hevolution” started circulating in the community, just like with the many other government initiatives, industry veterans did not expect anything serious to come out of it. But now I was certain that Dr. Michael Ringel is helping shape up the strategy and when BCG is involved, the project is usually very serious.

In the Summer of 2021, rumors started circulating that Dr. Khan was being brought in to lead the longevity initiative in Saudi Arabia. In September of that year, Dr. Khan started presenting at conferences with his new title. The first references to Hevolution Foundation appeared in tweets from the National Academy of Medicine (NAM) and Women Business Collaborative (WBC).

Mehmood Khan, M.D. – Chief Executive Officer

When searching for Dr. Khan’s biography on Google, the top results that came up were from and websites of the United States. Prior to joining Hevolution and Life Biosciences, Dr. Khan was PepsiCo’s Vice Chairman, Chief Scientific Officer, and Head of Global R&D. Prior to PepsiCo he was the president of Takeda’s global R&D Center and, prior to that, staff endocrinologist at the Mayo Clinic. He is an M.D. with substantial global R&D experience. This is as credible as you can get in longevity biotechnology. I was surprised to learn that he is also a certified pilot.

Felipe Sierra, Ph.D. – Chief Science Officer

In Spring 2022, it became apparent that the former director of the Division of Aging Biology (DAB) of the National Institute on Aging (NIA), Dr. Felipe Sierra, had joined Hevolution. I’ve known Dr. Sierra for over 12 years and applauded this decision, as did many other industry veterans. He came out as the Chief Science Officer (CSO) of Hevolution in March 2022 at his annual Euro Geroscience conference in Touluse where I gave a talk and even provided a small sponsorship.

A native of Chile, he did his PhD in biochemistry and molecular biology at the University of Florida and postdoctoral work at the University of Geneva in Switzerland. After working for Nestlé he became interested in aging and went back to the US to take academic positions. In 2002, he joined the Division of Aging Biology at the NIA and quickly became the director of the DAB. He is often credited for coining the term “geroscience”. In 2020, he retired from the NIA and joined INSPIRE, the “translational research platform in geroscience to improve healthy aging”.

In summary, Dr. Sierra knows how to allocate massive amounts of capital via non-profit competitive grants.

HRH Princess Haya Bint Khaled Al Saud, Ph.D. – Vice President of Impact and Insight

As you can judge from the family name, HRH Princess Haya comes from one of the world’s most influential royal families. The new policies introduced by HRH Crown Prince MBS, the role of women in Saudi Arabia was elevated to the standards of many Western countries. However, there are still many common misconceptions, and Dr. Haya defies all of them. After completing her bachelors in clinical nutrition at the King Saud University, she got her Masters degree in Genetics and Toxicology from McGill University in Canada and a PhD degree in Genomics of Common Diseases from Imperial College London. After completing her graduate work in genetics, Dr. Haya returned to Saudi Arabia to work on some of the most impactful projects in the country. She served as Director of the Saudi National Center for Genomics Technology, and as Director of the Saudi National Pre-Marital Screening Program. As a scientist at the King Faisal Specialized Hospital and Research Center, she carried out a range of research projects focusing on population genetics, and published multiple research papers in peer-reviewed journals.

After a brief meeting with the team it became apparent that Hevolution is a product of several years of hard work and they do have a very capable team. It is also clear that this is not an imported third-party idea. The mastermind of this initiative is HRH Crowne Prince MBS himself and the organization is reporting directly to him. Dr. Mehmood Khan is in full control and Dr. Haya is a strong co-pilot ensuring compliance, coherence with the vision, and smooth operation.

Inside Hevolution

When a longevity biotech wants to come out of stealth with much fanfare, it goes to Antonio Regalado from MIT Technology Review. He covered Calico, Altos Labs, and now – Hevolution. In June 2022, Antonio broke the story, sending shockwaves across the longevity biotechnology industry. This same month, I visited Riyadh on an unrelated business trip and saw firsthand that it is a truly innovative and high-tech place positioned for growth.

For many years, people have wondered if and when Saudi Arabia – a country backed by wealth, a strong network of scientists, and visionary leadership – would venture into the growing field of longevity. It wasn’t until the Hevolution Foundation came into the public eye that it became clear that the Kingdom is making grand strides in the field of human longevity. Hevolution Foundation is a non-profit organization and receives funding from the Saudi Arabian government to the tune of up to $1 billion per year to fund the science of increasing healthy human lifespan.

The Hevolution Foundation mission was clearly described in an article posted by Dr. Khan. The article states that Hevolution Foundation is a “pioneering new organization” with a key focus on significantly improving something that affects every human on the planet: aging. “Our mission is to drive efforts to extend healthy human lifespan, or healthspan, and to better understand the processes of aging, because the simple truth is: we all age, but we do not all age equally,” the article reads. The Foundation has an annual budget of up to $1 billion to accelerate science and bring therapies to market.

Although it is still unclear how this much money will be spent, one can make a few educated guesses. One possibility is that the Foundation will fund the $100 million XPrize for age reversal technology, as underlined in a recent MIT Technology Review article. If this were to happen, XPrize would benefit greatly from the funding in longevity.

And Hevolution leadership is clearly very familiar with longevity biotechnology and drugs that may serve a dual purpose. Life Biosciences, where Dr. Khan served as a CEO, is one of the longevity biotechnology companies developing a pipeline of such drugs. Dr. Khan is also a founding member of the Longevity Biotechnology Association.

The rest of the Board of Trustees largely includes members of the Saudi royal family and officials.

Exploring the Saudi Government’s Interest in Longevity

AI and healthcare are at the heart of the Saudi Vision 2030, a strategic framework that seeks to diversify the Saudi Arabian economy and boost the country’s image globally by investing in healthcare, education, artificial intelligence, and other projects.

Beyond that, Dr. Khan’s introductory article states that “there is evidence that Gulf Cooperation Council (GCC) populations are aging faster biologically than they are chronologically. Despite the region having one of the youngest populations in the world, its people are experiencing higher mortality from chronic conditions like heart disease and diabetes. Hevolution’s goal is healthspan equity and we will devote the resources needed to achieve it. This region, with its history of generating founding principles in science and medicine, yet suffering from significant age-related risks, presents a strong case to be the catalyst for the healthspan transformation worldwide.”

It is clear that Saudi Arabia is seeking to advance longevity science in order to help the global community. Under the headline “a transparent global organization,” the Hevolution Foundation website states that “we seek to democratize science and knowledge, by creating partnerships, offering grants, and making investments in the longevity space.” They go on to say that, “we aim to work closely with global entities and research centers that share the same mission and objectives. Global success depends upon global collaboration, which lies at the heart of our mandate.”

Lessons from the Past: Can Hevolution Solve Aging?

Will Hevolution live up to expectations? Only the time will tell. But it is very important to document its history from inception to be able to tell the story behind the headlines. What I learned during almost two decades in the field – mega projects that get a lot of funding but are not grown organically by a dedicated team seldom result in practical products. And in longevity biotechnology we have not seen any tangible success stories. Think Sirtris, ResTORbio, and Unity Biotechnology. The jury is still out on the former.

When Google launched Calico in 2013 – nine years ago – Time Magazine ran a famous cover story – “Can Google Solve Death?”. Management made it clear that they want to understand the fundamental biology of aging. Where are they now? Judging from the clinical pipeline, and recent presentations at GRC, where some very basic work on aging clocks was presented, the company is still scratching the surface and has also pivoted into cancer. Much of the founding team, including their Chief Computing Officer, Daphne Koller, and their president and R&D chief, Hal Barron, have left. The latter went to GSK to become GSK’s highest paid executive. How GSK performed is hard to say and I hope to write a separate article to cover his tenure. But upon joining, he stopped many collaborations in AI and age-related diseases to focus on genetically-validated targets and pushed into cancer, making made big bets in synthetic lethality. Before the COVID-19 pandemic, GSK was one of the largest players in vaccines and antiviral drugs. But during the pandemic it was Pfizer, which had only a tiny presence in antivirals, who took the spotlight with a vaccine and a drug. Barron is now CEO of another celebrated longevity biotechnology company making headlines – Altos Labs, dedicated to cellular reprogramming. Let’s hope they stay true to their cause. Recently, Hongkui Deng, who had every chance to be nominated for a Nobel Prize in 2008 for iPSC, published very solid work on chemical reprogramming in Nature on a very modest budget. Knowing the group, they are likely way ahead with other reprogramming methods and clinical applications.

Hevolution has an advantage in the field – with committed and experienced management, both a non-profit and for-profit component, and visionary leadership from HRH MBS. I hope that the Hevolution team takes the right steps to demonstrate better performance than the many large-scale projects that have come before.

And as they say in Saudi Arabia, Inshallah, meaning God Willing, Hevolution will deliver and will help us live longer and healthier lives!

The management team of Hevolution presented alongside many thought leaders at the 9th Aging Research and Drug Discovery conference, a non-profit industry event that brought together academia and industry from 29th of August to 2nd of September at the University of Copenhagen in Denmark.