Today’s interventions are the innovations of the past. Without them, healthy lifespans would not be as long as they are. Innovation continues to be critical to tackle diseases without known cures and to help increase uptake and adherence to interventions that work.
As part of the report Prioritizing health: A prescription for prosperity, the McKinsey Global Institute identified ten promising innovations, now in progress, that could have a material impact on health by 2040. Focusing on technologies that address the greatest unmet needs, we determined the impact of these innovations by interviewing experts and evaluating the current biological understanding of each disease, as well as the effort and excitement surrounding the new techniques as measured by funding.
Identifying and sizing the potential scope of innovations now in the pipeline is inherently difficult, but we estimate that these technologies could reduce the burden of disease by a further 6 to 10 percent, assuming aspirational yet realistic adoption rates by 2040—on top of the 40 percent from known interventions. Some of these innovations could not only fully cure a number of diseases but also significantly extend healthy lifespans by tackling the underlying biology of aging and therefore postponing the onset of several age-related conditions. These possibilities make a sharp contrast with the innovations of the past 30 years, many of which reduced the symptoms or delayed the progression of diseases but rarely prevented or cured them. In addition, the innovations we have identified here are more digitally enabled than those of the past; for example, artificial intelligence (AI) systems make advances in omics and molecular technologies, such as gene editing, faster and more accurate.
How can we improve health globally over the next two decades?
Omics and molecular technologies
These technologies—key components of the Bio Revolution—are therapeutics or diagnostics that harness the various types of molecules within cells (such as DNA, RNA, and proteins). Some omics and molecular technologies (for instance, genome editing) engineer these intracellular components or analyze them (such as proteomics and transcriptomics).
Example: CRISPR and curbing malaria
The current treatment includes antimalarial prophylactics and nonpharmaceutical measures (such as indoor residual spraying and insecticide-treated bed netting) and antimalarial medications. Genetically modifying malaria-carrying mosquitos by using gene-editing technologies, such as CRISPR, may significantly reduce disease levels by propagating the modified genes across the mosquito population.
Newer iterations of traditional chemical compounds (small molecules) and classes of molecules could be used as medicinal drugs, possibly with multiple and concurrent target structures.
Example: Senolytics and the regulation of cellular aging
Cellular aging (senescence) is considered an unavoidable physiological process that is not a viable field for drug development. But senolytics (a class of small molecules) may decrease or eliminate aging cells that can cause cellular inflammation, dysfunction, and tissue damage. This has implications for delaying age-related diseases.
Cellular therapy and regenerative medicine
Cellular therapy is a biological product, derived from living cells, used for therapeutic purposes to replace or repair damaged cells or tissues. Regenerative medicine has the power to restore diseased or injured tissues and organs, potentially decreasing reliance on transplantation.
Example: CAR T-cell therapy and the treatment of solid tumors
Today, treatment is based primarily on unspecific radiotherapy and chemotherapeutic agents, plus surgical interventions. In many cases, these approaches are ineffective. CAR T-cell therapy reprograms a patient’s T-cells (immune-system cells) to target tumor cells. When infused into the patient, the T-cells bind to an antigen on tumor cells, attacking and destroying them.
Vaccines stimulate the immune system to respond to and destroy a bacterium or virus. Historically, they have eradicated or controlled the spread of infectious diseases around the world. In the future, vaccines may target noncommunicable diseases, such as cancer.
Example: The AT04A vaccine and the lowering of cholesterol
At present, patients take statins (lipid-lowering medicines) to control or lower high cholesterol levels in the blood. Patients with cardiovascular disease must take these daily, but adherence is often poor. AT04A is a vaccine made up of molecules that bind to blood cholesterol and degrade it. The vaccine would be required only once a year, potentially improving outcomes.
Advanced surgical procedures
These include treating injuries or disorders of the body with minimally invasive incisions or small instruments (including robotic surgery), as well as any technique that improves surgery-related processes outside the operating room.
Example: Suspended animation for severe-trauma patients
After patients suffer acute trauma (such as an accident) it may take time to get them to hospitals for surgery. That significantly decreases their chances of survival. Suspended animation for severe-trauma patients would involve, for example, injecting a cold saline solution into them on first contact to cool the body to 10–15ºC and stop its normal functions. This would give the surgeon time to operate before resuscitating the patient.
Connected and cognitive devices
Portable, wearable, ingestible, or implantable devices can monitor health and fitness information, engage patients and their communities of caregivers, and deliver self-regulated therapies autonomously.
Example: E-tattoos for heart diagnostics
Today’s technology relies on a Holter monitor (a battery-operated device) to monitor the heart continuously. The monitor’s batteries last for no more than 48 hours, and the procedure can cause immense discomfort for patients. Ultrathin e-tattoos can monitor hearts for longer periods and make patients more comfortable while providing a wider range of data to enhance clinical decision making.
Small therapeutic agents can target the neural circuits of organs. Such therapies map neural circuitry with neural impulses (administered by an implantable device) delivered to these specific targets.
Example: Implantable microchips to mitigate chronic pain
Today, managing chronic pain involves nonindividualized treatment with multiple drugs (including opioids) and relatively ineffective late-stage surgery. But one technique now under development—stimulating the spinal cord—can improve the patient’s quality of life by increasing mobility, enhancing sleep, and reducing the need for pain medication.
Robotics and prosthetics
A wide variety of programmable, self-controlled devices consisting of electronic, electrical, or mechanical units and of artificial substitutes or replacements for body parts are now under development.
Example: Next-generation exoskeletons and mobility support
Today’s mechanical mobility aids do not fully restore movement in the elderly, so they do not prevent a loss of independence and the risk of accidental injuries. Next-generation exoskeletons, powered by small motors that mimic human muscles, could allow older patients to recover their autonomy while reducing the likelihood of accidents and falls.
These preventive and therapeutic evidence-based interventions, for a broad spectrum of physical, mental, and behavioral conditions, are controlled by software.
Example: An AI-powered app to change behavior
Apart from brief consultations, doctors now have few tools to help patients with chronic conditions adopt healthy lifestyles. In the future, digital therapeutics, powered by AI, patient data, and behavioral science, can use gamification and other forms of engagement to help patients adopt and sustain healthy behaviors.
Tech-enabled care delivery
These ways to deliver care incorporate new and larger data sets, use new analytics capabilities to generate insights, and help providers apply them to patients to improve the outcome, experience, and efficiency of care.
Example: Multichannel care delivery
Inefficient data management and poor communication among patients, payers, and providers hinder the continuity of care and therefore make treatment significantly less efficient. Innovative multichannel care delivery using online platforms may facilitate data sharing and make treatment more efficient. This is particularly relevant for chronic diseases, such as diabetes, because the glucose levels and other vital signs of patients are continuously shared with clinicians.
Innovation—in the form of new medicines, procedures, medical devices, technologies, and delivery models—will clearly be critical to go on improving the health of the world’s population. Realizing these innovations, however, will require continual R&D investments by pharmaceutical companies, medical and other technology companies, and academia.