MosheArditiMD

Fourth question on AI. One of the great promises of AI is the discovery of new drugs and cures, so that we can live longer and healthier lives. If and when this becomes a reality, it would indeed be a big achievement. These potential health benefits are often invoked to justify current investments (and lack of regulations). Some even argue that slowing down AI would harm humanity by delaying these benefits. (See a16z.com/the-techno-optimist…). This raises another uncomfortable question: can we justify rapid and large AI investments based on health benefits? Here is why I think this is an uncomfortable question. First, despite significant effort, AI has so far produced few gains in drug discovery or new cures. A fascinating new paper by Ryan Hill and Carolyn Stein documents significant (downstream) scientific work on proteins whose structures AlphaFold predicted. But the authors conclude “we find no evidence so far that more applied, early-stage drug development is targeting these proteins.” (See their paper here papers.ssrn.com/sol3/papers.…). This thought-provoking post by Daphne Koller explains the difficulties that AI is currently facing in drug discovery. Koller emphasizes that AI-based research is focused on the last layer of drug development (creating new molecular entities for already well-understood therapeutic modalities), rather than targeting new disease mechanisms (see deepphenotype.substack.com/p…). Understanding disease mechanisms is harder because there is much less data on it, and this endeavor requires more innovative approaches. It remains an open question whether current AI models are capable of doing this. Second and more importantly, if you want to improve life expectancy and health in the United States, there is plenty of low hanging fruit and diverting some of the huge investments going to AI for this purpose would likely do much more for health outcomes. The United States has the lowest life expectancy at birth among large rich economies. Americans live about five years less, in expectation, than the citizens of Switzerland, Sweden, Japan, Italy, South Korea and several other industrialized countries, and most of the gap comes from deaths before age of 70 due to chronic diseases, overdoses and other preventable causes (see, for example, healthsystemtracker.org/char…). These largely reflect failures in US public health: preventable problems, unhealthy diets, insufficient immunization rates, poor access to primary care; and poor information about health. The country spends much more than other peer economies on healthcare, but too little and too ineffectively on public health (here is a reference to my own work on this: aeaweb.org/articles?id=10.12…). Could we, and should we, divert some of the massive investments in AI towards public health if what we want is better health and longer lives for Americans? (And yes, new drugs will benefit citizens of other countries as well, but they can also invest more in public health and the bulk of global AI spending is currently in the United States).