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Developing countries – help yourselves! A case study of Kazakhstan

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On May 19, 2016, the World Health Organization released its report “World Health Statistics: Monitoring Health for the Sustainable Development Goals (SDGs)” describing the recent state of global health. The news is rather encouraging. The global life expectancy increased by 5 years, from about 66.5 to 71.4 presently, recording the fastest increase since the 1960s. The rightly so-called “developing” countries generally showed a much faster improvement compared to the complacently “developed” ones. Thus, Africa generally had the lowest life expectancy. The worst life expectancy was in Sub-Saharan Africa, just above 50 years of life expectation for the newborns in countries like Sierra Leone, Angola, Chad and Central African Republic. But at the same time Africa also had the fastest rate of increase, from about 50 years in 2000 to about 60 in 2015. Think about it: Every single year, about 8 months are added to the life expectancy in Africa, compared to about 4 months of yearly improvement globally. It gets better. Apparently, not only the general life expectancy is improving, but the healthy life expectancy, the number of years a newborn can expect to live in good health, is improving even faster. For 2015, the healthy life expectancy stood at 63.1 years globally, compared to about 56 reported for 2000 – over 7 years increase. In other words, the world has added almost half a year of healthy life expectancy for every passing year. Not only are people living longer, but they are also living healthier. This increase in fact demonstrates the possibility of a significant healthy lifespan (or “healthspan”) extension on a massive scale. Can and should we do better?

Still, the gaps in life expectancy and healthy life expectancy between the richer and poorer countries and between the richer and poorer segments in particular societies are quite appalling. About 30 years of expected life divide some countries of Sub-Saharan Africa, from the highest ranking countries with over 80 years of life expectancy, like Japan, Switzerland, Singapore, Australia, Spain, Italy, Iceland, Israel. The BRIC giants – Brazil, Russia, India and China – are struggling in the middle and upward, with the life-expectancies ranging around 68-76 years. Life expectancy is not a stand-alone parameter, but corresponds to and reflects other values of human development, such as education level and quality of life. Should the situation be improved? Apparently it should be. At least this is the directive of the United Nation’s Sustainable Development Goals (SDG), adopted back in September 2015, for which the present WHO health statistics report provides the data. Thus the Sustainable Development Goal – SDG 3 “Ensure healthy lives and promote well-being for all at all ages” asks the global community if they would please “Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines.” Do you know what your country and your government is doing or plans to do to accomplish those goals?

Apparently there is one country, within the “developing” cohort, that seriously considers taking some action to improve its national health. On May 25-26, 2016, there took place at the capital of the Republic of Kazakhstan a global gathering of economic and political elite – The Astana Economic Forum 2016. The speech of Kazakhstan’s president – Nursultan Nazarbayev, is quite indicative of the country’s ambitions to narrow the international gaps. President Nazarbayev emphasized the great disparities in the present levels of economic development and quality of life between countries. Thus, for example, as he pointed out, only 3.5% of the global education expenditures are dedicated to the poor countries of South-Eastern Asia and Africa, which are home to 45% of the children of the world. He estimated that about 50 billion dollars are required to finance universal basic education in poor countries, and suggested to finance it via restricting and/or taxing the offshore assets that currently amount to $30-40 trillion globally. To coordinate the efforts, he suggested creating a dedicated global “Foundation for the Development of Human Capital”. For Kazakhstan, such an improvement in education is not just a noble and commendable goal. It is vitally needed in order to shift the country from the current faltering “natural resources based economy” toward the “knowledge and innovation based economy”. Indeed president Nazarbayev strongly emphasized the necessity of this shift, the need for the “development of human capital”, strengthening the education and health systems, developing health and green technologies. He made a strong point about the fact that during the 25 years of the country’s existence, since its independence in 1991, the average life expectancy of the Kazakhstan people significantly increased, reaching 72 years (compared to about 64 in the early 1990s). This suggested the improving of health and longevity of the population as one of the main parameters of the country’s progress.

Going from directives to practice, it transpires that some concrete state-supported steps are now being discussed in Kazakhstan that would be explicitly dedicated to improving the country’s healthspan values, via strengthening national biomedical research, development and translation capabilities. A case study has been developed for a global healthspan extension program in Kazakhstan named “The Global Healthspan Extension Initiative”. The focus on healthspan extension is warranted by the increasing life expectancy and the corresponding increases in the incidence of aging-related diseases, such as cancer, diabetes, heart disease and neurodegenerative diseases, despite the demonstrated improvements in healthy life expectancy. Reducing these non-communicable diseases is a key priority for the SDG and WHO. As defined by Elya Duissemaliyeva, Managing Director of the Denobi Group and one of the key managers of this initiative, the aim of the program would be to “create a translation biotech hub (not just for basic research) in Kazakhstan with a primary focus on personalized and precision medicine.” “We intend to build a translation engine to drive massive biomedical innovation into the country,” she emphasized. The underlying idea is that it may be difficult for Kazakhstan to quickly reach the advanced R&D capabilities of the current leaders in the field by following in their footsteps. But it may be easier to “leapfrog” them – to create the favorable regulatory environment and incentives to rapidly draw in and help realize the most advanced R&D ideas that are currently struggling against various “brick walls” and “glass ceilings” in theirs countries of origin. “We will perform the meta-analysis and selection of advanced and emerging technologies in the field of healthspan extension, considering their potential efficacy and safety, with the aim to solve social and economic issues” — adds Professor Zhaxybay Zhumadilov, General Director of the National Laboratory Astana, at Nazarbayev University – one of the main prospective performance sites for the program. The architects of this initiative envision an end to the entrenched dichotomy between the “developing” vs. “developed” countries, but anticipated a new distinction between “innovative” and “less-innovative” countries.

Some of the negotiations on the program were conducted in mid-April at the invitation-only forum at the University of Oxford and in Astana in mid-May at the Nazarbayev University, coinciding with the 4th International Conference on Regenerative Medicine and Healthy Aging. The Global Healthspan Extension Initiative  under consideration in Kazakhstan aims to develop the country’s biomedical and biotechnological R&D and translational infrastructure by encouraging fast development and clinical translation of new life- and healthspan extension technologies through clinical trials, manufacturing, improved biospecimens and repositories, and IT infrastructure. It aims to establish new R&D centers and companies, building up collaborations of scientists and biotechnology entrepreneurs. It intends to accelerate R&D process and authorization of advanced new technologies thanks to expedited regulatory pathways and expert roadmaps for clinical trials and technologies approval. In short, the Global Healthspan Extension Initiative, if adopted, would set up the improvement of healthy lifespan, via advancement of biomedical technologies, as one of the explicit and central programs of the country’s development.

If indeed adopted and implemented, the impacts of the Global Healthspan Extension Initiative can be far reaching, not only for Kazakhstan, but globally. For Kazakhstan it could help ease the entrenched dependence on natural resources, generally modernize the economy, improve the country’s healthcare system and productivity. Globally, beyond regular professional cooperation that must be involved in setting up such a program, it may also serve as a model to consider, adapt or refine for other national contexts. It may be safely stated that, if approved and implemented, the Global Healthspan Extension Initiative would be one of the first, or even the first state-level program specifically dedicated to improving the healthspan for the country’s population via development of biomedical technologies. Moreover, if adopted and implemented, this would be one of the first, or even the first state-level program explicitly aimed to implement the UN Sustainable Development Goal 3 “Ensure healthy lives and promote well-being for all at all ages”. It may be highly informative to see how this experiment proceeds, to learn from its successes and failures. Just the fact of its planning and establishment may stimulate other countries to consider analogous or enhanced programs. As one of the main players in Central Asia, generating 60% of the region’s GDP, one of the active members of the Eurasian Shanghai Cooperation Organization, with the territory comparable to Western Europe, the place where practical space exploration started — the capacity and impact of Kazakhstan can yet be widely felt.


By Ilia Stambler


About the author: Ilia Stambler, PhD, is the founder and chair of the Israeli Longevity Alliance (ISRLA, He obtained his Ph.D. degree from Bar Ilan University, Israel, from the department of Science, Technology and Society. He has been strongly involved in education and advocacy for biomedical aging research, in Israel and Internationally. He is an affiliate scholar with the Institute for Ethics and Emerging Technologies, executive committee member and outreach coordinator of the International Society on Aging and Disease, and coordinator for the Longevity For All advocacy network.  He is the author of A History of Life-extensionism in the Twentieth Century ( and numerous academic papers on aging and longevity science, history and advocacy.


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