The race to live longer is leaving most people behind

A certain kind of health aspiration has taken hold in affluent circles: multi-omics panels, algorithmic diets, young-plasma infusions, and partial cellular reprogramming. The pursuit of longevity, once fringe, now sits at the centre of a rapidly expanding commercial ecosystem. But for those working at the intersection of biology, public health, and clinical research, the promises and the pitfalls are far more complex.

“If you look at human history honestly, inequality has always existed,” says Anant Agarwal, health consultant and founder of Infinite Health. “There has always been a small group with access to cutting-edge tools, and a large majority trying to secure basics. As a clinical research scientist, I don’t have the luxury of thinking about how the world should be; I have to work with how it is.”

For him, longevity is not simply an ethical debate. It’s also a science and systems question.

Losing touch with reality?

“Longevity is already stratified by class through diet quality, pollution, exposure, stress, healthcare access, and consumption,” adds Asad Hussain, longevity expert, exercise scientist, and founder of OddsFitness. “New longevity tech could widen that gap fast, because early versions will be expensive.” Even seemingly basic tools such as personal training or exercise remain inaccessible to most people. “It is concentrated in a few geographies, of course.”

According to Dr Astik Joshi, Child Psychiatrist, Fortis Healthcare, Delhi,
the modern obsession with longevity is a consequence of a thought process that believes technology can be used to overcome life’s certainties. From a psychological perspective, this is a form of an overvalued belief system that may make the individual lose touch with reality in their preparation for mortality and lead them to use technology to preserve the data they gathered in their lifetime.

Ethics and limits

At the upper end of the market, Agarwal sees no inherent problem with wealthy individuals experimenting with advanced protocols like “multi-omics testing, expensive supplements, fancy devices” as long as the research is transparent and scientifically rigorous. “Whether we like it or not, a lot of innovation has always started at the top 1% and then slowly trickled down.”

The failure, he argues, would be if the conversation remained only there. In India, “the real public health win is very unsexy: blood pressure checks, diabetes screening, clean air and water, vaccines, better nutrition, and basic lifestyle counselling.”

Extending life, in other words, is meaningless without extending healthy years. “I’m less interested in lifespan as a headline number,” he says, “and more interested in healthspan — the number of functional, independent years we can give to as many people as possible.”

The incomplete Silicon Valley metaphor

Longevity rhetoric often leans on a Silicon Valley metaphor: the body as software, ready for upgrades and patches. Agarwal calls the metaphor “not inherently dangerous; just incomplete.” Biological systems can be tuned, repaired, and supported, but not cleanly rebooted. “Biology is not software. You can’t just ‘reboot’ a failing organ. Some changes are irreversible,” he says. And treating the body like an endlessly upgradeable machine risks pushing people toward perfectionism and distraction from the fundamentals: sleep, movement, nutrition, blood pressure, and glucose control.

Still, he understands why the metaphor appeals. “People who’ve ‘won’ on money eventually realise that the one thing they can’t buy back is time in a healthy body,” he adds. The job of clinicians, he adds, is to turn that ambition into “grounded, evidence-based interventions, not fantasy.”

What we actually know

If the commercial wellness space has inflated expectations, ageing biology researchers caution against equally inflated claims. Hussain argues that the science of longevity is real, but not nearly as definitive as its marketing.

“Ageing biology is real science now,” he says. “But obviously it’s not just one single switch or one answer.” Instead, he points to the widely accepted framework of “multiple hallmarks”: DNA damage, telomere shortening, epigenetic drift, loss of proteostasis, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, chronic inflammation, and altered nutrient sensing.

Where the field excels is in demonstrating that some of these processes can be slowed in animals. The hype comes in when people jump from animal data to human reversal claims.

Partial cellular reprogramming, for instance, has produced striking results in mice and carries equally striking risks. Hussain emphasises, “It’s extremely potent and carries real risks like loss of cellular identity, cancers, tumour formation, if not controlled properly.”

And then there’s the hype

On the more speculative fringes, such as young plasma clinics, organ printing, and mind uploading, regulators and researchers remain wary. “Regulators explicitly warn that there is not good enough evidence that it works for reversing ageing or preventing ageing,” he says of plasma transfusion clinics.

Even the philosophical leap, the idea that mortality is merely a technical bug, fails to hold up under biological scrutiny. “Death isn’t one,” he clarifies. “It’s a long list of failure modes. And solving one just shifts the bottleneck to another.”

The realistic future, in Hussain’s view, is “radical extension of health span and not tech-enabled immortality.”

He points to a tension at the heart of the movement: “Is the longevity movement health or fear and control? It’s both,” he says. “Fear definitely sells. It’s a marketing strategy… parts of the industry lean into immortality narratives.” What people truly want, he notes, is not endless life but the avoidance of late-life decline. “It’s mostly that they don’t want to suffer and be immobile and have a disease. It’s compressing morbidity.”

For him, the test is simple: “Does the intervention reduce multi-morbidity risk with reproducible evidence in humans? And can it scale beyond a luxury market? If not, it’s more lifestyle branding than medicine.”

Precision wellness: Where’s the evidence?

In India, where wellness marketing often outpaces science, both experts point to a widening gap between aspiration and evidence. “Precision wellness sounds very sophisticated, but honestly, a lot of what is sold under that label is just clever branding,” tells Agarwal.

He frames genuine precision as rooted in restraint:

Run only the tests that change decisions.

Track outcomes, not dashboards.

Use diagnostics as feedback, not as fear marketing.

Be explicit where science is weak: This is experimental, here’s what we know, here’s what we don’t.

Personalisation, he adds, is often behavioural: two patients with identical biomarkers may require different plans depending on their stress levels, work environments, or cultural contexts.

Stick to the basics

Hussain’s view is blunt: the most reliable human evidence today supports “the boring stuff.” Exercise, nutrition, sleep, social connection — the fundamentals that make longevity commercially unglamorous but biologically powerful. “Your body is designed in a way that’s way more advanced than even doctors can understand,” he says. Before peptides and gene editing, most people would benefit more from muscle gain, glucose control, and strength training.

On emerging therapies such as senolytics, gene editing, and plasma treatments, he urges caution. “It shows promise, but jumping to a conclusion would be immature.”

Meanwhile, a debate around data ownership shadows the entire sector. India’s Digital Personal Data Protection (DPDP) Act and evolving health-data norms aim to place control with individuals, but Agarwal argues the deeper issue is trust. “Used well, aggregated health data helps us create better drugs, better diagnostics, and better protocols. Used badly, it can exploit trust.”

Hussain argues that governments should apply strict standards before approving any anti-ageing intervention. “Treat a proven longevity tech like public health, but only once it’s proven, not because a rat model showed promise,” he says. “Strict evidence standards, outcome-based approval, not just biological age marketing, post-marketing surveillance, real enforcement against clinics making anti-ageing claims without data — that should be protocol.”

He warns that without scaling public-good basics such as vaccines, blood pressure control, lipid control, smoking cessation, clean air, and walkable cities, elite therapies risk creating a world “where lifespan becomes a marker of class.”

And Dr Joshi warns that the promise of radical life extension is likely to increase anxiety levels and associated psychological conditions in the short term. Over time, not meeting expectations is likely to increase feelings of learned helplessness that may predispose people to depressive symptoms.

‘Biohacking is woke’

Hussain notes a growing wave of consumers seeking biohacking for identity as much as health. “We see it at odds as well, people coming for biohacking because it’s a lifestyle statement. It’s more woke,” he says. He sees echoes of the old mythologies: “Humans have always been fascinated by immortality… Everybody wants to be remembered.”

Even contemporary tech-driven efforts, like “Dipinder Goyal launching something exploring longevity,” reflect a familiar impulse: longevity as status, he says.

But the most defensible version of longevity is deeply humane. It’s about helping people stay strong, independent, cognitively sharp, and socially connected.

Hussain is equally cautious about the trend toward “digital afterlife.” “We can preserve data, photos, voice, writing style, behaviour patterns,” he says. “But we don’t currently have a validated method to extract or transfer consciousness.”

Even if transfer were possible, he argues, identity would still fracture: “Is it really that individual? Does it even make you the same person anymore?” Experience would reshape any copy. “Resemblance isn’t the same as survival,” he says. At best, digital replicas serve as “memorialisation… meaningful for families,” but not continuity of self. “The metaphysics here shouldn’t be misunderstood like an IT project.”

For Hussain, the pursuit of extra years without purpose is hollow. “What is one even going to do with it?” he says. “Purpose, community — it does matter to such an extent that people who don’t have that have fewer years to live.” Loneliness, he notes, “reduces lifespan by 14 to 15 years… on par with smoking.”

The real project of longevity, he argues, is social as much as biological: “Age-friendly communities, meaningful roles for older adults, reducing loneliness. The real win is health span plus social span — strong bodies, sharp minds, strong relationships.”