How to prepare for (and participate in) biology eating the world
About a year ago, Vijay Pande over at A16z published Biology is Eating the World: A Manifesto, which echoes Marc Andreessen’s famous thesis that software is eating the world (i.e. that code is being relentlessly applied to all niches of business and industry to provide value). While the era of software is well underway, I agree with Vijay that we’re entering a new era where biology has “shifted from an empirical science to an engineering discipline” and that “we have finally begun using nature’s own machinery—through biological engineering—to design, scale, and transform biology.”
You should also check out A16z’s new podcast: Bio Eats World.
While software engineers have generally enjoyed being in favorable position over the past few decades while software eats the world, many - like my friend Andy (a founder of Figment Networks, one of my firm’s portfolio companies) who posted the above question in our Slack group - are motivated to learn more about biology and how to engage in the new era.
I’ve had the privilege over the past ~15 years to build a career in software engineering as an entrepreneur spinning up and investing in technology startups, but my education and graduate work was spent deep in the bio world. I’ve been not-so-secretly excited about the intersection of biology and engineering/software innovation; it’s amazing to watch technologies such as machine learning, CAR T-cell therapy/CRISPR, and quantum computing enter the scene and dazzle us with inspiration and dreams for what the future can look like.
Where to begin?
So, to dive into addressing Andy’s question, I think - like anything - it starts with understanding how to frame the layers of topics and first principles to understand, which I’d argue for the software engineer (or anyone, really) begins with the following:
- First principles of physics, chemistry, and biochemistry
- Genomics
- Endocrinology
- How to read primary literature
- The regulatory environment for bioinnovation
- The healthcare value chain
(It may seem strange/arbitrary that I include endocrinology in this list versus other disciplines, but you’ll see why below.)
First principles of physics, chemistry, and biochemistry
If you took a class or two in school on these subjects then - realistically - you have the foundation to do some weekend reading to get reasonably up to speed and follow the rabbit trails that interest you, e.g.:
Two key foundational principles to understand, for example, include how complex biological systems are built to establish and maintain balance (homeostasis) and daily fluctuations (e.g. circadian rhythms). Far too often, popular-level health articles fail to even hint at the power and complexity inherent in our bodies’ ability to cycle and/or maintain very narrow ranges of certain molecules in various internal spaces throughout the day, month, quarter, and year. This dramatically affects how we respond to various diets, medications, and exercise regimes, for example, yet rarely will you ever hear anyone talk about it. Instead, we want to hear “take this drug or change this behavior and it immediately results in X.” The body, however, is usually fighting very (very) hard to keep things “the same.”
Understanding first principles will help anyone cut through noise, bad arguments, and “fake news” that is unfortunately rampant in biology and health science commentary today - often because they want to sell you something.
Genomics
Simply put, genomics is not as simple as the DNA-RNA-Protein “central dogma” process chain that you probably learned in school. Epigenetics and the interrelational complexities of DNA, RNA, and proteins that work to express our “genes” are far more mysterious than we originally thought during the infancy of this discipline back in the 80’s.
Thus, exciting new technologies such as CRISPR, which can modify DNA to treat disease, generate biofuels, prevent mosquitoes from transmitting malaria, and a host of other promising applications, unfortunately won’t be as easy as hacking code to produce a predictable, universally applicable outcome.
Endocrinology
While there are, of course, many sub-disciplines to choose from to dive into the vast universe of biology, bioengineering, and health science, I’ve found that most people who are interested in the basic health-science topics (e.g. sleep, nutrition, fat loss, muscle gain, disease prevention, etc…) have an unfortunate lack of understanding of the endocrine system (i.e. “the network of glands in your body that make the hormones that help cells talk to each other”).
Because hormones are so foundational to the core health topics that we all care about, undoubtedly there is going to be - and already is - a massive market for technology that monitors and controls our hormones, hence why I call-out this sub-discipline in particular as one to study.
Specifically, one of the “master hormones” that you should have a basic understanding of is insulin. This is not just for diabetics to care about. As a first step, I’d highly recommend reading the wikipedia article to wrap your head around how insulin works, which will then help you better understand how - thematically - other hormones such as cortisol, testosterone, estrogen, HGH, IGF, glucagon, leptin, adrenaline, etc… do their thing.
How to read primary literature
Whenever anyone with an academic background in the biosciences reads a story on a health science or biology-related topic, our natural inclination is to look up the research paper or papers (if any!) that prompted the story. Too often the hype is based on questionable research, which - to be frank - is pretty much anything except for a Randomized Controlled Trial (RCT) when it comes to the effect of a drug, food, or therapy.
This is not to say that correlation studies and other forms of research aren’t useful (e.g. they often prompt hypotheses that lead to robust RCTs), but it’s important to understand that headlines in the biotech/health-tech world are easily sensationalized based on little-to-no causal data.
Going a level deeper, when reading primary literature on any topic (such as you’ll be doing on genetics and endocrinology), it’s important to understand that nobody except a handful of experts in the field can fully evaluate the study. Thus, the rest of us are left to trust the reviewers, editors, and publication to present us with both a factual understanding of what happened and thoughtful commentary (i.e. the “introduction” and “discussion” sections) on why the results of the study are important.
For more on this, check out Peter Attia’s fantastic 5-part series: Studying Studies.
Thus, while it’s quite OK to just read the abstract of the paper and get the gist of an article, if you have time to read the introduction and discussion (if not the results and methods themselves!), this will help you get significantly ahead of most health bloggers and journalists out there.
A good practical tip is to search pubmed, find recent “review” articles, and follow the references to dive deeper into a topic of interest. An increasingly large number of articles these days can be read for free anywhere (which is encouraging!), but to really dive in you’ll need to visit a local university library (or ask a friend located on one) to get free access to a robust set of primary sources.
The regulatory environment for bioinnovation
Especially in the USA, regulations around innovating in the biotech/healthtech/medtech space are understandably complex.
To dive in, I’d recommend first reading Dr. Scott Gottlieb’s Aug 2018 article FDA’s Comprehensive Effort to Advance New Innovations: Initiatives to Modernize for Innovation, where he outlines the landscape, silos, and barriers for innovation, including how the FDA is working on optimizing the process of innovation using things like Real World Evidence and building standards for new technologies.
The healthcare value chain
Finally, while not directly related to biology, the unfortunate truth in most of the developed world is that the healthcare value chain (e.g. from producers to providers to purchasers) is maddingly complex and must be navigated by innovators in order for biology to continue “eating the world.”
[Caption] Source
To begin, I’d recommend a quick scan of Hector Rodriguez’s deck The Modern Healthcare Value Chain is a Care-centric Supply Chain, a careful read of Dennis Pitta’s 21-page paper on the topic, and ultimately - for a much deeper dive - Lawton R. Burns’s book The Health Care Value Chain: Producers, Purchasers, and Providers.
While there is a lot to study, and plenty of room in this value chain for disruption, what’s most important is to at least understand the overall framework for how “things get done” in the modern world and how - if you have the next great technology - you will need to navigate the system to bring about change.
Getting in the game
For those convinced that biology is indeed eating the world and that bio is today where information technology was 50 years ago, the key question is how to jump in and get in the game.
While it may seem insurmountable that getting drug to market these days takes $2.6 billion and about a decade, not all advances in bio need to be “drugs”; i.e. there are plenty of areas where an ambitious entrepreneur can bring new biotech to market, for example:
If you have expertise in one of these (or any other) areas of biotech and would be interested in starting a company to get after it, I’d love to chat. For everyone else, if you have any questions or recommendations for topics / materials I should have included above, please feel free to comment here and I’ll do my best to keep this article updated.
Author’s note: thanks in advance for any/all comments. Feel free to reach me via email at will@wclittle.com, on Twitter here, and/or subscribe to my newsletter to stay posted when I publish more thoughts on “bio eating the world” / health science, and/or various other tech topics. Special thanks to Andy, Tony, and Polina for help thinking through the content of this article (Thank you!).