Taking us by surprise
Very few people foresaw the use Viagra would be put to. Few saw semaglutide coming. Very few anticipated large language models and AI coming along so fast. Yet all of these have had a massive effect on society. And there are other man-made developments that might soon surprise us by their widespread effect.
The pattern is worth noting first. Neither surprise came from nowhere.
Viagra (Sildenafil) was designed by Pfizer as a cardiovascular medication. GLP-1 drugs were used for diabetes for over a decade before anyone noticed they could reshape waistlines, and the transformer architecture behind LLMs dated from 2017. The shocks came when quiet technologies crossed a threshold of cost or capability. So the best candidates are things already here, compounding out of sight.
CRISPR has already cured sickle cell disease in trial patients. The next step is editing genes inside the body, not in the lab. Early trials suggest a single injection could permanently lower cholesterol. If that works at scale, heart disease becomes a condition you fix once rather than manage for life. The pharmaceutical model of the lifelong prescription would take a heavy hit.
Solar costs have fallen roughly 90 per cent in fifteen years, and battery prices have tracked them down. Meanwhile enhanced geothermal, borrowing drilling techniques from the fracking industry, can now tap heat almost anywhere. Energy that is abundant and cheap changes everything downstream: desalination, fertilizer, manufacturing, even where people choose to live.
The same AI that writes prose is teaching machines to handle objects they have never seen. Driverless taxis already carry paying passengers in several American cities without a safety driver. General-purpose robots for warehouses, care homes and kitchens are a harder problem, but the gap is closing faster than most labour-market forecasts assume.
Ukraine has shown that a few hundred pounds of consumer hardware can destroy a tank worth millions. This rewrites military economics, and the civilian side is coming too, for delivery, inspection, agriculture, and emergency medicine.
Reusable rockets have cut launch costs dramatically, and satellite internet now reaches ships, aircraft and remote villages. The follow-on effects in communications, Earth observation and perhaps orbital manufacturing are only beginning.
Tests that detect traces of many cancers from a single blood sample are in large trials, including a big one in the NHS. Catching tumours at stage one rather than stage four would do more for survival rates than most new treatments.
The most speculative, but the most consequential, could come in ageing. Drugs or treatments that target the biology of ageing itself, rather than individual diseases, are moving from mice to humans. Semaglutide itself is showing benefits far beyond weight control in heart treatment, kidneys, possibly addiction and dementia. The idea that one drug can slow several diseases at once is no longer on the fringe.
The common thread is that each depends on declining costs meeting rising capability, which is exactly what markets are good at delivering and forecasters are bad at predicting.
Which ones, already under development, will surprise us by entering the mainstream? I predict treatment that prevents or reverses male pattern baldness, and one that increases healthy lifespan.
Madsen Pirie