India has added years to life. The next task, the stem cell researcher argues, is to add life to those years, and to keep the science honest while doing it.
For most of the last century, a nation’s health was measured by one number: how long its people lived. On that count, India has done remarkably well. A child born today can expect to live about twice as long as one born at Independence.
But Prabhu Chandra Mishra, a PhD researcher in biotechnology specialising in stem cell and regenerative medicine, says lifespan is only half the story. The other half is healthspan: the years lived free of chronic disease and dependence. A global analysis in JAMA Network Open in late 2024 estimated that people now spend close to a decade of life in poor health. “We have become good at postponing death, but not at postponing decline,” Mishra says.
Ageing faster than we prepare
India is a young nation, but it is ageing quickly. The UNFPA’s India Ageing Report 2023 projects that the share of Indians aged 60 and above will roughly double, to about one in five, by 2050. That shift will arrive on top of a heavy burden of diabetes, heart disease, arthritis and dementia, conditions that begin quietly in our forties. Mishra argues that the country needs a health system that treats ageing as something to be measured, delayed and managed, rather than simply endured.
A fast-moving frontier
Geroscience now describes ageing through measurable processes: cellular senescence, mitochondrial decline, chronic inflammation, epigenetic drift and the exhaustion of stem-cell reserves. What can be measured can, in principle, be targeted.
Mishra points to Shinya Yamanaka’s 2006 discovery that four genes could turn an adult skin cell back into an embryonic-like stem cell. That Nobel-winning work gave medicine induced pluripotent stem cells (iPSCs): a patient’s own cells, reprogrammed into almost any tissue. Early trials have transplanted iPSC-derived dopamine neurons into people with Parkinson’s disease, and stem-cell-derived islet cells have freed several people with type 1 diabetes from daily insulin.
A bolder idea is partial reprogramming, where the Yamanaka factors are switched on only briefly to reset a cell’s epigenetic age without erasing its identity. In mice, it has restored lost vision and extended lifespan in models of accelerated ageing, and the first human trials, beginning with eye disease, are being prepared.
Cell therapy is also rewriting cancer care. CAR-T therapy re-engineers a patient’s own immune cells to hunt cancer. In 2023, India approved its first indigenous CAR-T therapy, developed with IIT Bombay, at a fraction of the global price. In Germany, CAR-T cells have put patients with severe lupus into drug-free remission, a hint that the tool may one day reset a misfiring immune system.
Mishra is careful to add a note of honesty. Most of this is still early trials and promising signals, not settled practice, and no therapy has yet been shown to reverse human ageing. The strongest longevity interventions remain unglamorous: sleep, movement, nutrition, muscle strength, social connection and early detection of metabolic disease.
The charlatan problem
Wherever there is fear of ageing, there is a market. Clinics across Indian cities advertise “stem cell therapy” for everything from autism to arthritis to “anti-ageing”, at great cost and with little evidence.
The rules, Mishra notes, are already clear. The ICMR’s National Guidelines for Stem Cell Research (2017) state that, apart from bone-marrow transplantation for blood disorders, stem cell use outside approved trials is not standard care, and marketing it as such is malpractice. The New Drugs and Clinical Trials Rules, 2019 bring stem-cell-derived products under regulatory oversight. “What is missing is enforcement and public awareness,” he says.
A healthspan agenda for India
India does not need to import a Silicon Valley culture of costly gadgets and supplements, Mishra says. It needs an evidence-led agenda:
Measure ageing, not just disease. Grip strength, walking speed, waist size, blood sugar, blood pressure and inflammation markers can flag accelerated ageing years before illness, and belong in routine check-ups from 40.
Build Indian reference data. Most biological-age tools are calibrated on Western populations. India needs its own open datasets on how Indians age.
Enforce the rules. Unproven regenerative treatments should be offered only within registered, ethics-approved trials.
Train a new generation of doctors in geroscience, prevention and the evidence on iPSCs, CAR-T and exosomes, including when to say no.
That last gap is one Mishra has worked for over a decade to close. As Founder of the International Association of Stem Cell & Regenerative Medicine (IASRM), which has run the Longevity & Regenerative Medicine conferences since 2014, he oversees year-long fellowships in which every fellow must complete an original research paper. They are training programmes, not licences to practise, meant to produce clinicians who understand both the promise of this science and its limits.
He also sees a place for tradition. Ayurveda spoke of rasayana, rejuvenation through rhythm, diet and restraint, long before biology had words for senescence. Such traditions, Mishra says, deserve the same rigorous testing as any new therapy.
The real goal
For Mishra, the goal of longevity science is not immortality. It is a seventy-five-year-old who can climb stairs, manage her own affairs, play with her grandchildren and live without fear of becoming a burden. “That is a goal worth building a nation’s health policy around,” he says.
Prabhu Chandra Mishra is a PhD researcher in biotechnology specialising in stem cell and regenerative medicine, and a MedTech entrepreneur. He is the Founder of IASRM.