In this article, Muhammad H. Zaman, Professor in the Department of Biomedical Engineering and International Health at Boston University discusses the types of biomedical engineering solutions that may be needed in humanitarian crises, what is available, where the gaps are and what can be done to bridge some of those gaps.
The increasing role of technology in diagnosis, management and effective cure of disease in a functioning health system cannot be understated. In a health system that is under stress, due to a conflict or humanitarian emergency, the role of suitable and affordable technology is even more critical. While technology solutions, particularly those rooted in mobile health and electronic data analysis, are increasingly being used by aid agencies and NGOs focused on humanitarian health, the role of biomedical technologies is less well understood.
1) Biomedical Engineering Solutions: By Biomedical solutions we mean technologies that go beyond just data capture, resource management and electronic decision making. Biomedical engineering technologies would include rapid, point-of-care diagnostic tools to test for infection such as malaria or TB, diagnostics for non-communicable diseases such as diabetes, implants or prosthetics to increase mobility for the disabled and the injured, and therapeutics that can survive extreme temperature fluctuations. These technologies are meant to improve the quality and efficiency of care and strengthen health systems by providing diagnosis at the point-of-care, decreasing the dependency on expertise or infrastructure that may be difficult to find in an emergency, and delivering care with minimal resources.
2) Solutions, possibilities and challenges: Recent developments in have opened the door of new and exciting possibilities. For example 3D printing has made manufacturing flexible and accessible to address challenges in creating medical supplies and prosthetic solutions for those in need. Similarly, new rapid diagnostic tests are quick, specific and affordable for a variety of infectious diseases. There are companies, NGOs and research groups, such as D-Rev (prosthetics), BD Biosciences (Uniject solutions for vaccines) and Gradian (universal anesthesia machines) that are working to provide specific solutions for health challenges with limited infrastructural or human resources.
However, there are major gaps in biomedical engineering solution space that continue to persist. These challenges stem from three main reasons. First is awareness gap between technology innovators and those who work at the forefront. Lack of understanding of challenges makes it difficult to provide customized solutions. Second is associated with lack of resources or robust business models that will incentivize the development of new solutions. Finally, lack of trained staff or adequate training opportunities makes the appropriate use and upkeep of technology challenging. This results in technological solutions failing to live up to their full potential.
3) Bridging the gulf: There is little doubt that technology can, and should, play an important role in improving health outcomes during conflict and humanitarian emergencies. However, technology alone, without a proper integration into the rest of the healthcare delivery system will not be able to provide any meaningful advantage. Therefore, there is a need to develop context appropriate, robust, reliable and affordable solutions. To create specific and sustainable solutions, a three-pronged strategy is needed.
First, to increase awareness among innovators about technological gaps in humanitarian emergencies. This would require creating platforms that bring researchers from engineering and technology development closer to those who work in the field at the front line. Awareness may take several forms that include not only multi-disciplinary conferences and symposia but also awareness among students through classes and focused projects. Awareness will also increase technological understanding among healthcare providers and increase their ability to use, manage and provide adequate maintenance.
Second, increasing frontline innovation would require focused funding for research and development. Funding for new solutions for humanitarian emergencies is inadequate and a major barrier in developing solutions.
Third, solutions that show promise will need help in sustainability and scale-up. This will require new partnerships that bring together more than just financial investments. The long-term success will require new partnerships among technology innovators and front-line workers, but also leaders from the private sector, international aid agency leaders and policy experts.
© The London School of Hygiene & Tropical Medicine