Monday, July 1, 2019

Low Cost Medical Devices for Low-Resource Regions: Interview with Prof. Saad Bhamla, Georgia Tech

Advances in medical technology continue apace, with sophisticated new medical devices and therapies becoming available on an ongoing basis. However, medical technology often comes at a premium, and for low-resource regions sometimes even relatively basic medical devices, such as hearing aids, are inaccessible because they are too expensive. Similarly, basic equipment, such as centrifuges, that are commonly used in diagnostic or medical research laboratories can cost a lot, making it unaffordable for laboratories in many countries and institutions.   


These barriers to using tools commonly available elsewhere are a huge hurdle to healthcare and medical research. However, the antidote may lie in frugal science, a concept promoted by Saad Bhamla, assistant professor at the School of Chemical and Biomolecular Engineering at Georgia Tech. Bhamla specializes in developing low-cost medical devices and diagnostic/research laboratory equipment.




For instance, his group is in the process of developing a low-cost hearing aid, which could cost less than $1. The technology could make it affordable for millions of poorer people globally who currently suffer from hearing problems to get hearing aids.



Another frugal science invention is the Paperfuge, which is a substitute for bulky and expensive lab centrifuges. The device is based on a child’s toy, and is made using simple components including fishing line, PVC pipe, and cardboard. Costing less than 20 cents per device, the Paperfuge is very affordable, and can be made by anyone. It can separate plasma from whole blood sample is as little as 90 seconds, and takes just 15 minutes to isolate malaria parasites from patient samples. A 3D printed version of the fuge (called the 3D fuge) can handle larger blood sample volumes.


Other projects

include the Electropen, a small and inexpensive (20 cents) electroporator,

which is a piece of lab equipment for cellular genetic modification which

traditionally costs thousands of dollars. The device includes simple components

such as aluminum foil and a cigarette lighter, but has been shown to be comparable

with an industrial grade electroporator in terms of performance.


Medgadget had the opportunity to talk to Bhamla about his frugal science initiatives and find out more about this fascinating field of research.


Conn Hastings, Medgadget: Please give us an overview of the frugal science concept.




Saad Bhamla: We live on a

planet with almost eight billion people now, but with finite resources. So,

frugal science asks, ‘how do we essentially apply this constraint of cost to

both scientific tools that address challenges in science education and global

health?’ Frugal science asks us to be conscientious about building devices and

engineering ideas such that they scale, not just for a few people, but for billions

across the globe. Essentially what we do is put ourselves in this box of trying

to make devices and ideas for a dollar, and then we have to think outside of

that box and reengineer them. Some of our devices have addressed global health

issues, such as low-cost centrifuges and hearing aid. We also tackled science

education and synthetic biology with the ElectroPen and a couple of other devices

we are working on.


Medgadget: How did you get involved in this area? What inspired you to create your first frugal science device?


Saad Bhamla: I was

introduced to this concept during my post doc work with my advisor Manu Prakash

at Stanford. About the time that I joined him, Dr. Jim Cybulski a PhD student

in his lab had just co-invented the world’s cheapest microscope called the Foldscope,

which is paper-based and costs $1.50. They were working in the same building

where I was finishing my PhD on building a biomedical platform that mimics your

eye to enable testing of contact lenses and ocular health therapeutics to

address dry eye symptoms. We sold my technology to multiple Fortune 500

companies, and I distinctly remember arriving at these company’s R&D labs

and setting up my device next to other commercial instruments, knowing very well

that it would influence biomedical research, but this approach had its

limitations. Across in my soon to be postdoc lab, I saw an opportunity to

conduct research and invent tools that had more direct impact on global health

issues, and after I joined, one of my first inventions in this philosophy was a

20-cent paper-based centrifuge for enabling diagnosis of infectious disease

like malaria.


Medgadget: How do you set about creating something that is so much cheaper than commercial alternatives, while still delivering comparable functionality?


Saad Bhamla: We have to ask

ourselves, ‘if we were to reinvent the wheel today, would we use the same materials

and technologies that people used when it was first invented?’ And the answer

might be no; now we are more open to other technologies and ideas. Here’s a few

examples. The centrifuge we made uses 3D-printed polymers and paper because we

have more manufacturing flexibility in our labs. With the ElectroPen, we wanted

to create a device that generates a huge amount of electricity by mechanical

means versus stored power such as batteries. So, we had to look at basic

physics to determine the best way to generate enough electricity. In my lab, we

often look to household items or toys for inspiration because they are often

very simple, but also very nonintuitive and puzzling because they challenge

your thinking. A part of our effort is to rigorously develop mathematical

models, optimize materials design, and engineer our frugal tools to achieve performances

comparable to existing gold standards. Just because something is low-cost,

doesn’t mean its performance has to suffer.


Medgadget: Please give us an overview of how the frugal hearing aid, Paperfuge/3D-fuge, and Electropen work?


Saad Bhamla: The hearing

aid device costs less than a dollar. It functions just like any hearing aid,

but it again uses 3D-printed materials, low-cost electronics and is optimized

to address age related hearing loss in adults. Here, our goal was to challenge

ourselves to build the simplest device possible, at the lowest cost.


The

Paperfuge and 3D-fuge take a droplet of blood and separate pure plasma from

whole blood in less than 90 seconds, and it can isolate malaria parasites in

15 minutes. Devices like this are especially critical in developing countries

that lack resources to purchase medical equipment and where remote villages do

not have access to care.




The

ElectroPen costs about 20 cents, and it’s portable. It’s made with a 3D

printer, aluminum foil and a cigarette lighter. With it, we can genetically

transform competent E. coli. We also

found the ElectroPen to be comparable to an industrial-grade electroporator,

and it allows any high school student to participate in synthetic biology and

engineer living cells for new applications.


Medgadget: Part of your goal is to empower people, and particularly school children, in low-resource areas to manufacture and develop frugal devices by themselves. Please give us some background on this, and how it has been going.


Saad Bhamla: The biggest

thing that drives me is the hunger and curiosity that I see when I interact

with high school students. I’m trying to nurture and provide access to tools

and technologies that these high school students clearly want. In my state of

Georgia and across the U.S., a lot of public schools’ science budgets are

constrained, limiting access to scientific tools. It is especially tough for

schools in low-income areas. It’s a sad reality, because we all know that hands-on

science really sustains a young person’s curiosity and helps them become a life-long

participant in science. Enabling scientific education is critical to equip the

next-generation for some of the planetary scale challenges they will tackle as

they grow up. So, in my lab, we encourage students and their science teachers to

participate in the full cycle of science – from ideation to publishing. We

train them to become problem-solvers, inventors and scientists. By publishing

their work, they also empower other students and teachers across the globe to

build on their research and contribute to this growing community of frugal

science.


Medgadget: What are your future plans for these devices? Have you set your sights on developing any other inexpensive medical devices?


Saad Bhamla: We are currently trying to expand the ElectroPen’s application beyond single cells, like bacteria, to entire organisms in order to study neuroscience and development of the nervous system. Understanding how the brain works and our nervous system is currently a grand open challenge. We need to provide tools for the students to be able to explore this important next scientific frontier. Another part of my work with the ElectroPen is on the global health side. We are hoping to use it for vaccine delivery, particularly in low-resource environments. We are working with other researchers here at Georgia Tech to develop a low-cost gene-based vaccine delivery system for human diseases. For the hearing aid, we are making a dozen prototypes that will be tested in developing countries on actual patients with hearing impairment. It’s important to get patient feedback on early prototypes and understand their efficacy in real-world conditions. We are going to ship these devices and do a cohort study where we can obtain quantitative data on their usefulness across diverse locations. We have US data but gathering data from low-resource locations is equally important because of the diverse socioeconomic factors and understanding how different humidities and conditions affect the device.




Link: Bhamla Lab

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