Can nanotechnology improve public health?

Nanotechnology's potential to improve public health will be maximised only with a conducive environment.

There are around five billion people in the developing world who could benefit from the use of nanotechnology in key sectors such as health. Nanotechnology is already stimulating radical changes in health that promise to both improve existing medical practices and make them more affordable.

In India, for example, researchers have made several advances in nanomedicine, including the development of nano-bioceramics that repair bone and tissue and an aerosol spray that uses nanoparticles to deliver lung cancer drugs.

Other applications developed in India include a nano-based water filter and the “iSens” sensor - an affordable and user-friendly nanodiagnostic tool that anticipates heart attacks and is expected to become commercially available soon.

But how effective such advances will be in improving public health will depend on a range of factors beyond the technology itself. These include the existing regulatory framework, funding and infrastructure, and the extent to which the private sector and users participate in technology development.

Can't get the staff

Nanotechnology could potentially broaden public health structures that are capital intensive and require specialised skills. But for countries like India, which has just a dozen nanomedicine specialists, human capital is likely to be a limiting factor. While developing countries supply 56 per cent of all migrating physicians, they receive less than 11 per cent. India is among the top two countries suffering from this brain drain and faces a shortage of skilled medical professionals.

And, as in all areas, funding is critical. In India, scant and belated funding for nanotechnology for health - just four of the 141 projects launched under the 2007 Nano Mission relate to health - constrains research and development (R&D) activities.

Other factors such as poor lab-firm integration and a lack of involvement of the private sector further hamper the commercialisation of nano-based health products. A 2007 study by an industry board found that the private sector accounts for just 22 per cent of total national spending on nanotechnology R&D, despite that three of the six public-private partnerships established under the Nano Mission are in the pharmaceutical sector.

This can be explained in part by the fact that venture capitalists are reluctant to invest in nanotechnology because only 3 per cent of projects worldwide provide a lucrative return for investors. But even so, the private sector's involvement in India remains far below that seen in developed countries such as Japan (66 per cent) and the United States (50 per cent).

India also has to contend with poor policy co-ordination at the government level. Conflicting priorities and mandates between the Department of Science and Technology and other departments such as the health ministry have resulted in a push to promote nanotechnology before necessary risk research and regulatory processes have been put in place.

Working in a bubble

This poor co-ordination goes hand in hand with a lack of effort to engage or consult medical professionals, health workers or the general public, which means that the state's nanotechnology activities are largely conceived within purely technocratic frameworks.

Health is a largely social arena that requires more human resource management than technological intervention, including promoting lifestyle changes, raising awareness, and encouraging moral responsibility towards the environment and the community. Engaging all stakeholders in the research process is critical to ensuring that national nanomedicine programmes can meet local needs.

Building partnerships between the technology users and the scientific community can also help ensure take-up of the technology once it is developed. The success of a nano-based water treatment project in South Africa is due in large part to the close involvement of the local community in its design and maintenance (see "Community ownership is key to nanotech water projects").

International collaborations are another route for improving national nanotechnology initiatives. Joint ventures such as the India, Brazil and South Africa (IBSA) Nanotechnology Initiative promote co-operation and collective learning in nanotechnology for areas such as energy, water, agriculture and health.

Under the initiative, a school on health and water was established in South Africa last year and researchers from all three countries are collectively working on a nano-based drug delivery system for antiretrovirals.

There is little doubt that nanotechnology holds a great deal of promise for improving public health in developing countries. But realising this potential will be no easy feat. It will require co-operation and engagement at every level - from international research collaborations to synchronised national programs and the involvement of the local community.