Box C.1: Biosensing futures

By Adrian Mackenzie

The auditorium stacks to the back rows, health ministers, local politicians and university dignitaries to the front, and a university audience behind. We sit back to hear about micro-wearables, nano-technology biosensors engineered to ‘functionally interface’ with the skin. The Entrepreneurial Professorial Fellow's startup will engineer devices that ‘gain access to the skin for all manner of signals.’ He shows photographs of a small square patch stuck on a forearm like a plaster and a video of an ECG (electrocardiogram) signal, pulsing smoothly. The signal is ‘clean’ because nano-sized sensor spikes probe interstitial fluids without puncturing cell walls, without needles for blood or vials for urine. In a planned ‘biotech skunkworks,’ innovation will slalom past pharmaceutical or medical device manufacturers with their fifteen year product pipelines. It will be like Google, he claims, because the biosensor field is moving too fast for the regulatory regimes of medicine. Micro-wearable biosensing, we hear, is more like contemporary cars than clinical observations: 200– 2000 continuous signals can be recorded. The data will not only feed into population-level data collection but into profiles of individual variability. In the crowded lobby afterwards, white-aproned waiters pour glasses of local wines and neaten up trays of canapés for the guests. Despite the biotech skunkworks – an interdisciplinary incubator for high-tech – and the vaulting ambitions to change clinical practice in global North and South, the microwearables, should they reach a market, do not figure in the talk or in the chorus of talk in the lobby as elements of a platform. The devices might combine science, engineering and medicine, and they might ‘break through the silos between global science, technology and people,’ but their alignments with biosensing and its platforms are not mentioned.