Team:TUDelft/Sustainable
Sustainable Development Goals
Our project AptaVita, an accessible, quantitative, and modular vitamin detection test, aims to help reach Sustainable Development Goal #2 Zero Hunger by increasing data availability to build effective intervention programs. Here, we show how we incorporated feedback from SDG-stakeholders both in the design of AptaVita, and our local community implementation plan to help attain the Sustainable Development Goals.
Sustainable Development impact of our project
To eradicate world hunger, we aim to contribute in helping reach one of the United Nations’ (UN) Sustainable Development Goals (SDGs), #2 Zero Hunger [1]. We do this with the goal to tackle hidden hunger, which are deficiencies in micronutrients that remain highly prevalent in many developing countries. In order to overcome the current issues of lack of accessible diagnostics for practical actions, we focused on developing an accessible, quantitative, and modular rapid diagnostic test (RDT). Throughout our entire project, we have set our focus on the target country Uganda - a country with a high micronutrient deficiency incidence - to provide a proposed implementation of our RDT according to the needs of the local community. By contributing to help reach SDG #2 Zero Hunger, our project directly and indirectly contributes to the rest of the global goals, #1 No Poverty, #3 Good Health and Well-being, #5 Gender Equality, #10 Reduced Inequalities, #12 Responsible Consumption and Production, and #17 Partnership.
SDGs - AptaVita targets
1.4 By 2030, ensure that all men and women, in particular the poor and the vulnerable, have equal rights to economic resources, as well as access to basic services, ownership and control over land and other forms of property, inheritance, natural resources, appropriate new technology and financial services, including microfinance.
Throughout the design of our project, we highly considered how to make our RDT accessible, user-friendly yet accurate and reliable, to address this goal. To conquer this challenge, our RDT is designed to work on a paper-based system with dedicated hardware for the read-out. These decisions came from literature searches and involving relevant stakeholders. Through the interview with Dr. Jan-Carel Diehl, we were encouraged on the development and use of dedicated hardware that allows for quantitative analysis that is robust and user-friendly. We developed our hardware with the aim to make it as cheap as possible yet reliable through quantitative measurements. Furthermore, alternative strategies for price reduction were proposed to make our RDT as affordable as possible, which can be found on our Entrepreneurship page.
2.2 By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons.
3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births.
5.6 Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.
10.3 Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard.
Our project identifies most with goal 2.2, in particular contributing to ending hidden hunger. Since our RDT aims to provide an accessible and reliable diagnosis of vitamin deficiencies, appropriate effective actions can be taken. We further focused on adolescent girls, pregnant and lactating women and chose Uganda as our target implementation country. As women at reproductive age often have deficiencies in micronutrients such as folate, it shows the need of promoting and taking actions towards nutritional needs [2]. Our RDT will contribute to providing quantitative measurements and aid in exposing the vulnerable regions. This will also contribute to achieving SDG 3.2, namely Good Health and Well-being. The UN Human Rights Council reports nutritional deficiencies as one of the main risk factors of the leading cause of death in children aged between 1 month and 5 years [3]. Research has shown the effectiveness of supplementation of multiple micronutrients to pregnant women, greatly reducing neonatal mortality [4]. With our accessible RDT, multiple micronutrient supplements tailored to deficiencies of each individual or group could be made possible, as a single micronutrient supplementation was shown not to be as effective. At the same time, this will help achieve SDG 5.6 by providing universal access to our RDT. Lastly, in the long-term, if our RDT provides accessible diagnosis leading to improved nutrition intakes, symptoms of hidden hunger will no longer create inequalities in access to education and work opportunities due to micronutrient deficiency related health issues. As a result, we strongly hope this will contribute to reducing socio-economic gaps regarding micro-nutritional intake.
12.5 By 2030, substantially reduce waste generation through prevention, reduction, recycling, and reuse
For the production of RDTs, sustainability has not always been high on the priority list of village healthcare workers compared to the importance of improved health. As our responsibility as scientists, the implementation of sustainability into the design of our RDT accompanied the development of our technology. Therefore, we did look into the prevention, reduction, recycling, and reuse of our vitamin detection test. By answering the question "When the world is using our product, what problems do you encounter?" asked by Sam Krouwel from the National Institute for Public Health and the Environment, we gained better insight into issues that could arise throughout the world.
Disposal regulations are not the same throughout the world and therefore minimization of the produced waste is essential. The only single-use aspect of the AptaVita test is the paper-based test component. Ideally, the test component would be biodegradable. Our current efforts focused on making the technology work properly and for future research, we would recommend focusing on making the technology work on biodegradable papers. The difficulty of the test component is that it belongs to biological waste after usage and therefore needs to be disposed of in a specific way. Therefore, regulations and proper disposal opportunities need to be adopted worldwide to ensure waste management.
The other aspect of our test, the dedicated hardware, consists of 3D printed plastic components, electronics, including a raspberry pi (which is a tiny computer), a battery pack, and a user interface screen. The plastic components of the test are biodegradable, and also for mass production with molds, biodegradable plastics can be used, thereby promoting the prevention of plastic waste. The electronics can easily be replaced due to the straightforward assembly of the test and the raspberry pi is open-source software. Furthermore, for assembly of the electronics, lead-free soldering is used to ensure more friendly waste management and will adhere to the Restriction of Hazardous Substances certification [5].
Multi-stakeholder partnerships: 17.17 Encourage and promote effective public, public-private and civil society partnerships, building on the experience and resourcing strategies of partnerships.
Data, monitoring, and accountability: 17.18 By 2020, enhance capacity-building support to developing countries, including for least developed countries and small island developing States, to increase significantly the availability of high-quality, timely and reliable data disaggregated by income, gender, age, race, ethnicity, migratory status, disability, geographic location and other characteristics relevant in national contexts.
Our team recognizes the importance of well-established partnerships to realize the screening of communities for micronutrient deficiencies and follow-up treatment. A good relationship with governments is essential for approval of the test, subsequent distribution throughout the country, and anticipating and implementing intervention programs based on vitamin deficiency data from our RDT. Without the help and approval of the local government, AptaVita cannot be implemented in society. Parties who can help to establish relationships with governments are health organizations. Both employees at international health organizations informed us about their well-established relationships with governments throughout the world. These health organizations could promote our vitamin detection device to various governments.
We want to build on the experience and resourcing strategies of partnerships by keeping close contact with local governments and health organizations. By keeping close contact with health organizations, we could benefit from their expertise in setting up intervention programs and learn from their past accomplishments. A partnership with local governments can help the distribution of AptaVita by making use of healthcare systems that are already present. For instance, testing for malaria with rapid diagnostic tests is already common practice in Uganda [6]. Furthermore, AptaVita can increase the availability of high-quality, timely, and reliable data. The obtained data can be used to identify high-risk regions for micronutrient deficiency. For the set-up of informed intervention strategies to prevent the irreversible effects of micronutrient deficiency, partnerships are needed.
Possible long-term negative impact of AptaVita
The positive impact that our product AptaVita can have on the achievement of the SDGs 1, 2, 3, 5, 10, 12, and 17 were highlighted in the previous section. However, it is also necessary to consider potential long-term (negative) impacts on the SDGs or issues that might arise upon implementation. One of the long-term negative impacts could be that the vitamin detection test ultimately proves unsustainable. Therefore, we have already addressed some future research that would need to be conducted to make the test sustainable in the long term by including biodegradable materials and implementing the required guidelines for the disposal of biological materials. However, governments have a crucial position in implementing and enforcing these types of guidelines. AptaVita does not have the capacity to intervene in politically unstable countries, and therefore implementation in these countries could lead to unsustainable usage of the vitamin detection test. Regardless, keeping in mind the aim of AptaVita, the benefits our RDT brings are not different for the citizens of these countries.
AptaVita is an accessible, qualitative, and modular RDT; we are positive that we will provide a device for diagnosis. The vitamin detection test will increase data availability about vitamin deficiencies, increasing the likelihood of awareness about the importance of micronutrient deficiencies. If interventions or action plans from the government are slow and still ineffective, this could cause the patients to be worried about their health. Diagnosis without a possible treatment is morally irresponsible. As our product cannot impact SDG #16 Peace, justice, and strong institutions, our device needs to be implemented in the presence of solid partnerships and with treatment programs in place.
References
- THE 17 GOALS | Sustainable Development. (n.d.). Sustainable Development. https://sdgs.un.org/goals
- Rosenthal, J., Largaespada, N., Bailey, L. B., Cannon, M., Alverson, C. J., Ortiz, D., Kauwell, G. P., Sniezek, J., Figueroa, R., Daly, R., & Allen, P. (2017). Folate Deficiency Is Prevalent in Women of Childbearing Age in Belize and Is Negatively Affected by Coexisting Vitamin B-12 Deficiency: Belize National Micronutrient Survey 2011. The Journal of nutrition, 147(6), 1183–1193. https://doi.org/10.3945/jn.116.242628
- WHO. WHO Guideline: Use of Multiple Micronutrient Powders for Point‐of‐Use Fortification of Foods Consumed by Infants and Young Children Aged 6–23 Months and Children Aged 2–12 Years. Geneva: WHO, 2016. [Licence: CC BY‐NC‐SA 3.0 IGO]
- Smith, E. R., Shankar, A. H., Wu, L. S. F., Aboud, S., Adu-Afarwuah, S., Ali, H., Agustina, R., Arifeen, S., Ashorn, P., Bhutta, Z. A., Christian, P., Devakumar, D., Dewey, K. G., Friis, H., Gomo, E., Gupta, P., Kæstel, P., Kolsteren, P., Lanou, H., . . . Sudfeld, C. R. (2017). Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality: a meta-analysis of individual patient data from 17 randomised trials in low-income and middle-income countries. The Lancet Global Health, 5(11), e1090–e1100. https://doi.org/10.1016/s2214-109x(17)30371-6
- Teel, J. (2021, Sept 29). From Prototype to Mass Manufacturing – Understanding Scaling Costs for Physical Products. Predictable Designs. https://predictabledesigns.com/from-prototype-to-mass-manufacturing-understanding-scaling-costs-for-physical-products/
- Ministry of Health Republic of Uganda (n.d.). National Malaria Control Program. https://www.health.go.ug/programs/national-malaria-control-program/