Choice of Targets

Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

Target 3.D: Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.

SDG Summary

We aim to promote early screening for Alzheimer’s, focusing on mental and neurological health in aging populations.

How Our Project Applies / Problem Identifications

AD is often diagnosed at a late stage, when effective intervention is limited. Our project aims to develop an early screening and detection method that enables vulnerable populations to access safe and affordable testing and take early action. This supports SDG Target 3.8, which aims to achieve universal health coverage, and Target 3.D, which strengthens early warning and risk reduction for health risks.

Feedback from relevant SDG stakeholders

Our discussions with Professor Liu and other stakeholders provided important insights into how our Alzheimer's diagnostic programme aligns with SDG 3 (good health and well-being).Experts like Dr Li, the psychiatrist, said it is very important to develop easy-to-use tools to spot problems early on. These tools should be part of the main healthcare system, especially in rural areas where people don't have access to healthcare. They said that our low-cost and easy-to-use detection tools could help a lot with achieving Goal 3.8 (universal health coverage) by reducing the difference in how often older people in cities and villages are diagnosed. But they also said that more testing is needed to make sure it works well before it can be used more widely.

Long term and short term benefits

Our project aims to create real benefits now and in the future, which will help us achieve the goals of Sustainable Development Goal 3 (SDG 3). In the short term, we plan to rapidly improve access for elderly populations in underdeveloped communities by providing a low-cost (50-60% cheaper than current methods) bedside screening solution. This will help to make healthcare more affordable in rural areas, collect important data about diseases, and create new healthcare roles in communities. This will happen within 2-3 years of the start of the project.

In the long term, our initiative will make a huge difference to global health. By enabling early detection, we can make sure that people get the right treatment quickly. This will stop the disease from getting worse, reduce the future healthcare burden, and improve the quality of life for patients and their families. This helps to achieve Target 3.8, which aims to include affordable neurological care as part of universal health coverage. By setting up a sustainable way of monitoring people's thinking and collecting important information about early signs of problems with their brains, our project will improve the early warning systems for health risks to the brain. This will help to achieve Target 3.D and make health systems stronger so that they can last for many years.

Potential Harms

As we talked through our grand visions, we also had to acknowledge the thorny ethical and social issues inherent in our project. A good, responsible project must take responsibility for the potential negative impacts, and here are some that we've considered:

• The Psychological Burden of Early Knowledge: In the absence of a known cure, an early diagnosis is the gift of crushing anxiety and depression to the person and their family, likely robbing them of quality of life long before they would have ever felt symptoms. We must take human toll of this knowledge into account.
• The Strain on Healthcare Systems: The success of our screening tool, if implemented widely, would come with an exponential influx of newly diagnosed early-stage patients. This would put massive pressure on the limited pool of specialists and support systems, especially in the rural and underserved populations we hope to reach, creating a new bottleneck to care.
• The Risk of Misinterpretation and Stigma: There is a real danger that our easily accessible screening tool will be misinterpreted as a diagnostic tool. A false positive would create undue panic, and a false negative would give a false sense of security. Worse, a positive result, if mishandled, could give rise to new forms of social or financial discrimination.

Acknowledging these risks is not a weakness; it is a core part of our commitment to responsible innovation. It clarifies that our final solution must include not only a test kit but also robust educational materials and clear ethical guidelines for its use.

Figure 3

SDG Summary

We aim to educate different age groups about Alzheimer’s disease by providing better education in this area. By doing so, Alzheimer's disease will become more widely accepted, and people will be more willing to pay for early screening, thereby taking better care of their health.

How Our Project Applies / Problem Identifications

Our educational programe deals directly with the main problems that stop progress in the fight against Alzheimer's disease. These problems are wrong information, stigma and unequal access to medical resources. Many people think that Alzheimer's disease is just a normal part of getting older, but it is actually a disease that the brain can fight.

This misunderstanding causes serious social stigma, which stops people and families from getting help quickly. This problem is made worse by the lack of educational resources that are suitable for different age groups. Young people are not aware of ways to prevent the disease. Middle-aged people often do not notice the early symptoms in older relatives. And older people often worry about the diagnostic process itself. All of these things together mean that people are not prepared to deal with problems with thinking skills. There is a gap between scientific progress and public awareness. This creates an 'acceptance barrier'. This means that even if there are effective and affordable screening tools, low health literacy and cultural stigma can limit how often they are used. Also, traditional ways of reaching people often don't work well for vulnerable groups, like people who live in the countryside or don't have much access to computers. This makes it worse that some people don't know about the problems.

Feedback from relevant SDG stakeholders

During our conversation with Professor Liu, we realized that if we want our product to be accepted by the general public, it is important for people to understand and have a correct understanding of Alzheimer's disease. Therefore, we have planned science popularization activities targeting different age groups and have already begun to implement them. At the same time, we also realize that both offline and online activities can only reach a portion of the public. Therefore, we need to make certain adjustments to our plan.

Long term and short term benefits

Short-term Benefits:

In the short term, our education programe (we’ve implemented all kinds of educational campaigns regarding Alzheimer’s disease, targeting young childern, middel-age people and elderly citizens, for details please visit our Education page) will raise public awareness of Alzheimer's disease and reduce the associated stigma across generations. Through targeted outreach campaigns, we can swiftly dispel common misconceptions, encourage open and empathetic dialogue within families and communities, and empower individuals with knowledge. This will foster a more supportive environment for those affected by the disease and lay the groundwork for the acceptance of early screening technologies.

Long-term Benefits:

• The lasting social impact of our project is to foster a more informed, inclusive and proactive society. By raising public awareness of Alzheimer's disease, we are committed to creating a future where the disease can be promptly detected and appropriately managed without fear or discrimination. This ongoing awareness campaign will encourage lifelong brain health practices among people of all ages, reduce social isolation among patients and carers, and help communities to maintain resilience and provide support in the face of challenges posed by neurodegenerative diseases. Ultimately, this shift in public attitude and knowledge will ensure that medical technological advancements are met with readiness and trust, thereby maximizing their social impact and enhancing the overall quality of life for the elderly population.

Potential Harms

Although our educational initiatives are well-intentioned, there are potential risks that must be managed proactively to avoid negative consequences. Alzheimer's disease is a complex and emotionally charged issue, so if information is communicated improperly, it may inadvertently exacerbate public anxiety or reinforce existing stigma. This is particularly likely to happen when information is oversimplified or exaggerated.

Figure 4

Choice of Targets

Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status

Target 10.A: Implement the principle of special and differential treatment for developing countries, in particular least developed countries, in accordance with World Trade Organization agreements Indicators

SDG Summary:

The United Nations Sustainable Development Goal (SDG 10) aims to reduce inequality within and between countries, with a focus on promoting social, economic, and political inclusion. As the world’s wealth is held by a very small group of people, financial and social discrimination often occurs. Thus, for nations to flourish, creating fair opportunities and prosperity for all, especially for vulnerable groups is crucial. When every individual is self sufficient, the entire world prospers.

We are designing our test to be affordable and usable in underdeveloped areas, including rural and aging communities that often lack access to current early diagnoses.

How Our Project Applies / Problem Identifications

Problem #1: Opportunities to obtain diagnoses

A large part of ensuring that everyone has access to appropriate medical treatment is to provide sufficient opportunities for everyone around the world to obtain such treatment. The elderly in low-resource communities often lack access to current diagnostic tools, such as CT scans and cerebrospinal fluid analysis, which contributes to the unequal diagnosis of AD.

Solution to Problem #1:

Our project addresses this gap by developing a fast, accessible screening technology and reducing stigma through educational outreach. This supports SDG Target 10.3, which seeks to ensure equal opportunities and reduce discrimination.

Problem #2: The inequality caused by income

Although different methods for detecting Alzheimer's disease have different pricing, most detecting methods are expensive. For example, PET screening costs $3000-$8000 (¥7000-¥10000) in China, Cerebrospinal Fluid Sampling costs around 800 to 1500 RMB in China depending on quality, and fluid based a-amyloid & ß-amyloid protein detection costs ¥200-¥400 each time. These high cost detection methods creates inequality caused by income as lower class and lower-middle class often can’t afford these expensive detection.

Solution to Problem #2:

Comparing from other methods to detect Alzheimer’s disease, our product’s pricing is definitely lower than them, meaning that our product is more affordable for people in lower class and lower-middle class. This supports SDG Target 10.2, which aims to empower and promote the social, economic and political inclusion of all.

Feedback from relevant SDG stakeholders

We spoke with Professor Liu and provided important insights into how our Alzheimer's diagnostic program aligns with the mission of SDG 10 to reduce inequalities. He state that our screening technology is both cost-effective and readily accessible, particularly in rural areas with scarce medical resources and low-income urban communities. For more thoroughly and refined SDG 10, professor Liu suggested 10.2 (empowerment and inclusion of all) and 10.A (special and differential treatment for developing countries) as a more specific target and goal for our program. As we consulted affirmed that our solution's projected can be planned for 50-60% cost reduction compared to current methods could significantly bridge income-based diagnostic disparities. However, after Prof.Liu’s reminder, we realized that publicity is very important to our project, and if it is not done properly, it may lead to further inequalities; therefore, we need to be more specific in how we publicize our products.

Long term and short term benefits

Economic Perspective

• Short-term: Compared to existing methods, costs are immediately reduced and set to a range that is affordable for a wider range of public, which will make it easier for low-income groups and underdeveloped communities to access screening programs, allowing them to allocate their resources to detecting Alzheimer's disease.
• Long-term: By creating a sustainable and affordable way to diagnose the disease, our project can help reduce the huge future financial pressure that Alzheimer's care puts on families and healthcare systems. If we can spot it early, we can slow the progress of the disease. This will mean much lower medical costs and better use of care resources in the long term. The project will also create a new market for low-cost diagnostics. This will help local economies and create jobs in areas such as manufacturing, distribution and community healthcare.

Social Perspectivc

• Long-term: The project aims to make a real difference to health outcomes for people in different communities. We want to build a more inclusive society where people with a mental illness are not isolated, but supported. To do this, we must promote early screening and reduce the stigma around mental illness through targeted education. This helps to make communities stronger and more resilient. It also creates a model for how to fairly share future healthcare innovations. This makes sure that progress benefits everyone, no matter what their economic status or geographical location (which supports Target 10.A).

Potential Harms

Economic Perspective

• Market Distortion: The introduction of ultra-low-cost diagnostic technologies may disrupt existing markets, potentially exposing professionals and clinics that specialize in traditional, more expensive diagnostic technologies (such as PET scans) to financial risks, leading to job losses or reduced services in certain areas.

Socieial Perspective

• The ‘diagnostic paradox’ and the exacerbation of inequality: As Professor Liu said, if we don't handle publicity properly, most of the information will reach people who are already well-educated, have a lot of money, and live in cities, and who already know a lot about their health. This will make it easier for people to spot problems early on. But it will also leave behind people who are less well off and who should be helped the most. This will make the health gap between these groups and others get bigger, even though we should be making it smaller.
• Stigmatization of Untreated Populations: If we can't make sure that people in poor areas have access to support and treatment, it might create a new group of people who are aware of their condition but can't do anything about it. This would lead to more anxiety and social isolation.

Figure 5

Target 9.5: Enhance scientific research, upgrade the technological capabilities of industrial sectors in all countries, in particular developing countries, including, by 2030, encouraging innovation and substantially increasing the number of research and development workers per 1 million people and public and private research and development spending indicators.

SDG Summary

By applying synthetic biology, we are developing a safer, more accessible diagnostic method that future researchers can continue to improve.

How Our Project Applies / Problem Identifications

Our project drives innovation in biotechnology by advancing early diagnostic methods for AD using novel biomarker detection. This contributes to SDG Target 9.5, which promotes scientific research and the upgrading of technological capabilities in health sectors.

Feedback from relevant SDG stakeholders

We spoke to Professor Liu and other experts, and we learned that the project matches the focus on industry, innovation, and infrastructure in Sustainable Development Goal 9 (SDG 9). Professor Liu said that it is very important to develop cheap ways to do tests that can be used in places with few medical supplies, like the countryside and old people's homes. He said that our use of synthetic biology methods for detecting Alzheimer's disease is a significant innovation (SDG target 9.5), but also stressed the need for careful assessment of the economic and environmental impacts when increasing production.

Long term and short term benefits

Economic Perspective

From an economic perspective, our project establishes a foundation for a sustainable and scalable biotechnology sub-sector. By demonstrating the cost-effectiveness and feasibility of synthetic biology in medical diagnostics, we can encourage the public and private sectors to invest in this innovative field. This aligns with the goal of increasing research and development expenditure, as outlined in Target 9.5. Bringing this product successfully to market could enable a region or country to become a leader in affordable medical biotechnology, enhancing export competitiveness and strengthening technological autonomy. Most importantly, by enabling widespread early detection, this project will generate significant long-term macroeconomic savings for the national healthcare system. Delaying disease progression through early intervention reduces future demand for expensive long-term care, boosting productivity and maintaining the economic potential of an ageing population.

Potential Harms

As we drive innovation to achieve Target 9.5, it's important to also responsibly acknowledge the potential negative externalities of technological innovation:

• Creative destruction and job loss: Our disruptive low-cost technology may displace older diagnostic methods, putting the jobs of highly-skilled workers at risk and causing financial loss for companies that have invested heavily in the prevailing technology and its infrastructure, with broader negative economic impacts.
• Unequal capture of innovation's benefits: If the technology proves to be a successful patented monopoly, the economic gains of our R&D spending and hard-won innovation will accrue to a small group of shareholders, with the potential for high pricing that excludes many, rather than inclusive sustainable industrialization.
• R&D misallocation: An ultra-high performing technological solution, in particular when achieving a disruptive cost-performance profile, risks capturing an outsized amount of public and private R&D spending, potentially taking too many valuable R&D resources and brainpower away from other important, non-technological, areas of AD care, like better support systems for caregivers, or public health infrastructure.

Figure 6

SDG Summary

Our solution emphasizes sustainability and the reduction of biological waste throughout the screening process.

How Our Project Applies / Problem Identifications

We aim to make our device low-cost and compatible with sustainable laboratory practices. This supports SDG 12, which promotes more sustainable patterns of consumption and production in developing countries.

Feedback from relevant SDG stakeholders

Consultation with Professor Liu provided us with critical guidance on achieving sustainability through diagnostic equipment As an expert in environmental economics, he said that our electronic manuals and recyclable reagent kits are a good idea for Sustainable Development Goal (SDG) 12, but also said that if we don't manage it properly, bedside testing could create a lot of plastic waste. Professor Liu recommended looking at how well all materials worked and exploring biodegradable alternatives for test components without making them too expensive. He said that we have already seen that 'lower costs and new technologies can sometimes lead to wasting resources'.

Long term and short term benefits

Environmental Perspective

The long-term environmental benefits of our project lie in demonstrating and promoting the concept of a circular economy within the medical diagnostics industry. Our aim is to create a closed-loop system that significantly reduces the cumulative ecological footprint of point-of-care testing by pioneering the use of biodegradable materials to manufacture testing components and establishing effective recycling and reuse programmes. This shift from the traditional 'extract-manufacture-dispose' model to a circular economy model will prevent thousands of tonnes of biomedical waste from being generated in future. Furthermore, by showcasing the technical and financial viability of sustainable practices, we are setting a robust precedent that can inspire major manufacturers to adopt comparable eco-design principles, thereby accelerating a wider transition across the healthcare industry towards more sustainable consumption and production models.

Potential Harms

Achieving this SDG is a laudable goal, but it’s important to be mindful of the potential environmental consequences of a successful disposable test:

• Increased waste volume: If our low-cost, single-use kit becomes ubiquitous, this will create a massive new stream of plastic and biomedical waste, with a risk of overloading the waste management systems of the very communities we hope to serve.
• The “rebound effect”: Cheap and easy access to testing may result in over-consumption. The environmental savings on a per-test basis could be dwarfed by the vastly increased total number of tests consumed, with a net increase in resource consumption.
• Potential drawbacks of “green” materials: The use of biodegradable or recycled materials is not a silver bullet that can be easily retrofitted to the product. This approach can increase the cost and has its own hidden environmental footprint (e.g., energy for recycling, land use for bioplastics), which may merely shift the environmental burden downstream.

Our foray into this three dimensions has provided us with a humbling lesson, a stark realization that feels almost ironic given that it mirrors the essential mantra of the 2030 Agenda itself: Nothing exists in silos. We were exposed to a novel truth: we simply cannot rectify a social, economic, or environmental issue in isolation from the others.

The development of our aptamer-CRISPR-microfluidic diagnostic platform for early stage of AD is by all accounts an ambitious testament to scientific innovation, but the rippling reality of the 2030 Agenda has allowed us to recognize that each of these three dimensions are closely and intimately intertwined.

At every step of our process, we were forced to ask:

How does our social intention of closing the gap in healthcare access (SDG 10) through the development of a cheap, accessible test go hand-in-hand with our economic intention of promoting innovation in the biotechnology industry (SDG 9)? More pointedly, our use of aptamers over costly antibodies or the plan to develop an in-house method for purifying Cas12a directly echoes an economic intention to be competitive and profitable. But it could not be achieved without the social motivation of making our test as cheap as possible.

How does our economic intention of developing an industry-disruptive CRISPR-based diagnostic platform (SDG 9) benefit society and individual patients in terms of more accurate, earlier diagnosis (SDG 3)? Conversely, could the disruptive nature of our economic intention not also lead to a displacement in jobs at companies working on older diagnostic modalities, leading to a social and economic issue all on its own?

How does our environmental intention of using recyclable materials and working towards the development of a recyclable microfluidic chip (SDG 12) reinforce our social intention of being an ethical, responsible project? But at what point does the use of sustainable or specialized materials, in turn, make our project more costly to produce, coming at odds with our economic intention of keeping the test as cheap as possible so that it reaches and benefits the low-income communities it was designed to serve?

Our Final Synthesis

The exercise of tracking these interconnections and their various unintended consequences and feedback loops has been by far one of the most challenging, but also one of the most rewarding, components of our Human Practices experience. We came away with the lesson that building a truly sustainable and responsible project is not an exercise in finding perfect solutions to all the problems we encounter, but rather one in making complex trade-offs and difficult decisions, all the while armed with transparency, responsibility, and a will to continuously improve.

Our project is more than just an aptamer-CRISPR-microfluidic system for diagnosing AD. It is an intervention in a web of complex human, economic, and environmental relationships. This exercise of holistic, three-dimensional analysis is our pledge to not take that for granted; to try to take it all into account. It is our promise to move forward not just as scientists and engineers, but as global citizens aware of the global impact our work will ultimately have on the world around us.

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https://globalgoals.org/goals/3-good-health-and-well-being/

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United Nations. (n.d.). SDG 10 Reduced Inequalities. The Global Goals.

https://globalgoals.org/goals/10-reduced-inequalities/

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https://globalgoals.org/goals/12-responsible-consumption-and-production/

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