Testing for disease with paper the size of a postage stamp

Diagnostics For All device

By Christina Hernandez
Aug 19, 2010

It’s postage stamp-sized technology with global implications for healthcare. With a mission to provide diagnostics for the developing world that are cheap, portable and easy to use, the nonprofit Diagnostics For All has developed a testing technology made from paper.

Founded in 2007 on the work of George Whitesides, a chemistry professor at Harvard University, the Massachusetts-based Diagnostics For All is preparing to begin field testing its device next year. I spoke last week with CEO Una Ryan about the implications of this technology in the developing world — and in the United States.

Your diagnostic tool is made from patterned paper. How does that work?

Instead of trying to re-engineer some of the big, expensive devices we have in the U.S., [we thought] about the problem and what would be the cheapest, most convenient way to address it. The cheapest and most ubiquitous substance that’s available worldwide is paper. We have printed micro-fluidic channels onto the paper. If you take a biological fluid, like blood or urine or tears, it will move down that pathway and interact with chemicals we put in those reservoirs. You get a color reaction that you can easily read by eye. For a more permanent record, you can take a cell phone picture of it. Since everything we do is telemedicine compatible, it gives us the opportunity to make some amazing databases tracking worldwide health trends.

Which medical conditions can the technology detect?

Ultimately we want it to be for everything, so patients can monitor their health and populations can be monitored. You can’t begin to manage healthcare until you know what you’re dealing with. That’s why we started with diagnosis. [But] you need to be able to monitor the course of the disease. If somebody is lucky enough to have medication for that disease, sometimes they cause side effects.

One of the [tests] we started with was liver function. Patients who have HIV or [tuberculosis] and get drugs are at risk of getting liver damage from those drugs. In the U.S., for example, the incidence of liver damage is 2 percent. In the developing world, it’s 25 percent. That’s because people aren’t checked. We wanted tests [with] a very easy, inexpensive action. We wanted tests where it’s just a finger prick or a urine specimen, you get the answer immediately, you could be given the drug and counseling and you’re on your way.

There are many ways our tests can be used. Since they’re paper and the size of a postage stamp, they’re very portable. We could mail them. A healthcare worker in a rural area can carry them in a satchel. Our tests [don't] require electricity. They don’t require water. They don’t require a doctor. It’s game changing.

What’s the status of the liver function test? When will it be put into use?

We have about 10 we’ve tested. Liver function is the most advanced, largely because we have funding from the [Bill and Melinda] Gates Foundation. Now, we’re testing our test with discarded blood from one of the Boston hospitals. We’re finding a nice correlation between our results and [the hospital's]. When we’ve completed that lab-level testing, we want to be in the field. We hope to start field testing at the beginning of 2011. We will probably be testing in Africa.

What are the other conditions you could expand testing to?

Diabetes, cholesterol. We could also [test for] heavy metals in water. We can test for iron imbalances in sweat. We haven’t yet developed them into a product, [but some have been tested at the lab level].

We talked about these tests in the context of the developing world. Do you also see uses for this technology in the U.S.?

Absolutely. We’re already getting an enormous amount of corporate interest from companies here. Medicine is moving more toward the patient. We all want to be empowered to manage our own health. But patients need to be compliant with their drugs. If you have a way of testing yourself, you can very quickly see if you’re not eating well, not taking your medicines. It gives you a sense of control.

Since we take just a small prick of blood, this will be very useful for pediatrics. We think it will be useful on ambulances. We think it will be directly applicable to consumers, [such as] runners in the Boston Marathon who want to check their sweat. We think about this for the military. The uses for the developed world are huge. We can teach the U.S. a thing or two about the cost of healthcare.

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