Is space really the next frontier for medical manufacturing?

Astronauts aboard the ISS are already using innovative technology to bioprint medical devices in space. Credit: tynyuk / Shutterstock

The International Space Station (ISS) has many items you would expect to find on a low-orbiting hunk of metal such as spacesuits, airlocks, and freeze-dried food. But a printer making biological tissues certainly raises eyebrows.

In February, NASA flight engineer Nick Hague spent his shift cleaning and maintaining the BioFabrication Facility (BFF), a system designed to manufacture human organs in space, located in a laboratory module on the ISS.

Printing the small and complex structures inside organs such as capillaries are hard to do on Earth due to gravity. US company Techshot developed the BFF to see whether printing organ-like tissues in microgravity is possible. Working with NASA astronauts on the space station, Techshot was successful in becoming the first US company to 3D-print organic products in space.

As the advantages of microgravity in making products become clearer, other companies are sending devices to the ISS in a bid to evaluate technology away from Earth’s downward force.

Medical Device Network investigates the reality of in-space manufacturing, and what challenges will first need to be overcome.

The idea of manufacturing away from Earth’s gravity is not a new concept. The approach has its roots during the space race of the Cold War, with Russian cosmonauts welding different types of metal in space aboard a Soyuz spacecraft. Technology has come far from the 1960s and a main application of current innovations is for healthcare products, which range from implantable devices to cell and gene therapies.

Microgravity is the main advantage of space manufacturing. The absence of a downward pull affects materials across a plethora of scientific parameters. Microgravity removes sedimentation and buoyancy, whilst promoting diffusion and surface tension. This results in more precise, uniform, and complex structures that would not be possible if made on Earth.

“On Earth, usually we have to add supports when fully 3D-printing a device or add some kind of scaffolding around the parts so it cannot collapse on itself,” says Dr Gilles Bailet from the University of Glasgow’s James Watt School of Engineering.

For healthcare applications, this explains why bioprinting tissue and organs on the ISS is a promising avenue. On Earth, such intricate structures would usually collapse. But in the gravity-absent corridors of the ISS, the matrix remains stable. With transplantable human organs in such shortage currently, the ability to print alternatives would ease lengthy waitlists.

NASA has been keen on exploring the limits of the technique, creating a programme to provide funding and expertise to promising innovations in the US that could advance manufacturing in space. Aptly named InSpaceProductionApplications (InSPA), the space agency has invested more than $60m to bring technologies to the ISS for testing.

Virtual Incision, for example, sent its surgical mini robot to the station to understand how zero gravity impacts surgery. US-company Auxilium meanwhile won a research grant from NASA in 2022 to send its bioprinter to the ISS. Last month, its system – called the Auxilium Microfabrication Platform (AMP-1) – successfully built eight implantable medical devices on the space station in just two hours.

Auxilium’s CEO Dr Jacob Koffler says: “The idea is to manufacture products in space and bring them back to Earth to benefit, in our case, patients. What we did in the first mission was to rebuild the printer so it can work in space, and we’ve shown that, yes, it works.”

With the underlying science that allows manufacturing of products in space on lockdown, the opportunities are becoming ever-more tangible.

“The ability to manufacture advanced biological products in sustained microgravity conditions enables new opportunities to benefit human health and create a sustainable human environment both on Earth and as humanity explores deep space,” says Richard Vellacott, CEO of BiologIC Technologies, a UK company that is developing biocomputer technology for space bioscience infrastructure.

Exact data on the share of medtech manufacturing capabilities by country is difficult to extract, though it is clear the US dominates the industry in terms of revenue and scale. According to LEK Consulting, China is the second largest medtech market in the world and is undergoing turbulent relations with the US following President Trump’s tariffs.

According to Vellacott, the promise of bioprocessing in space is about creating a democratised landscape.

“We are building biomanufacturing capability that can be used anywhere by anybody – whether on Earth, by the bedside, in the developing world, by any startup biotech company, or in low-Earth orbit, on the Moon, on Mars, or in deep space.”

However, Vellacott does add space biomanufacturing will likely generate valuable intellectual property (IP). This would provide a basis for terrestrial biomanufacturing, potentially shifting market dynamics depending on the applications of technologies. Over time, certain applications such as complex organs could be more permanently paired with space manufacturing.

Longer term, he anticipates that space biomanufacturing will support human exploration as further space environments are built.

Commenting on what the bigger opportunity of space manufacturing is between patients here on Earth or supporting space travel, Dr Bailet says: “It’s pretty clear that it’s going to be for Earth market because the market is so big, the opportunity is clearly there.”

Perhaps the first and most near-time challenge is the lifespan of the ISS. The space station is currently the main platform in which companies can test upcoming technologies. NASA has said that the ISS will be decommissioned at the end of 2030, meaning companies are already having to work on product adaptability to new space modules.  

“We designed our printer with forward thinking about what’s going to happen in the next few years, because the ISS is not going to be there forever. The printer was designed to be integrated with other platforms,” says Koffler.

The bigger challenge, according to Koffler, is transportation of manufactured products. Currently, there are no commercially available cargo shuttles to and from space. SpaceX is the current leader in developing ‘free flyers’ – spacecraft that rely on robots and software for operation. For space manufacturing to become a reality, a high cadence of launches that go to space and frequently bring back products is needed.

“I’m thinking in the context of a supply chain, and when you’re thinking about supply chains in space, it can be called space supply chains,” Koffler remarks.

Away from the commercial side, there are also still advancements in science that need to be made. Though these are more in the astrophysics department rather than on the biology side.

“I’m worried about what the impact of re-entry will be on the design of manufactured products. You are going to space to get away from some of the design constraints of Earth’s gravity, but then that force is being exerted on products when they’re brought back down [to Earth],” Dr Bailet says.

Overall, the unique challenges that biospace manufacturing presents means that advancing the landscape is “highly capital intensive and the revenues are long term”, according to Vellacott.

“Combined with the highly regulated environment, this results in a high-risk, high-reward business model,” he adds.

Still, both BiologIC Technologies and Auxilium’s CEOs are confident that, if challenges are recognised and addressed, space will become an established location in which medical products are made in the future.

And amid critics from society who question funding being directed to space ventures, Dr Bailet says that while the sector could do more to engage with people, he is adamant that “there is a beautiful impact of space technology”.

Australia could be one of the main beneficiaries of this dramatic increase in demand, where private companies and local governments alike are eager to expand the country’s nascent rare earths production. In 2021, Australia produced the fourth-most rare earths in the world. It’s total annual production of 19,958 tonnes remains significantly less than the mammoth 152,407 tonnes produced by China, but a dramatic improvement over the 1,995 tonnes produced domestically in 2011.

The dominance of China in the rare earths space has also encouraged other countries, notably the US, to look further afield for rare earth deposits to diversify their supply of the increasingly vital minerals. With the US eager to ringfence rare earth production within its allies as part of the Inflation Reduction Act, including potentially allowing the Department of Defense to invest in Australian rare earths, there could be an unexpected windfall for Australian rare earths producers.