Semi-Autonomous Medicine and Surgical Intervention Innovations for Space and the Dual-Use for Low-Resource Health Systems

Long-duration human spaceflight exposes very healthy astronauts to complex risks including neuroocular changes, musculoskeletal and cardiovascular deconditioning, radiation injury, immunologic disturbances, and surgical emergencies. An integrated, autonomy-focused medical architecture for missions of 30 days to over 2 years is needed, emphasizing in-situ diagnosis, therapy, and monitoring under severe resource constraints. The clinical framework maps conditions to mission phase and outlines space-adapted diagnostic strategies centered on AI-guided point-of-care ultrasound, wearable biosensors, and microfluidic lab-on-chip assays. Preventative countermeasures are specified including structured exercise, lower-body negative pressure, bone-protective pharmacotherapy, radiation shielding, and AI-assisted psychological support. Evaluating the clinical need for monitoring, diagnosing, and even for some possible invasive therapeutical interventions led to the definition of a compact modular system combining miniaturized surgical robotics, on-demand 3D printing, and AR/AI guidance to even enable minimally invasive procedures by a non-expert crew. The ressources that are required to build such a system for a very limited application and benefitting just very few people are very high. They might provide an ideal base with dual-use potential for low- and middle-income countries however, where similar design drivers—ease of use, automation and autonomous operation, small footprint, and local service, repair and parts fabrication—address the current critical gaps in under-resourced health systems. Of course low cost of manufacturing and operation is likely the most important feature for that application. Co-designed "space–global health" technologies could simultaneously enable safer deep-space exploration, for which development ressources are available, and expand access to high-quality diagnostics and interventions on Earth providing very high impact to the population, which unfortunately does not attract sufficient development funds despite a huge need.