This report presents the outcomes of a foresight project led by the Emerging Technologies, Research Prioritisation and Support unit and the Blood and Other Products of Human Origin team at the World Health Organization (WHO) on 3D bioprinting and global health. The project was conducted between August and November 2023.

3D bioprinting could be used to meet crucial public health challenges, such as the demand for repair or replacement of human organs and tissues. The foreseen applications of the technology include research, training and various medical uses. Outstanding issues include quality, safety, efficacy, equity of access and ethics, and appropriate regulations and governance should be considered to address those issues efficiently.

The project was conducted with a participatory approach, including horizon scanning and developing scenarios in a series of virtual workshops with a small group of experts. The scenarios were then used to identify actions, which were discussed in a final workshop with a larger group of experts. The approach was an adaptation of work on classical scenarios in the global business network.

Scenario logics were developed from identified drivers of change in 3D bioprinting and global health, with a time horizon of 2033. The logics are based on two variables with drastically contrasting end-points: mode of prioritization (with the end-points “evidence-based focused on public health” and “fragmented interest-driven foci”) and “extent of cooperation” (with “collaborative” and “antagonistic” end-points). These logics resulted in the following scenarios:

- survival in silos”: antagonistic and evidence-based focus on public health;

- a new era for humankind”: collaborative and evidence-based focus on public health;

- sailing in troubled waters”: antagonistic and fragmented interest-driven foci; and

- follow the rainbow”: collaborative and fragmented interest-driven foci.

These scenarios are not proposed as normative or probable but rather as a group of strongly contrasting general future situations for exploring the topic. They were used to structure discussions on this advanced technology and how it could be used to improve global health.

Various aspects of 3D bioprinting and global health were explored, with the opportunities and risks in each scenario and the adaptations, optimization or inventions they would require. The similarities and differences of scenarios were used to develop ideas for action. Discussions on six main topics for near-term actions are summarized according to how people of today could help the people of 2033 to better apply 3D bioprinting for global health:

1. Support harmonized, appropriate regulation of 3D bioprinting.
2. Establish data standards and practices on use of 3D bioprinting in medical applications.
3. Train future clinicians and medical technologists in all regions.
4. Establish a technology and IP platform for innovators and manufacturers.
5. Communicate effectively with the public about 3D bioprinting.
6. Raise global awareness of the availability of 3D bioprinting, and pool resources.

The ideas developed in the project were designed to stimulate conversations and to serve as seeds for new initiatives to guide development of this advanced health and medicine technology.