International multisite implementation of distributed cell-free protein biomanufacturing to advance health and research equity.

Limitations in global access to research and health care capacity undermine equity, sustainability, and resilience, particularly in resource-limited settings. Molecular diagnostics and biologic therapeutics are set to revolutionize medicine; however, our dependence on centralized biomanufacturing and cold chain logistics restricts access to these benefits. These constraints reflect a chronic and unmet global challenge. Here, with research teams in North and South America and Asia, we challenge the top-down paradigm by advancing community-driven solutions that empower underserved populations to participate in the bioeconomy, producing what they need, when, and where they need it. Our approach leverages low-burden biomanufacturing-built on cell-free protein synthesis and open-source hardware-to enable local, on-demand production of high-value bioproducts, including growth factors, vaccines, and diagnostic enzymes, demonstrating performance comparable to commercial gold standards. Implemented at 10 sites worldwide, this platform supported patient trials targeting globally relevant pathogens. Together, these efforts lay the foundation for a globally inclusive biomanufacturing ecosystem, where innovation goes beyond geographic boundaries.