Nine requirements 7 of 9
Hygiene and healthcare
Just ideal production. The interesting question here is making medicine, sanitation and care locally against an open design commons.
Compiled 4 September 2026.
Medicine, sanitation and hygiene, preventive and restorative, for the biological instrument. Mental, dental and reproductive care included rather than bolted on.
Of the four modes, this requirement is the one where the fourth carries almost all of the weight. That is not this page's reading imposed on the instruction. It is the instruction.
There is a real tension to name first. The matrix records four working mechanisms for this requirement, including an equipment lending pool and a shelf of toiletries that scores like groceries. Those are true and they stay on the matrix. The instruction is that they are not the interesting part, and this page follows the instruction rather than balancing it out for symmetry.
Jakob's position, in his own words
For hygiene and medical, it is just ideal production.
How this page reads that
Cosmolocal production only. No sharing story worth building, no consumer scoring story worth having. Care is not a shelf: you get the health system your polity funds, and no amount of shopping changes it.
What is left is the question the fourth mode asks. Where a device, a medicine or a sanitation system is unaffordable or simply unavailable, can a published design plus a local fabricator beat waiting for a supplier who is not coming. That question has real answers, some of them working, and it also has a wall in front of it that this page does not pretend away.
Jakob's own notes on this requirement
From the 9EPhR node. These sit alongside the position above rather than under it, and they are about personal provision.
- The basis is self-healing: the body's natural healing, plus emotional processing.
- Hygiene: purchase periodically.
- Medicine: also purchase, to have a supply.
- And location: where the nearest emergency room is.
Tana D_8xZ66o0nkl, read 4 September 2026.
Which of the four modes apply
Read from the matrix on the nine requirements page, not restated. The wording below is the wording in the grid.
Sharing somebody else made it
Equipment lending. Crutches, wheelchairs and care beds are needed for weeks and last for years, which is precisely the profile that rewards a lending pool over a purchase.
Ideal consumption somebody else made it
Toiletries and cosmetics are an ordinary shelf decision and score like groceries. Care itself does not: you get the health system your polity funds, and no amount of shopping changes it.
Reuse somebody else made it
Durable substitutes for single-use items on the household side, and refurbished and recertified equipment on the clinical side, where a device outlasts several of its owners.
Cosmolocal production you make it
The clearest case anywhere for the fourth mode: where a device is unaffordable or simply unavailable, a published design plus a local fabricator beats waiting for a supplier who is not coming.
Glia, 3D Printing Industry [B]e-NABLE [C]Open Insulin Project [C]
The open design commons, each checked
Every entry below was checked in this pass rather than recalled, and the ones that are winding down or unconfirmed are listed with that stated. A survey that showed only the healthy examples would be marketing.
- Glia live The strongest case in the set. Publishes 3D printable medical hardware, including a GPL-3.0 tourniquet and an open stethoscope, and manufactures under a real Health Canada medical device establishment licence. Repository commits through 2026.
- e-NABLE live A volunteer network printing prosthetic hands. Licences are Creative Commons and differ per design, so there is no single project licence to cite.
- Open Insulin Project in design Develops open protocols for insulin analogues. Active as research and not a supply mechanism today, and this page does not describe it as one.
- SOIL, EcoSan household toilets live The sanitation half, which is easy to forget is in this requirement at all. Urine-diverting toilets built from locally available materials, co-developed with Stanford researchers and documented in the Hesperian guides.
- Open Source Pharma Foundation activity unconfirmed A real nonprofit working on open drug discovery. Its own site still presents COVID-19-era work as current and no recent output was found, so current activity could not be confirmed either way.
- Four Thieves Vinegar Collective ended Described, not endorsed. Publishes DIY pharmaceutical hardware and synthesis tooling that sits outside medicines regulation in most jurisdictions and carries real chemistry and dosing risk. The collective states it is finishing this chapter after ten years and continuing mainly to archive.
What the search did not find
No European or Austrian open medical hardware project, and no commons-governed local pharmaceutical production, was found in this pass. Austria has a large conventional pharmaceutical manufacturing sector, which is a different thing entirely.
That is a failed search rather than a proven absence, and confidence in the negative is about 0.6. It is recorded because the pattern matters: the working examples in this field are Canadian, American and Haitian, and the nearest thing to a local instance is a supply chain rather than a commons.
The wall in front of the fourth mode here
Publishing a design is not the same as supplying a treatment, and in this requirement the gap between the two is regulatory rather than technical. Glia is the instructive case precisely because it did the unglamorous half: it holds a medical device establishment licence. That is what turns a printable file into something a clinician may use.
Any serious move by this project into this requirement would run into that first, and would need an answer to it before it needed a printer. Naming that is more useful than a list of designs.
Where this leaves it
Nothing exists in the portfolio for this requirement, and this page does not start anything. What it does is fix the shape of the question, so that the next pass argues about approval pathways and local fabrication rather than about whether care can be scored.
The nearest adjacent piece the portfolio already has is the distress-selling safeguard in the clothing handoff, which routes somebody in trouble toward livelihood resources rather than toward more listings. That is a care decision inside a resale tool, and it is not healthcare work.
Recorded as missing on the matrix No health work in the portfolio. The nearest adjacent piece is the distress-selling safeguard in the clothing handoff, which routes somebody in trouble to livelihood resources rather than to more listings.
Sources
Tier A is a legal, governmental or scientific primary source, B is journalism or trade press, C is a community, project or company describing itself. Confidence below 0.7 is flagged and carries a stated reason. Where a figure could not be established it is named as unestablished rather than replaced with a plausible one.
| Claim | Publisher | Date | Tier | Confidence |
|---|---|---|---|---|
| Glia publishes a 3D-printable tourniquet under GPL-3.0 and manufactures under a Health Canada Medical Device Establishment Licence | Glia, 3D Printing Industry | repository active June 2026 | [B] | 0.85 |
| e-NABLE volunteers print prosthetic hands under Creative Commons licences that differ per design; there is no single project licence | e-NABLE | accessed 4 September 2026 | [C] | 0.75 |
| The Open Insulin Project develops open protocols for insulin analogues and has not reached approval or patient-scale production | Open Insulin Project | accessed 4 September 2026 | [C] | 0.7 Active as research. It is not a supply mechanism today and should not be described as one. |
| SOIL in Haiti runs urine-diverting EcoSan household toilets built from locally available materials, co-developed with Stanford researchers and documented in the Hesperian health guides | SOIL, Sustainable Organic Integrated Livelihoods | accessed 4 September 2026 | [C] | 0.75 A concrete project rather than a design commons. No umbrella open sanitation commons comparable to Open Source Ecology was found. |
| The Open Source Pharma Foundation exists as a nonprofit working on open drug discovery, founded 2018 with Tata Trusts funding | Open Source Pharma Foundation | accessed 4 September 2026 | [C] | Weakly supported: 0.55 The organisation is real. Its own site still presents COVID-19-era activity as current, and no 2025 or 2026 output was found, so present programmatic activity could not be confirmed in either direction. |
| The Four Thieves Vinegar Collective publishes DIY pharmaceutical hardware and software, including the Apothecary MicroLab reactor and the Chemhacktica synthesis planner, and states it is winding down after ten years | Four Thieves Vinegar Collective | accessed 4 September 2026 | [C] | 0.8 Described, not endorsed. This work sits outside medicines regulation in most jurisdictions and carries real chemistry and dosing risk. It is listed because a survey of open medical design that omitted it would be incomplete, not because it is a route this project recommends to anybody. |