{"entity":{"id":"idea-acc-open-hardware-linac","kind":"idea","name":"An open-hardware radiotherapy machine built for unreliable power and dust","aka":[],"tldr":"Design a radiotherapy machine from scratch for hospitals with patchy electricity, heat and few engineers, and publish the design so several companies can build it cheaply.","summary":"Commercial linear accelerators are built for well-staffed Western hospitals; in sub-Saharan Africa they sit idle for long stretches because of power failures, heat, and the cost of a service call. A consortium (the CERN/STFC/ICEC 'Project STELLA' work is a precedent) would specify a ruggedised, modular, remotely diagnosable machine with battery-buffered power, sealed electronics, swappable modules that a local technician can replace, and an open interface specification. The design and test data would be published so multiple manufacturers can bid; the buyer pays for uptime, not for the box.","asOf":"2026-09-08","links":[{"label":"IAEA DIRAC directory of radiotherapy centres","url":"https://dirac.iaea.org/"},{"label":"IAEA Rays of Hope","url":"https://www.iaea.org/services/rays-of-hope"}],"tags":[],"related":[],"cancers":[],"sections":["radiation"],"technologies":["imrt-igrt"],"targets":[],"drugs":[],"companies":["varian","elekta","united-imaging"],"institutions":["iarc"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-global-access","b-surgery-radiation-innovation"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"A purpose-designed machine will achieve more than 90% scheduled uptime in district hospitals in sub-Saharan Africa, against a historical figure well below that for conventional linacs in the same settings, at a total ten-year cost of ownership at least 40% lower.","rationale":"Every other capital good used in low-resource health systems (solar vaccine refrigerators, oxygen concentrators, GeneXpert) was eventually redesigned for the environment rather than shipped as-is. Radiotherapy has never had that redesign, despite the IAEA DIRAC database showing dozens of countries with one or zero working machines.","test":"Fund a two-year design phase with a published requirements document, then a three-site field trial (one machine each in three countries) measuring uptime, mean time to repair, dose accuracy audits by the IAEA, and patients treated per month against a matched conventional linac.","maturity":"speculative","actor":"engineering","cost":"large","horizonYears":7},"route":"/ideas/idea-acc-open-hardware-linac/","neighbours":{"section":[{"id":"radiation","kind":"section","name":"Radiation Therapy","route":"/fronts/radiation/"}],"technology":[{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"}],"company":[{"id":"elekta","kind":"company","name":"Elekta","route":"/companies/elekta/"},{"id":"united-imaging","kind":"company","name":"United Imaging","route":"/companies/united-imaging/"},{"id":"varian","kind":"company","name":"Varian (Siemens Healthineers)","route":"/companies/varian/"}],"institution":[{"id":"iarc","kind":"institution","name":"International Agency for Research on Cancer (IARC / WHO)","route":"/institutions/iarc/"}],"bottleneck":[{"id":"b-global-access","kind":"bottleneck","name":"Most of the world has almost no cancer care","route":"/bottlenecks/b-global-access/"},{"id":"b-surgery-radiation-innovation","kind":"bottleneck","name":"Surgery and radiotherapy cure most, get least","route":"/bottlenecks/b-surgery-radiation-innovation/"}]}}