Strategic outlook Engineered living therapeutics By Dubai Future Foundation Engineered living therapeutics represent a promising reimagining of medicine, not as a conventional treatment but as a living system inside the body. This approach could shift drug production from pharmaceutical facilities to biological processes within patients, potentially opening new frontiers in how and where healing occurs. For healthcare systems globally, this represents a potential solution to persistent distribution challenges. As living therapeutics enable localized, capsule-based or food- embedded treatments, traditional manufacturing and distribution models will be redefined, prompting a shift to decentralized production and the repurposing of existing pharmaceutical infrastructure for broader accessibility in areas previously deemed inaccessible. For patients, the transformation extends beyond convenience to fundamentally alter the experience of managing chronic conditions. The current paradigm could evolve towards treatment approaches that operate seamlessly in the background of daily life. The psychological burden of constant health management could diminish as treatments become more autonomous and adaptive, potentially improving not just clinical outcomes but overall quality of life. The pharmaceutical landscape could undergo significant transformation. Pharmaceutical corporations, biotechnology firms and research universities are likely to lead the development of living therapeutics, with new players such as dairy and probiotics manufacturers possibly entering the field. Mergers between non-traditional partners may emerge as this field evolves, with some researchers exploring the potential for carefully regulated probiotic-based platforms to support future consumer health applications. The integration with wearable technologies could create feedback loops between therapeutic organisms and external monitoring systems. Wearable technologies may further enhance this by enabling precise, real-time monitoring of bacterial therapy, ensuring both safety and efficacy. Scaling this technology will require advancements at the intersection of AI, biotechnology and health technology. AI is expected to support the safe and targeted design of bacterial functions, helping optimize their therapeutic performance and compatibility with the human body under tightly controlled clinical conditions. The convergence of biology and technology, both in bacterial production and real-time product monitoring, will be key to living therapeutics.Strategic preparation requires addressing several critical challenges. The ability to terminate microbial activity on demand will be needed to mitigate risks of uncontrolled replication or unintended genetic transfer. Researchers are exploring innovative safety mechanisms, such as externally activated, light-responsive bacterial systems,53 that may offer additional layers of control compared to traditional ingestion-based shutdown methods. Regulatory frameworks are a critical part of responsible development, with structured sandbox environments offering a way to test these innovations under defined conditions, while ensuring robust ethical oversight and public accountability. Decision-makers face a pivotal moment in healthcare’s evolution. Organizations that proactively invest in engineered living therapeutics will be positioned to: Transform chronic disease management from episodic treatment to continuous care Redesign pharmaceutical supply chains for enhanced accessibility and resilience Create localized production systems that reduce dependence on centralized manufacturing Develop new treatment modalities that respond dynamically to individual patient physiology Pioneer regulatory frameworks that balance innovation with appropriate safeguards Over the next decade, healthcare organizations, pharmaceutical companies and biotechnology firms that engage with the development of engineered living therapeutics may contribute to a meaningful evolution in how medicine is delivered and experienced. Progress would likely depend on collaboration across synthetic biology, AI, clinical medicine, patient advocacy and regulatory science to explore a future where treatments might adapt to patients rather than patients adapting to treatments. Related DFF megatrends: Future Humanity and Advanced Health and Nutrition54 Top 10 Emerging Technologies of 2025 20