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Mono audio output with pulseaudio and alsa on embedded system

I am running an embedded system using pulseaudio and alsa.
I need to downmix all audio inputs to a single mono output.
I have seen other answers that involve modifying /etc/pulse/default.pa like the example below.
https://askubuntu.com/questions/17791/can-i-downmix-stereo-audio-to-mono

I have tried this, but it doesn’t seem to work while in system mode.
When I try to run the pulseaudio service as the pulse user it seems to be reading the file /etc/pulse/default.pa but I get an error: failed to open module "module-remap-sink".

I am OK using either ALSA or pulseaudio to achieve mono output. How can I achieve this?