India’s fight against Covid-19 requires a domestic industrial response that is akin to wartime production. At this hour, India’s lazy procurement culture of depending on imports will simply not cut it, given that the international availability of pandemic-fighting kits — whether it be test kits or ventilators or even personal protective equipment (PPE) — is already riven with shortages. Rather, indigenous production of such equipment has the potential to serve the world at this time of need and help beyond fighting just the pandemic by allowing key industries to keep humming.
As we shall see, there are examples aplenty that give us confidence that Indian industry can indeed rise to the challenge. However, any industrial response will operate within the ambit of India’s larger institutional response, which needs to be repurposed for rapid provisioning using domestic sources and this is as good a time as any to do that. Indeed, while a ‘whole of society’ approach may be touted by New Delhi, that ‘whole’ needs to shed the red tape for once.
The curious case of newly developed indigenous test-kits being accepted for trials by the Indian Council of Medical Research’s (ICMR’s) National Institute of Virology (NIV), only for the suppliers to hear from the Drug Controller General of India that they needed USFDA or European CE approval before commencing production must not be repeated. Of course, the Narendra Modi government has since clarified that an ICMR-NIV stamp is now sufficient and at least one indigenous kit has already passed trials and is scheduled to enter the market shortly.
Incidentally, this test-kit called PathoDetect made by MyLab is going to cost only a quarter of what imported test-kits cost, can deliver results much faster and has demonstrated 100 per cent ‘sensitivity and specificity’ in ICMR evaluations. Better still, the company says that it can deliver between 1-1.5 lakh patient tests every week.
There are other indigenous kits that are also close to demonstrating the necessary reliability levels and their entry into the market will provide India with the ability to conduct hundreds of thousands of tests per week, if it can concomitantly deploy enough trained paramedics with PPE and viral transport media (VTM). Although ICMR doesn’t believe in what it calls ‘indiscriminate testing’, it is clear that much greater testing will be required to achieve what the ICMR wants to do — ‘isolate, isolate, isolate’.
Cheaper and potentially superior domestic test-kits being rapidly produced is exactly the sort of ‘innovation at scale’ that India needs to comprehensively contain the novel coronavirus. However, it was only late last week that the Technology Development Board (TDB) under the Department of Science & Technology ‘invited’ proposals for fighting Covid-19 and wants those related to respiratory or protective equipment to be submitted before 27 March 2020.
Move beyond proposals
While the TDB move is noteworthy, this is not the time to merely invite proposals for possible innovative solutions to combat COVID-19. The Modi government should be pro-actively scouring India’s scientific-technological landscape to identify possible breakthroughs. Because other countries certainly are.
Take the case of a Covid-19 inhibiting device invented by Bengaluru-based scientist Rajah Vijay Kumar, which is currently being evaluated by the US and Mexico.
Naturally, any relevant innovation or invention needs to be mass-produced, given the situation. Then there is the issue of increasing production of even well-established items such as ventilators and PPE, stocks of which are currently inadequate. In the matter of ventilators, some progress is being made with the government engaging Skanray Technologies, a domestic ventilator-maker that exports units to some 80 countries worldwide. Although currently able to produce only about 200 units on a monthly basis, Skanray says that it can ramp up production to 30,000 in a couple of months and to about a lakh subsequently.
Skanray is also offering its designs to other companies, so that they too can ramp up production. However, India’s ventilator-makers depend on imported components and increased production requires either greater imports or indigenisation of the same.
While some military flights will be mounted to source imports, the Defence Research and Development Organisation (DRDO) is now working with Skanray and others to get the necessary components from India’s aerospace and defence parts’ suppliers. Here too, the use of India’s small but growing clutch of 3D printing companies such as WIPRO 3D can be enlisted to manufacture key ventilator components such as regulator valves, as is already being done elsewhere in the world. Incidentally, DRDO is working on a multi-patient ventilator, which is expected to be ready for production by the first week of April 2020, and the Mahindra Group has been roped into making components for this design. This ventilator will cost around Rs 4 lakh.
Bharat Electronics Limited has now been asked by the government to manufacture some 30,000 ventilators in a consortium with Skanray. And the Department of Science and Technology (DST) has given a Pune-based start-up Rs 1 crore to make negative ion generators that can scrub a room of up to 99.7 per cent of its viral load in an hour. Some 1,000 such negative ion generators are expected to be deployed to hospitals across Maharashtra shortly.
Preparing for the future
Even as the ventilator availability issue seems likely to get resolved, much greater movement is required on the PPE front, with social media already awash with doctors across India flagging shortages of even simple kit such as masks and gloves. While the government says that it is taking adequate steps to scale up indigenous sourcing of the same keeping in mind technical requirements, material availability and standards, the difference on the ground is yet to be felt.
Ultimately, the Covid-19 industrial response has to be on a proverbial war-footing. Which means the usual processes of government procurement will simply not do. As such, it is better if the Modi government creates an ‘Empowered Committee for Covid-19 Production’ that operates under Defence Regulation-11 (DR-11), which enables the government to provision itself without the usual multi-step procurement chain. This can be invoked even for the production and stocking of disinfectants as well as VTMs. VTMs will be crucial to any mass testing effort, since preserving samples on the way to laboratories is sine qua non for that.
Building up strategic reserves of vital equipment even as India is in a lockdown is a no-brainer, really. It is not just a matter of stocking up for testing and critical care related to Covid-19 suppression efforts either. Adequate provisioning will also ensure that the ‘rest of healthcare’ does not end up suffering due to coronavirus-related diversion of supplies. Furthermore, if the lockdown succeeds in breaking the chain of transmission and India averts a pandemic, the scaled-up production will help India meet worldwide shortages of such items. Adapted for industrial uses, PPE can also be used to re-start production in the wider industrial sector once India moves towards normalcy.
In the end, a credible industrial response will translate into better and cheaper provisioning for India’s overall healthcare sector in the years ahead.-The Print