Unprecedented times shake down systems. The very systems that have served us long and are etched in our daily life and experiences. An epidemic of this scale, a war, or a calamity-all cause huge distress to the structures of society and governance. But as the legacy systems break down, humans often come together to make huge shifts which create absolutely unthinkable new structures.
In the end, we are left more sober and better prepared to face the next one. And as I write this, we are struggling and surfing under this gigantic wave of COVID-19 and I strongly believe that we will emerge with a highly equipped healthcare system which will serve for years to come. I will share my perspective mostly from diagnostics standpoint.
Diagnostics before COVID-19
Before the epidemic, we were living in the dark age of diagnostics in India. For years, diagnostics had not had the upgrade it desperately needed, except in tertiary centers.
We were still using out dated methods and assays of diagnosis, while the world had moved to newer and accurate technologies. I recently read an article which said that Amitabh Bachhan is living on less than half of his liver because he received untested blood transfusion.
And yet today, thousands of people in India get infected with diseases like HIV/HCV every year because NAT testing is not mandatory, and we mostly rely on serological tests. One of the reasons for this was molecular diagnostics was costly, limited, and inaccessible.
Very few laboratories had the capability for RT-PCR based tests. Molecular tests were mostly imported from foreign companies. Further, only a limited portfolio of test was readily available across all centers due to storage requirement. To top it up, general awareness about high-accuracy diagnostics was super low.
A common man did not have a clue about the test that would be used when he/she visited a lab. Media had hardly ever reported/talked about parameters as sensitivity/specificity.
60 years in 6 months
This was the system that had been around for so long that we did not notice that it needed a change. Until we were down under this epidemic.
And as human beings have done historically, we swung into action with all hands-on deck. And what I can see happening is a completely ramp-up of diagnostics infrastructure in India–both in private and public sector.
Just to give you a sense, today we have more than 2,000 labs that support RT-PCR testing. This is leap of a magnitude which was unthinkable before COVID. Almost every state and UT now has the capability to conduct advanced molecular diagnostics.
Thousands of lab technicians have skilled themselves on molecular diagnostics and are now ready to serve a modern diagnostics system. This large installation base of infrastructure and reskilled human capital will remain in place for years to come.
In addition to this, molecular diagnostics became more accessible than ever. Many Indian biotech companies have developed high quality tests and now we have more than 100 companies that offer COVID-19 test.
This means that we have made depth in the ecosystem now. At Mylab, we have developed a benchtop machine for conducting molecular diagnostics, the patent for that is still pending.
Compact XL, essentially a lab-in-a-box is specifically targeted to increase penetration of high-accuracy diagnostics in India.
This will allow entrepreneurs to set up labs at a low investment. It will also have uses to establish labs at strategic places such as high-end airports, army bases and at oil fields.
The supply chain of raw materials has improved significantly with storage and handling facilities available for the temperature-sensitive materials.
The most important progress, however, has been in the how the awareness about diagnostics has improved. Today, citizens know that some tests are more accurate than others.
Journalists have spent hundreds of hours understanding the type and accuracy of tests and communicating it to the masses in an easy to understand language.
Government agencies have also communicated and educated people about tests and their use. Today, we should not be surprised if a layman asks a lab what is the sensitivity of the test that they are conducting. This was unthinkable a few years back.
Where from here?
Now when we emerge out of this crisis, what should we expect? I think there will be shifts across multiple dimensions. Firstly, high-quality diagnostics will now be affordable for the masses.
Price of a test reduces to a small fraction with scale. This is something we saw in the case of COVID-19 tests. If we adopt molecular diagnostics for the masses, we are hopeful that we would be able to reach price points where benefits outweigh the cost.
Secondly, we believe that the innovative solutions will allow diagnostics to reach small cities and rural areas. We look forward to entrepreneurs in rural areas establishing small labs and enabling diagnostics at the grassroots.
Finally, I believe that an ecosystem of innovation has just got the motivation it needed to make solutions for the world.
With the right incentive, small start-ups can achieve great feats. We should aim to prepare the Indian biotech start-ups to create solutions which will perform at international levels.
At Mylab, we are already aiming for that and expanding our international footprint. Our dream is to help countries across the world access cutting-edge diagnostics solutions at affordable price points. To sum up, these are difficult times, but let’s believe we will emerge better!