While the self-reliant model seems promising, it is important to note the role of the global industry, which, so far, has catered to 70% of India’s medical equipment needs
By Amir Ullah Khan
To bring India on the path of rapid development, five things are very important to build a self-reliant India-intent, inclusion, investment, infrastructure and innovation”, said PM Modi in a recent speech as India entered its first phase of ‘unlock’. As the pandemic impacts close to four lakh lives in the country, the dire need for building capacity has set in motion India’s long-awaited dream of self-reliance. From zero, the country now manufactures 4.5 lakh PPE suits a day and has more than 600 companies certified to make them. Inching closer to developing a vaccine, one of India’s pharma giants has entered the second phase of the clinical trials of a drug, which is touted among the most promising treatments of coronavirus. Moreover, three Indian companies also made it to NASA’s list of international manufacturers who were selected to make a new ventilator tailored for coronavirus (Covid-19) patients. India is also leading the race to make affordable, low-cost ventilators. Self-reliance has taken a whole new meaning for the country as we wait for the pandemic to wane. But how self-reliant are we, especially with an abysmally low spend on healthcare?
While it is encouraging to see the domestic industry getting the much-needed impetus, the government must be careful about the quality assurances it is giving its people. For instance, even as the domestic players get the legal nod on making kits and ventilators, the quality of these products has been a cause of concern. One such incidence that questioned the quality of ventilators and focused on patient safety was the Gujarat model of 900 ventilators, where fake ventilators were installed across the state without any mandatory licence from Drug Controller General of India.
India has become the world’s second-largest manufacturer of PPEs, second only to China. This news fits perfectly into India’s self-reliant rhetoric. The demand for PPE kits has brought many players into the market, who are getting the government’s nod to manufacture and sell. However, with little to no information available about the identification of kits, the end consumer is bound to have a trust deficit. Some of them do not even carry a certification notice. We are being told that India is working in line with the global best practices. Recent reports revealed, many PPEs from India don’t carry any certification marks and are not using the GS1 global standards being used by all manufacturers of genuine products. We know that nurses at All India Institute of Medical Sciences (AIIMS) and many other healthcare centres in the country have been complaining about the lack of PPEs and proper guidelines to handle the Covid-19 situation. We also had Dr Srinivas Rajkumar T from the AIIMS raise the issue of the quality of N95 masks provided by the hospital for use.
This is exactly why we need to comply with global standards. Now, let us understand what GS1 means for the Indian market.
GS1 standards are required to enable identification of medical products unambiguously. These standards also help in identifying counterfeit products in the market, thereby, assuring patient safety and quality. In India, GS1 India operates with a ‘Smart Consumer’ app, which gives access to information about products by scanning their barcodes for complete identification. What happens when the products are sold without these identifications in the market? Healthcare workers and patients utilise products that could potentially have serious quality lapses.
So, when we hear the PM speak of the country producing over two lakh PPE kits in a day (with numbers doubling every day), it does little to assure protection and quality if these standards are not met. And, even with a shortage of PPE kits in the country, recent reports were emerging out of Punjab that their kits were unutilised, the state apparently has 35% underused stock. According to media reports, “the Industries Minister Sunder Sham Arora has written to Union minister of commerce and industry, Piyush Goyal, to allow export of PPE kits so that the industry may operate to the fullest”. This is where global partnerships come into play. Battling the disease front and centre, the only way to salvage the situation is for governments and the medical industry to work in tandem to contain the spread.
The push for self-reliance also comes at a time when India is collaborating with the world for everything from vaccines to drugs, medical equipment and more. Even as India speaks of making its ventilators, the industry is still heavily import-dependent. The disruptions in global supply chains have not undermined the potential of the global industry in meeting India’s demands. From ventilators to PPE kits, the country has reached out to the world for better access, and the world has responded to its call.
With India ranking fourth in the number of global Covid cases, we need to upend healthcare systems like never before. And, clearly, relying on the domestic market alone is only putting more lives at risk. While the self-reliant model seems promising, it is important to understand the role of the global industry, which, so far, has catered to 70% of India’s medical equipment needs.
The government must pull all stops to ensure that India has the diagnostics, ventilators, protective gears and equipment our people need to fight the disease. Even as PM Modi assured some $20 billion budget for healthcare professionals, it does not change the fact that the system is still reeling under an acute shortage of diagnostics, testing kits, only 48,000 ventilators and the need for more than 38 million masks to combat the virus.
Even as India tries to create its gear and equipment, it will not happen overnight; we would still need to work in tandem with the global players who are willing to offer help at this point. In a promising step, to evaluate the quality of coronavirus testing kits, the country has given test licenses to around fourteen private companies, which also includes Swiss firm Roche Diagnostics India and Abbott. Partnerships like these matter now, more than ever. The one thing to learn from the crisis is that we need to look at the situation from a global lens.
With the Covid-19 juggernaut rolling at a pace that could put millions of more lives at risk, maybe, what India needs to look at is creating an environment that fosters innovation and improves the quality of care for its people. India needs to create a conducive policy environment to ensure that global innovations come to its shores and reach its people. Moreover, at a time when the world is looking at India as the next big manufacturing hub, the government should look at global partnerships to bolster its stance.
The author is Development Economist, Former Senior Policy Advisor, Bill and Melinda Gates Foundation
Views are personal