Socio-economic developments and its associated lifestyle changes are instigating several noncommunicable diseases and embarking multiple healthcare opportunities. Besides increasing population is rising them thus challenging healthcare. But pursuing a coherent and consistent fulfilment for them is too complicated because they persistently incite the needs for affordable, accessible and acceptable services, facilities and devices. moreover, these needs are also exceeding indigenous manufacturing capability, capacity and competence in India, this distress is alarmingly rising and compelling an inevitable reliance on imports. As a backlash enterprising laboratories, hospitals, diagnostics centres and medical device manufacturers aren’t privileging the needs of diverse marginalised society or perhaps are unable to deliver proper value for those fulfilments. In this regard, healthcare value chain portfolio is extensively attracting niche interventions including affordable, accessible and acceptable manufacturing prospects. Holloing applicability of advanced science and sophisticated techniques to obtain more value among these intervening endeavours are driving manufacturing through a paradigm shift especially catering to healthcare needs in India. However, the diversity of relevance to all strata of society and persistent disparities in infrastructure provision and resource utilisation are weakening developments. Progresses are exclusive on highly dense urban areas and are accessible to few privilege sections of the society. Besides, they are unorganised, unregulated, ad-hoc/ casual, randomly distributed and even if they are available, they compete with the distress. Although piloting is catalytic to assess economics, enhance confidence for investments and decisions for testing, validation and scaling; mass producing complex prototypes is difficult through existing technologies. Hence, despite thriving opportune in scale, size and pertinence demystifying current and future challenges is still a puzzle.
Rate of non-communicable diseases (NCDs) is consistently increasing while communicable diseases (CDs) are in control to a large extent. Thus, CDs are reducing whereas NCDs are dominating for now among top 10. This increase of NCDs attributes to malnutrition, pollution, dicey dietary and tobacco abuse while iron deficiency causes most disabilities.
Despite precise emphasis to develop appropriate technologies, most of the scientific advancements are just augmenting capacity and manufacturing excellence is a distant hope for India’s leadership as a global medical device manufacturer. Mainly because they’re staggered along with many gaps across the value chains. These value chains involve patients, healthcare providers, manufacturers, investors, policymakers and regulators. Most of the stakeholders across these value chains don’t have the means to get access and leverage appropriate existing technologies. Hence despite thriving opportune in scale, size and pertinence demystifying current and future challenges are still a puzzle.
Distinguishing several medical devices from drugs and cosmetics in the most recent policies is giving better impetus to fulfil healthcare needs from manufacturing perspective like prioritising essential unmet needs. Policies are asserting the severity of risk in these medical devices to classify them as Class-A for low-risk devices, Class-B for low to moderate risk devices, Class-C for moderate to high risk and Class-D for high-risk devices. This is emphasising use of cutting-edge technologies and adopting sophisticated advancements to de-risk devices from Class-D to Class-A. Such reformations are prompting innovative philosophies of realising improvements that are coherent, contingent and contemporary to interests of all stakeholders.
Devices and equipment have bigger stake in economy than implantable, disposables, consumables and other constituents. Incidentally, Indian manufacturing has characteristic dominance in the aforesaid low-value subset, primarily relying on subtle technologies. Instead to make highvalue devices ranging from a defibrillator, catheters, cardiac pacemakers, bio-sensors, laparoscope to tissue retractors they would need state of the art manufacturing infrastructures involving multidisciplinary technologies and knowledge convergence from electrical, electronics, biomedical, chemical, information and mechanical engineering. Such high-value devices are indispensable to achieve minimally invasive diagnosis or surgery. The tools, gauges, machines, fixtures to manufacture these devices involves extensive customisation, more complex, highly compatible and configurable features. Besides, they also need expertise in ultra-high precision manufacturing along with classified sterile, clean-rooms to meet acceptable quality, performance and frugality for supporting associated tasks. Application of high-resolution sensor and tactile control systems can enable adaptability and versatility. A multitude of innovations with augmented and virtual reality are needed at the point of care support with customised diagnosis or screening. IoT, artificial intelligence, blockchain will redefine medical record sharing, data security and enable doctors to engage almost any device for monitoring of patient’s health, this will slacken off liability for clinician’s physical presence.
Thus, further scale healthcare accessibility and enable more affordability. Robotic technologies, smart automation and big data analytics in biotechnologies are likely to steer the rigor of such developments. Like satellite-enabled communication systems can enable doctors to reach out rural/peri-urban areas for remote consultation using portable gadgets. Primarily because they will transform the way healthcare facilities, procedure and resources are fulfilling healthcare needs.
Policies regulating the matrix of resources, domestic capabilities and existing infrastructure should prompt partnerships among stakeholders towards integration for extreme value. It should systematically penetrate to fulfil primary, secondary and tertiary healthcare needs; while inciting reliability, resilience and self-reliance to sustain those developments. Also having appropriate design models in a prior development stage should be the crux of manufacturing. For that, it’s important to leverage underutilised public infrastructure, local resources and existing distribution channels by engaging state-of-the-art technologies throughout the value chain and have robustness across all associated endeavours for the dignified wellbeing of all. Establishing manufacturing facilities in rural/periurban areas for local participation and use of native resources will encourage and sustain social diversities. This will also curtail variance in economic development between urban and rural areas and hopefully bring harmony. More so the development must be eco-friendly and promote made by people for people.
Besides affordable cost, healthcare characteristics such as quality, reliability, consistency is important; that accentuation ought to pursue valuebased approach. Exploring application of promising technologies from interdisciplinary domains for realising affordability, accessibility and frugality augmentation. Compatibility, compaction, portability, aesthetics, ergonomics, etc. might save considerable time, make more relevant, improve pertinence.
This way healthcare proviso has to leapfrog from a low value to highvalue fulfilment persistently. So public policies should appreciate dynamics in healthcare need, technology advancement, versatility of fulfilling, etc., and revive their coherence. To relegate this responsibility with private parties to manage use and maintain shared resources will lead to a severe erosion of the system holistically including stakeholders, resources, etc. Besides, bulk subsidies to aggregators and capital aggregation by a few privileged will give in to indiscriminate exploitation of civic resources and fiercely agitate the value chain ends i.e. producer and consumer. Earnest coerce to manufacture medical devices and instruments with emphasis on non-invasive treatments is an essential requisite. Concerned developments have to rely on resilient technologies such as bio-electronic miniaturised implantable, magnetic separation of cells, capsule robots for targeted drug delivery. At this backdrop technological improvements artificial heart, kidney and genome editing has to quickly drift in to mainstream healthcare. We must utilise the best of modern cognition, native knowledge, traditional practices, indigenous culture to pre-empt external influences and local resources to sustain across the value chain so healthcare ambits the most deserving beneficiaries.
