The significance of creating strong infrastructure, supportive policies for competition and innovation

What is APACMed’s response to PM Modi’s call to go ‘Vocal for Local’ as part of the fiscal stimulus for India’s industry? Specific to the medical devices sector, do you think that India has the capability and capacity to manufacture medical devices, given that a large percentage of medical devices (over 60 per cent) need to be imported?

Prime Minister Modi’s ‘Vocal for Local’ is good progress toward achieving the vision to Make in India for the world. The ultimate objective of our sector is to improve patient access to the right care at the right time, at an affordable cost for patients – and this will certainly support this aim. We believe there are three key elements that support this vision – Innovation, Collaboration and Access. Our experience has been, for these elements to be realised, they require active and open cooperation between local and global networks; best practice sharing; and sufficient expertise and capacity.

Local capacity building is critical and is ultimately underpinned by policy and regulatory frameworks that incentivise the entire healthcare industry to innovate, conduct research, and develop and manufacture products for use in India. For any industry to flourish, there is also a need for strong infrastructure, a supportive environment for competition, an impetus for innovation, and encouragement of the introduction of new technologies, be they indigenously developed or imported. These are some of the ecosystem characteristics required for the local medical device industry in India to become a global hub for medical devices.

Nurturing MedTech startups is one of APACMed’s key objectives. We support innovative start-ups who seek to improve the quality of care and strengthen healthcare systems. With the recent establishment of our office in India, our objective is to work closely with policymakers, industry, clinicians, patients and academia to create this conducive environment for innovation to thrive and grow the Make in India vision.

APACMed has appreciated that the health cess and customs duty on the imports of COVID-19 test kits, ventilators, face and surgical masks, and additional Personal Protective Equipment (PPE) has been waived. What are the other devices that APACMed feels need to be added to this list and how would these benefit patients?

Looking to the World Health Organisation (WHO) guidelines, published on March 17, in addition, to test kits, ventilators, face and surgical masks, and personal protective equipment (PPE), a number of other devices are required for the treatment and management of COVID-19. These include disposables/consumables, implants, in-vitro diagnostics, and medical equipment.  High customs duties on these items will adversely impact the overall cost of treating COVID-19 – costs likely to be ultimately borne by patients. The medical device industry has also been impacted by the reduction in elective surgeries and it is, therefore, critical to consider retracting customs duty and health cess on this broader range of devices to ease some of these pressures on the industry.

Any specific recommendations post the Finance Minister Nirmala Sitharaman’s rollout of the finer points of the fiscal stimulus on May 14, especially relating to medical devices?  For instance, the diktat that global tenders will be disallowed up to Rs 200 crore for government contracts, if applied to medical devices, might prove tough for most import medical devices?

APACMed supports maintaining the global value chain in procurement, especially during the current pandemic where the world needs to come together to support patients.  At present, 86 World Trade Organisation (WTO) countries are trying to reduce import barriers and maintain the global value chain, and policies that contravene this may be detrimental and may compromise access to global technologies for Indian patients if realised. Having said that, we are still seeking more clarity on the matter as prima facie it implies that Indian subsidiaries of foreign companies are able to participate in these tenders.

Supply chains have been disrupted thanks to COVID-19 and consignments of life-saving PPEs etc from importers like APACMed’s member companies have been held up at ports. Any suggestions on how the government can ease the passage of these so that they can help in the battle against COVID-19?

The medical device sector is an essential service and the industry is playing a critical role in ensuring that hospitals are equipped on the ground to respond to this pandemic. We commend the Government of India on the proactive steps taken to reduce the impact of the COVID-19 outbreak on the citizens of India and ensuring that essential medical supplies can reach patients during the current state of national lockdown.

However, operational challenges with respect to the movement of manpower and materials persist on the ground, which has resulted in a widening demand-supply gap. A robust, uninterrupted supply chain is required to ensure that essential medical products and services can be produced and rapidly provided to patients.

The pillars of access, quality and affordability in healthcare are paramount during this time. APACMed recommends that all government notifications for relaxation be interpreted and understood to the last mile at the level of the District Magistrate and local law enforcement, to ensure smooth land movement of essential supplies. It is also important that ancillary industries, whose functioning is critical to the MedTech sector, be allowed to operate, keeping all SoP’s in mind.