Pakistan and the med-tech sector

The continued challenges with the pandemic have hit the economies hard. The impact on lives and livelihoods is real, and millions will require real support to put the pieces of their lives back. While many traditional industries have taken a serious blow, other industries are reporting both high growth and robust demand for months and years to come. Medical technologies — ranging from disposable rapid diagnostics to hospital equipment like ventilators — are not just in need right now, but are going to be needed in the foreseeable future. Recent industry data suggests the growth in medical technologies is highest it has been for decades and the biomedical technologies are going to be among the most rapidly growing industries in the next five years.

Pakistan, unfortunately, has not done well in hardware innovation in general, and medical devices in particular. Nearly all rapid diagnostics, which are essential for higher and rapid testing and safe reopening of the country, are imported. So are the machines that are required to read and analyse the tests. There is some interest in creating ventilators, but those are not new innovations and are mostly based on existing (off-patent) designs. Finally, limited manufacturing capacity means that even if we had innovators come up with novel designs, the cost of manufacturing would make our technologies far more expensive than what is already available in the international market.

Given these realities, what is it that we can do in Pakistan? There are three things that I have heard from industry leaders in med-tech when I asked them about the opportunities in Pakistan. First is demand creation. In part this already exists because of the pandemic but a lot more can be done. For example, while Pakistan follows the WHO guidelines of essential medicines, it has not done the same for essential diagnostics (a list that WHO came up with nearly two years ago). A national essential diagnostics list would require hospitals to have a number of technologies available at all times, thereby protecting vulnerable lives on one end, and creating a demand for technologies.

Second is quality control. One of the reasons hospitals and institutions opt for international products is because there are no national alternatives available. But this is only part of the problem. The second part has to do with a general sense of trust associated with foreign companies and a sense of anxiety about local brands. A stronger, transparent and robust quality control system that would be run by non-partisan professionals (and not career bureaucrats with little training in medical technologies) would be the first step in ensuring that quality would not be compromised. This needs to be backed up by real action against those who fail to comply with quality standards, and an incentive for those who do.

Third — and perhaps most importantly — a recognition that any technology, including medical technology, does not come into being in a vacuum. It requires investment in basic science and basic research, the foundation on which the industry can develop and thrive. Separating technology from basic science and basic research leads to our innovators playing catch-up, or simply copying what already exists. That is neither sustainable nor particularly attractive for innovators.

Beyond creating our own, there is also an opportunity to partner with those who have been in the business for sometime and are looking to expand in new markets. My biomedical engineering students, as they graduate, are often asked by large companies if they would be interested in expanding businesses in Asia. Pakistan is never mentioned, citing the three reasons of local demand, regulation and disconnect in education. The pandemic may be an opportunity to change both the local industry and the international perceptions.

Published in The Express Tribune, November 3^rd, 2020.

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