Atmanirbhar in healthcare technologies - Where are we?

With the helplessness exposed by even the most developed nations in the world during the pandemic, Skanray, BEL and DRDO delivered more than 90 per cent of the Ventilator demand of the nation in just a few weeks creating a world record.

Mahindra/Skanray joint development presented to the GoI, the world's most advanced IOT ventilator that wasn't scaled commercially, but demonstrated the most suitable technology option to prepare for any eventualities in the future.

Skanray was manufacturing high end ICU ventilators for the domestic and export market since 2014, but caught the attention of the Government during the crisis with the imports getting blocked due to global shortages and a ban on export imposed by most countries having hi-tech healthcare devices.

Seamless co-ordination between the govt and private sector, coming together of the Ministries of Health, Pharma, Defence, External affairs and the PMO saw nothing short of a miracle. The feather in the cap for this programme was also that it was one of the few deals, which were GoI to GoI and no middlemen involved. Atmanirbhar, Digital India, transparency in public buying and speed of response was put to test, but the results are here for the entire world to see.

Is this just a fluke? Response to emergency / struggle for survival or is it going to be sustainable and extended to all sectors post-Covid?

We have no need to compete with China or any other nation for the global market. India has the unique advantage when it comes to being the health and med tech hub for the world.

India is sitting on a $100 billion global telehealth, health tourism, and home care technologies and services market that is a low hanging fruit going by our size, IT strength, the number of doctors and skilled paramedics in the country. It's just the right policy, the right kind of investments and infrastructure that can drive this segment.

It is time the GOI eases laws to let Indian companies hire highly skill European, Eastern European, Russian engineers and scientific talent since we are far behind in system and application knowledge compared the developed nations. Our strength lies in specific domain skills and services not in full system design.

Indian core research, R&D, product development costs are 70 per cent cheaper than US, Europe, Japan and most developed economies, while we are 80 per cent lower costs in product engineering, installed base support, product V&V, testing, life testing, logistics management and allied services. In skilled manufacturing labour Indian costs are 70 per cent cheaper than the rest and about 50 per cent cheaper than even China.

China beats us in high volume low mix products, while we are versatile and cost effective in high mix, low volume products and high complexity sectors.

The issue we have is with raw materials where we have no great advantage over any other country in the world. We are about the same but can achieve 40 per cent cost down in material processing when done locally. Our supply chain base is far from what is needed to be a favoured destination for bulk manufacturing.

In the design and applications front the following point's needs very quick attention.

l Electromechanical/ robotics and manufacturing technology: This is one of the weak areas as a nation. This needs to be strengthened through Incentivisation and support from govt research labs like DRDO, ISRO, the CSIR Labs, CAIR, BEL, ECIL and many others.

l Sensor technology: Close to 100 per cent of sensors is imported and sensor is the heart of the med device. DRDO/ CSIR labs have technology in space research that can be commercialised

l Imaging: Indian engineering is used for coding, system design is concentrated in the US, Europe and China. India has the competence

l Clinical and application core: AIIMS, NH, Fortis, Apollo and corporate hospitals to dedicate to medical devices development and S/W

l CT/ MRI/ nuclear medicine: Here we need to attract MNCs and FDI through a dedicated programme

Here are my few points for the Industry and the Govt to Ponder.

1) Streamline tendering processes: Atmanirbhar is leaning heavily on simplification and transparency in Govt tendering. We need to move from creating tenders' specs to Catalogue buying to eliminate corruption and fair opportunities for home grown products that are in par with Global products in quality and safety. Most of the rigging happens in pre tendering work through custom specifications while not many goods are made exclusively for the Govt except in defence and space.

2) Move from production-linked incentives to export-linked incentives: Atmanirbhar and Make in India shouldn't lead to substandard products being thrust on Indian buyers. Export-linked incentive scheme should replace the production linked schemes. Also, no Company shall have more than 20 per cent of its revenues coming from Govt, PSU, semi govt, and Public Tender business.

3) ESDM/ Tech parks/ EOU parks/ STPI project tracking systems: We need a public tracking system to ensure that all public expenditure to promote Indian entrepreneurship and local manufacturing to be tracked and reported to public. Projects of this nature, public funded have been unfinished, gathering dust and unutilised for decades.

4) Make in India / Atmanirbhar: It has to be clearly defined to keep off final stage assembly and importers who get kits from cheap sources and label, partial assembly locally to benefit from the schemes and thus keeping off real R & D and manufacturing projects.

5) Hi-tech MNCs need fairness and longevity in policy to invest in India: A mix of Global and local players is essential for any progress in technology, local manufacturing and being up to date in Technology with the global standards.

6) Inverted duty structure and law of reciprocity: The Govt should enforce law of reciprocity strictly to avoid dumping and unfair playing ground for startups and Indian Tech companies. There are countries who levy 30 to 60 per cent duties on Indian good and using the regulatory route to block Indian products while they enjoy Zero or 5 per cent duty structure to sell their goods in India.

7) Global regulatory standards: There is trend pushed by certain organisations to push Local regulatory standards to block quality imported products. Evolving new quality, safety and performance standards needs decades of work. Indian standards have not been revised for decades.

8) Laws to enforce govt payments on time: The delay in the government-related payments has killed several startups. Several state Governments haven't paid for supplies made many years ago.

9) Electronics manufacturing focus: We see a lot of buzz on electronics manufacturing, however, there needs to be review and reporting on the effectiveness of the schemes in view of Indian having close to $60bn in electronic imports, next only to petroleum imports. About 50 per cent of this can be saved through simple policy matters that have the potential to employ more than 20 lakh skilled and unskilled workers. Speed is the essence of every policy. Time bound programs, target dates for each action and public display of the results will bring in action and sensitivity in the Govt and private bodies who are beneficiaries of Public funds.

10)Stability of govt project heads: Frequent transfers of IAS officials hamper every single project of the Govt. It is de-stabilising and demotivating for the officials and the Private sector stake holders who seem to be at the mercy of the elected representatives who are usually ignorant of Technology programs or its impact. There are instances of officers staying for just a few days and some cases even hours. The Government should publish the public-funded programs with the Single point of ownership, the timelines and the tenure of the key officials for each program to ensure accountability for timely execution. Co Ordination between the various departments needs review both at State and centre. Too often we see even the top officials helpless in front of the same system they created and own.

We now have a national government that seems to be serious with long-term policy matters even in the midst of electoral challenges. This is the time to look at sustainability, timely execution and accountability and not just announcements.