Tuesday, 02 November 2021

Pandemic moves role of MedTech sector front and centre

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SAMED conference focuses on growing Medtech post-Pandemic and identifies the key role SA’s medtech sector can play in economic recovery

SAMED’s annual conference which took place virtually from 19-21 October 2021 highlighted the fundamental role that the medical technology (medtech) sector has played in the global pandemic response, and how it continues to play a foundational role in the frontline delivery of quality healthcare and economic recovery.

With the conference theme of ‘Growing Medtech Post Pandemic: Adaptability, resilience and sustainability’, burning issues covered included the need for greater localisation and boosting local manufacturing capabilities; addressing shortcomings in relation to medtech policy and harmonising regulations for a highly diverse industry sector while ensuring patient access; addressing healthcare workforce shortages and the impact of corruption in both the public and private sectors; to our country’s preparedness for meeting the enormous demand for medtech in inevitable future health crises and a growing burden of disease.  Additionally, the pandemic provided important lessons in respect of Universal Health Coverage and the government’s chosen vehicle to achieving UHC, National Health Insurance. 

“The COVID-19 pandemic exposed new vulnerabilities resulting from changing social, environmental, demographic, regulatory and technological conditions, all of which have the potential to reverse the gains in health, wellness and prosperity that have been enabled by medical advances and health systems over the last century. At the same time, the pandemic has also leapfrogged tremendous advances throughout the healthcare delivery system, bringing about greater innovation, more research and development, and most notably, unprecedented levels of collaboration across public and private sectors and academia, and across geographies.

“These rapid developments were driven by the catastrophic impact of a globally synchronous pandemic that had massive implications for all human life. The advances and collaborations, in the absence of the pandemic impetus and urgency, may have taken many years to materialise, if ever. In the post pandemic recovery, it is incumbent on every stakeholder to ensure that the gains made on the frontlines of healthcare delivery in this crisis are not lost. We must continue to build a more resilient, robust and self-sufficient medtech sector and value chain that is able to respond not only to future pandemics, but also the growing burden of disease and inequitable access that has widened in our country since the pandemic broke,” explains Marlon Burgess, the Chairperson of the South African Medical Technology Association (SAMED).

Some of the key themes unpacked at the conference included: 

  • Medtech Innovation

South Africa needs to unpack where our next innovative medtech solutions are coming from, and how we can improve our current offerings, onshore. The traditional innovation pathways between SMEs, industry and universities need to be revived, capacitated and funded. There is an important government role to be played in bringing funders, SMEs and the academic sector together and providing the tax and financial incentives needed to support collaboration and innovation right here on our shores.

Open innovation is another area that was tremendously effective during the pandemic and needs to be fostered in our post-pandemic recovery. Instead of following the traditional routes to market for medtech innovation – many of which fail because of the high risk and upfront capital-intensive requirements - open innovation platforms allow professionals to submit an idea in its earliest form by allowing the most valuable ideas to be identified, patented, funded and developed through collaboration, without the risk of having their IP stolen or lost. This was done to great effect during the pandemic when there simply was no time to do deals, build things up and wait for much-needed funding. The open innovation and the open-source community played a significant role during the pandemic, and such opportunities need to be made available to SA’s medtech SMEs, where there is no shortage of innovation and entrepreneurial appetite.

Boosting local manufacture and job creation

There is no disputing that Covid-19 has been as contagious socio-economically as it has been medically. South Africa’s reliance on imports and our dwindling manufacturing capabilities were thrown into stark relief during the pandemic.

A stronger South African medtech manufacturing sector would without doubt boost South Africa’s economic recovery, enhance trade into Africa, strengthen national and continental healthcare systems, and improve access to health services.  South Africa has the potential to be a MedTech hub for Africa and relevant legislation should enable economic engagement with the rest of Africa - aligned to the African Continental Free-Trade Agreement which has come to the fore in recent months.

Yet, despite highlighting the country’s dependence on imported medical devices and pharmaceutical products, South Africa has yet to see major upscaling of local manufacture of healthcare products – granted the process takes time and needs to be viewed as a longer-term project that requires sustained resources and significant cross-functional collaboration. Here, government has a major role to play in providing well-informed strategic guidance, developing a more enabling policy and regulatory environment and resolving cross-cutting economic challenges including securing the power supply and cost. With the right political will and collaboration between government and business, South Africa has significant potential for a vibrant medtech manufacturing industry in South Africa and the continent.

The government has recognised the healthcare sector as a priority sector for economic stimulus projects, and to this end the DTIC approach SAMED and MDMSA to collaborate in programmes with the Industrial Development Corporation (IDC), Council for Scientific and Industrial Research (CSIR), Department of Science and Innovation, the SA Medical Research Council (SAMRC) and the Technology Innovation Agency (TIA).  Going forward, it is important for government to scope the requirements for increasing local manufacture while ensuring the sustainability of medical technology industry.

Other countries, such as Malaysia, Ireland and Israel, have succeeded in increasing local manufacturing capacity for medtech and dealt with similar challenges to those faced in South Africa and provide important lessons from their experiences.  To this end, the Israeli embassy in South Africa was part of the conference and provided insights on Israel’s journey, with the country just recently announcing that a new record of $18billion investment in innovation had been reached in the last nine months, of which medtech is a significant sector.

Medtech policy and regulations

Regulation of healthcare, including the medtech industry, plays a critically important role in all circumstances and certainly during health emergencies. However, there is a need to review and reform regulatory processes and overhaul related administrative systems to attain the agility required in times of crises.

Robust problem-solving, agility in introducing new policies and regulations, and capacity to fast-track licensing are critical to ensure supply in times of crisis and should be considered in crisis planning.

The pandemic has highlighted an urgent need to review, align and improve regulatory processes across government agencies before another health crisis occurs. SAMED impressed upon policy makers the need to formulate a joint response to future health emergencies and include input from all key stakeholders. Scenario planning and pressure-testing, with the participation of all stakeholders would identify gaps and help build solutions that can be efficiently implemented, and avoid the unintended consequences of regulation that does not fully appreciate the diversity and complexity of the medtech sector.

Most crucially, the complexity, resilience and variety of medical technology supply chains needs to be appreciated by policy makers. The complexity of the medical technology industry value chain should be considered together with job creation and innovation which creates more jobs. With a more enabling policy and regulatory environment, the medtech sector’s current estimated R20 Billion market value could be significantly increased to re-position South Africa’s role and contribution to the sector across the rest of Africa.

Universal Health Coverage and NHI

Attaining Universal Health Coverage is a laudable and necessary policy objective now regarded as international norm. NHI is merely one type of funding mechanism of which there are dozens of international variants. SAMED recognises that the inequities of the current fragmented healthcare system are untenable and that a well-formulated NHI is crucial to advancing universality and social solidarity in a patient-centric, equitable health system. The reality is that both private and public healthcare face enormous challenges and that failed implementation will have catastrophic consequences for patients and the economy.

From a medtech perspective, SAMED highlighted a number of aspects in the context of the NHI bill, including the pitfalls of a single payer/single buyer system which will not ensure optimal outcomes for price or supply of medtech due to its monopolistic nature. Furthermore, the nature of medtech must be taken into consideration. Medtech hasrapid cycles of improvement, clinical variation and innovation, there is a need for data management, software upgrades, replacement of consumables, after sales service, maintenance and training, service contracts, sub-specialities of devices and bespoke products made per patient. The role of healthcare practitioners also comes into play as the main users and specifiers of medtech fit for each patient’s needs – all of which is mismatched to a single buyer/payer model proposed under NHI.

South Africa’s worsening fiscal constraints and eroded tax base also have significant implications for a purely public-funded system. It was pointed out that no public funder/single payer system has achieved universal access anywhere in the world, and that the private sector plays a significant role to close the gap. 

Collaboration for a comprehensive response

“Collaboration among a wide range of role-players is fundamental to strengthening the South African health system, which is the country’s best defence against future pandemics and health crises. It is crucial to sustain and deepen the relationships forged in the heat of the COVID-19 response, contributing to common initiatives to “build back better” in an authentic and, when necessary, constructively critical manner. In all efforts, the patient should be at the centre to ensure preparedness not only for future national and global health emergencies, but also in advocating for the continuity of health services that are not linked to the pandemic crisis. Ongoing and long-term patient care cannot be sacrificed, and therefore policy makers must consider models and mechanisms for patients to receive the care and consultation they require, even during a pandemic.

“We support the funding and implementation of health innovation as a tool to meet diverse and challenging health needs within all communities. Most of all, as the representative body of the medtech industry in South Africa, SAMED stand ready to engage with government and all its agencies on measures aimed at accomplishing and building an improved and agile healthcare sector,” concludes Burgess.

Published in Health and Medicine