Open Source Medical Infrastructure

I’m not sure what day we are in this national lockdown! These are definitely unprecedented times, this is the first time I have seen India value human life over money. Take for example, on any given day in Mumbai, there are about 10 deaths due to the local trains. The trains are packed, they don’t have doors and people need to get to work. You could add more trains, but that costs money. You could add doors but then you would have to air condition the trains and that costs money.

I assume one of the main reasons the Indian government called for a national lockdown is because they know the healthcare infrastructure is just not designed for the crush of patients that COVID-19 would create. So the only logical thing to do is shutdown the country. Of course, that means the economy is in the toilet but every economy around the world is in the same situation.

A year ago a friend was buying some medical equipment and he mentioned the problem they face is “we buy equipment in Dollars and have to charge in Rupees.” He said there are very few locally manufactured medical products and most are sold by the large multinationals like GE Healthcare and Siemens. This makes it very difficult for most Indians to get access to good healthcare. Everyone is selling a Mercedes and most people can’t even afford the fuel, as he put it.

The COVID-19 pandemic has created so many medical innovations from all over India to bubble to the top. Take for example the COVID-19 test, the government set a cap of Rs. 4,500 per test. Then the college institution IIT-Delhi said they have a test that is available for Rs. 500 and would give an open license so others can manufacturer it. A great example of public/private partnership, of course in this case no one will really make much money from it but the entire population can benefit from it.

In the US, the need for ventilators was so large that the state governments were begging Trump to give them access to the national stockpile of ventilators. In India, there is no national stockpile of ventilators and I don’t think we have the financial capacity to go out and buy 100,000 ventilators and bid against other countries. This has led to many startups and even the Mahindra Group get into the act of saying they can manufacture ventilators. T-Works a startup incubator in Telengana has built an open-source bag-valve-mask (BVM) ventilator for Rs 75,000 ($1,000). Again, the design can be used by others who can manufacture the device.

The Indian healthcare infrastructure needs to be thought of as critical/essential and national policies should be framed around it. The Indian Ministry of Electronics and Information Technology (MeitY) recently launched an innovation challenge to find a local video conferencing product to compete against foreigned owned companies like Zoom, Skype and Microsoft Teams. That same thought process needs to be applied to the healthcare system in India. Every piece of medical equipment should have a local equivalent that can compete against the foreign competitors. Most of the pharmaceutical medication consumed in India is produced in India and we need to take the leap and move to hardware.

Very soon it will be standard operating procedure to have infrared thermometers everywhere monitoring our temperature. There is an open source initiative that allows anyone to build an infrared thermometer that is 80-90% cheaper than what can be found on Amazon. There are many more examples of this “open source” type initiatives across the world. India has all the ingredients to make this happen and just needs a formal push from the government to say it’s “all in” on open source medical infrastructure.

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