As the world’s hospitals buckle under the stress of the deadly coronavirus pandemic, so the need for extra ventilator systems has become critical in the healthcare sector. While early statistics show that 80% of Covid-19 sufferers recover without treatment, 20% do require hospital care, at various levels of ventilator support. Breathing a mixture of pressurised air enriched with oxygen has proved successful in the treatment of many of these patients.
For South Africa’s already stretched healthcare system, the hammer blow of an out-of-control virus epidemic could shatter it. Severely afflicted Covid-19 patients (the 20%) suffer from an acute lack of oxygen in their blood supply. For them, adequate ventilator support often means the difference between life and death. Projections by the South African government therefore show a steep increase in demand for ventilators in hospitals, both locally as well as in the rest of Africa.
The limiting factors in terms of meeting this requirement are lack of availability, cost and a shortage of suitably trained healthcare professionals. Luckily, the majority of patients requiring ventilator support can be treated with continuous positive airway pressure (CPAP) machines, with only a fraction of them requiring actual mechanical ventilation and highly trained intensive care unit (ICU) staff. Therefore, the South African government has decided first to ensure that adequate numbers of the simpler CPAP devices are available. To this end, it has tasked the National Ventilator Project (NVP) with acquiring an initial 11 000 such units, with a possible requirement for an extra 50 000 in the future.
It’s a three pronged strategy. Firstly: to supply the much needed CPAP equipment to hospitals and healthcare facilities around South Africa. Secondly: to leverage the participation of SMMEs, where possible, through providing unique opportunities to participate in the production and supply of locally manufactured personal protection equipment (PPE). And thirdly: to create new export opportunities through supply of this equipment into the rest of Africa.
SAVE-P’s proposal based on the Nuffield 200 ventilator
As part of the NVP, the government has requested proposals to supply 1000 CPAP devices in May and a further 10 000 in June. The South African Ventilator Emergency Project (SAVE-P, a not for profit company) is one of the teams that answered the call, submitting a proposal to produce a CPAP device based on the Penlon Nuffield 200 ventilator system.
The project team is a multidisciplinary mix of people from the medical, legal engineering, manufacturing and quality management industries, as well as international bodies such as the European Union Chamber of Commerce and Industry of Southern Africa. Marc Van Pelt, vice chairman of the EU Chamber and managing director of Pepperl+Fuchs in South Africa, is a member of the Finance and Fundraising committee. At the recent Policy Dialogue webinar covering “South African SMMEs in the regional and international context: finding solutions to the Covid-19 crisis”, Van Pelt, speaking in his EU Chamber capacity, outlined the SAVE-P project to delegates.
“With our borders closed under the current lockdown regulations, we need to look after our own requirements,” he explained. “This has opened up an opportunity for South Africa to ramp-up the local manufacture and supply of medical equipment and CPAP devices in particular.
Recognising that through lockdown the government had bought the healthcare system the time it needed to prepare, the SAVE-P team set about looking for a ventilator design that could be locally manufactured using the existing skills base and without any reliance on imported components. The mechanical/pneumatic Nuffield 200 ventilator fit the bill.
“We settled on the Nuffield system because it is robust and easy to use, ideal for African conditions,” outlined Van Pelt. “It’s tried and tested over 35 years and no longer covered by valid patents. Most importantly, it’s based on technology we could produce locally.”
To fulfil the NVP’s requirements, the SAVE-P team reverse engineered the Nuffield 200 into a subassembly of its components that could be used to produce a CPAP system.
In terms of local production, the Society for Automation, Instrumentation, Measurement and Control (SAIMC) has added its weight to the project. At this stage, it is involved in an advisory capacity through CEO Johan Maartens, who is assisting project manager, Elizabeth Wolmarans, to identify industry experts willing to assist with the automation and control aspects of the design.
“To date, team members have donated their time to the project on a pro bono basis, approximately R800 000 has been spent on R&D; so far,” Van Pelt explained to the audience. “Now, we need to secure R5 million in order to adequately capitalise the SAVE-P non-profit organisation. Should we be chosen as the NVP’s preferred supplier, an additional R20 m to R50 m will be required to cover working capital requirements, depending on government requirements. Primarily, this will be used to procure the necessary parts from the various sub-component suppliers.”
As a delegate to this policy dialogue webinar myself, I was struck by the passion of everyone working behind the scenes to try and identify the opportunities created by the potentially disastrous Covid-19 threat. South Africa desperately needs its SMMEs to survive and prosper in what is going to be a very different post coronavirus world. My impression is that we have all the courage and determination needed to win this fight. What we need now though is for the engineers, technicians and project managers of our country to show the world what we’re really made of. The team at SA Instrumentation and Control salutes you.
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