Empowering healthcare innovation in LMICs through local research and prefabricated construction

In the past several decades, the world of healthcare has borne witness to countless innovations in drugs, vaccines, therapeutic modalities, medical technology, and healthcare delivery. From the eradication of smallpox and the novel use of mRNA for vaccine delivery to remote monitoring devices and telemedicine for remote medical consultations, the health sector has come a long, long way in improving people’s health outcomes and overall quality of life.

We’ve achieved so many radical transformations in how we treat diseases and manage health, but this is far from the end of the road. There are misconceptions that the future of pharmaceutical research won’t be marked by too many more blockbuster drugs – can anything new transform the health landscape like the smallpox vaccine or immunotherapies did? The short answer is yes.

The specialty drug market is thriving. Since 2021, the US FDA has approved at least 80 specialty drugs and innovation doesn’t seem to be slowing down. Nephron Research even predicts that the specialty pharmacy market could touch $375 billion by 2025.

As healthcare innovations take the world by storm, low- and middle-income countries (LMICs) mustn’t get left behind or forgotten. The best way to ensure this is to empower LMICs to innovate for their populations. This involves the related actions of one, promoting local research dedicated to addressing local epidemiological concerns and two, developing supporting infrastructure to successfully work on research priorities.

Bringing technological advancements to people through research and innovation

Innovation can be defined in many different ways. Some have described it as the process of doing things differently in economic life. Others use the term to refer to the industrial or commercial application of something novel. Yet another definition of innovation is the introduction of a new element or a new combination of old elements in solving a problem.

Today, the word innovation is often used to refer to original technological changes which make an act or a process more effective or efficient. Rather than just referring to the technological upgrade, however, innovation also encompasses the commercialisation of the product or service.

Research – be it exploratory lab experiments, clinical trials, or any other such exercise – is a cornerstone of the overall innovation process. It helps seed ideas, validate them, and convert basic scientific findings into useful inventions which can be commercialised. Thus, close connections between research communities, industry, policymakers, and end-users (patients and healthcare providers in the case of the health sector) can help foster thriving, effective innovation ecosystems.

Pharma and medical technology, or medtech, involves applying science to develop solutions to health problems in an attempt to prevent, delay, treat, or manage them. Today, innovations in these domains are extremely diverse; they underlie the repertoire of highly specialised care which makes modern medicine as powerful as it is. They range from pills to cell therapies, from simple devices to complex equipment that brings together multiple technologies.

Since they are meant to enhance human health, health innovations need to meet extremely high standards and regulations. This has created a need in the health sector for highly customised tools and models to navigate the landscapes of research and innovation. All of these elements ultimately come together to improve people’s health and lives and streamline existing systems of care.

Lessons from India in promoting health sector research

In 2023, India introduced the Promotion of Research and Innovation in Pharmaceuticals and Medical Devices (PRIP) scheme. Designed to promote R&D in high-priority areas of the pharma and medtech sectors, the scheme includes two components.

Component A is targeted towards strengthening research infrastructure. Under this, the scheme will support the establishment of 7 centres of excellence (CoEs) in the National Institutes of Pharmaceutical Education and Research (NIPERs). Such research would cover the areas of anti-viral and anti-bacterial drug discovery and development, bulk drugs, medical devices, novel drug delivery mechanisms, flow chemistry and continuous manufacturing, phytopharmaceuticals, and biological therapeutics.

Component B will target specific projects in priority areas like new chemical/biological entities, precision medicine, complex generics and biosimilars, robotic surgical devices, AI/ML-based devices, orphan drugs, and medicines to fight drug-resistant pathogens. Under this component, the scheme will provide funding support to researchers at different stages of the innovation cycle.

LMICs keen on developing healthcare innovation within their borders could use this Indian example to invest in their research infrastructure.

The healthcare innovation lifecycle

There are several models to guide and support innovation in healthcare, but the most common one is the CIMIT model, developed by the Consortia for Improving Medicine with Innovation and Technology. Under this model, the Healthcare Innovation Cycle outlines 10 steps – clinical need, idea, proof of concept, proof of feasibility, proof of value, initial clinical trials, validation of the solution, approval and launch, clinical use, and finally, the innovation becoming a standard of care.

Clinical trials are an important step in this innovation cycle, but the world over, there are some gaps and challenges in clinical trial infrastructure. Ideally, clinical trial infrastructure would be consistent and reliable so that it can be used beyond just a single trial to improve the efficiency of the entire innovation ecosystem.

Challenges in clinical trials vary based on geography and the size and sophistication of the research operation. Some challenges include extremely high costs, difficulties in enrollment, inefficiencies in implementation, and more. In LMICs and under-resourced health systems, there are additional gaps in terms of physical infrastructure like laboratories, testing facilities, research sites, manufacturing setups, and more.

Local research and prefabricated setups: Key ingredients in healthcare innovation in LMICs

Researchers have noted that clinical practice guidelines and approvals of treatments, medical devices, and other modalities sometimes lack robust bases of evidence. This is because, often, these decisions are made based on data from other countries, different population mixes, varied clinical approaches, or without coordination with the target patients and their healthcare providers. Essentially, research from one context cannot be cut and pasted to develop innovations in another context.

The most effective pharma and medtech research participates in local or regional ecosystems. Such ecosystems bring together diverse stakeholders within the health sector and allow for an end-to-end perspective of the problems that need innovation.

In such a scenario, it is vital for LMICs to localise research and innovation in pharma and medtech. Not only will this help researchers to develop relevant, targeted and affordable healthcare solutions but it will also reduce import dependence and boost local economies through job creation.

Building physical infrastructure is an essential part of developing local research and innovation capabilities. This includes building laboratories, diagnostic facilities, drug compounding setups, manufacturing setups, and more.

You can’t build such infrastructure overnight, but you can accelerate the pace significantly by relying on prefabricated modular construction. The modular construction approach is fast, cost-effective, and adaptable to local health needs and research priorities. Labs, testing facilities, and manufacturing plants can be up and running in a fraction of the time taken by traditional construction. As a knock-on effect, they can speed up the development of new drugs and medical technologies, fostering an ecosystem conducive to innovation. Prefabricated structures for pharma and medtech applications form important stepping stones towards enhanced healthcare in LMICs.

To put it succinctly, innovation thrives in environments where researchers have the resources and infrastructural support that they need. Innovation is a non-negotiable in LMICs, which need tailored pharma and medical interventions to address their unique epidemiological landscapes. Innovation can help multinational and homegrown companies in LMICs to not only seize a substantial share of industry revenue but also tap into new opportunities.

Health sector innovation in LMICs can boost pharmaceutical security and accessibility, incentivise the development of a sophisticated R&D workforce, and ameliorate the population’s disease burden. Essentially, innovation supported by local research and prefabricated construction can be the ticket for LMICs to develop high-value, high-volume pharma and medtech industries in the future.