Unexplored, yet promising

Bangladesh experienced a crisis of supply of Pulse Oximeter, a device for monitoring a person’s oxygen saturation and pulse rate, soon after Covid-19 struck the country due to international supply chain disruption.

Bangladesh produces only injection devices and some protective gears and remains import-reliant on all sorts of general and hi-tech medical devices.

Importers, suppliers, manufacturers, the authorities concerned and consumers said pandemic worked as a catalyst for change of views that forced them to realize the need for local production of medical devices.

After the development of pharmaceutical companies, the country has been able to produce veterinary medicines. Now, the Covid-19 has opened up the eyes of manufacturers and government.

Manufacturers hoped that they would soon be able to meet the local demand for those medical devices.

The Drug Administration, however, said they didn’t see any hope for the country to be self-reliant on manufacturing those devices soon and it would take time and the country has to depend on import for years.

Medical device market and current situation

According to statista.com the projected volume of global medical device market is US$455.10 billion in 2022. Revenue is expected to show an annual growth rate (CAGR 2022-2027) of 5.95 per cent, resulting in a market volume of US$768.80 billion by 2027.

Only approximately 5-7 per cent of the demands are met by local production, Bangladesh Investment Development Authority (BIDA) said on its website. It could amount to $ 55-60 million.

According to the estimation of the Bangladesh Association for Medical Devices and Surgical Instruments Manufacturer and Exporter, there is an annual demand for medical devices worth Tk10,000 crore which has been growing at around 20 per cent in recent years.

Only 30,000 types of a total of 2 million varieties of medical devices found on the world market are in demand in this country.

Among the locally produced items, majority are consumables/disposable. Aside from consumables, Bangladesh also produces orthopedic products, surgical sterilizers, hospital furniture, home care devices, electrocardiogram and other small instruments, albeit on a small scale.

JMI, ANC, Getwell, Opsonin, Incepta Hygiene and Hospicare, Techno Drugs, Bi-beat and Promixco are some of the companies that initiated medical device manufacturing.

Physicians in the country are using a lot of hi-tech medical devices for cardiac troubles, cancer treatment and kidney dialysis round the year. The items are mostly imported.

Some of the imported high tech devices widely used in hospitals and clinics in the country include cardiac stent, cardiac pacemaker, artificial heart valve, digital blood pressure monitors and devices, hearing aid devices, blood bag, urine bags, dialyzer tube, medical ventilators, digital thermometer and X-ray and ultrasound machines.

Existing problems

According to the manufacturers, lack of adequate data bank on medical devices, unauthorized inflow of medical devices including misdeclaration decreasing prices of imported devices, inadequate regulatory guidelines and control of devices at questionable price and qualities and finally absence of well-defined government patronizing mechanism are the major causes of not being self-reliant till now.

Joint Secretary of Bangladesh Medical Instrument and Hospital Equipment Dealers and Manufacturers Association Md Jasim Uddin said importers themselves do not have the capability to set up manufacturing plants of medical devices while consumers are skeptical of the quality of products made here.

SM Shafiuzzaman, Managing Director of Hudson Pharmaceuticals and Secretary General of the Bangladesh Association of Pharmaceutical Industries said the government was not very cooperative to encourage entrepreneurs.

As pandemic has unearthed the real scenarios, Prime Minister Sheikh Hasina gave emphasize on the industry. And so, some companies from pharmaceutical industry are getting interested in the medical device industry, he added.

Abhijit Paul, Executive Director (ED) of JMI Syringes and Medical Devices (JSMD), said medical devices as a whole have a very big market in the country.

The scale of single product market is also a major discouraging factor for investors. Machinery requires bigger investment but benefit comes late compared to other conventional industries, he added.

Besides, unauthorized inflow of medical devices and importing the devices with misdeclaration are another blow for the local production. It decreased the price of those devices, the JSMD ED said.

Data from National Board of Revenue (NBR) showed that although the country reportedly had a medical market of Tk10, 000 crore the country imported medical equipment of Tk6, 722.65 crore in 2020-21 fiscal year which was Tk5,059.87 crore in 2019-20 FY and Tk5,319.00 crore in 2018-19 fiscal year while Tk5,103.14 crore in 2017-18 and Tk4,120.07 crore in 20116-17 FY.

MD of Hudson Pharmaceuticals SM Shafiuzzaman said it would be tough for a few companies to cater to all the demands. “We need a huge investment to fulfill the gaps in this sector,” he added.

Kamruzzaman Kamal, Director (Marketing) of PRAN-RFL Group, pointed out that due to lack of backward linkage many investors restrained them from investing in this sector.

The local manufacturers know very little about comparative technology needed for investing in the sector.

Importing raw materials for the production is also another drawback. The government should ease the official process and patronize the manufacturers providing access to the market, SM Shafiuzzaman said.

JSMD ED Abhijit Paul said it would be more sustainable if the investment came with a tie with international suppliers to grab the already established global market.

Under-invoicing of imported devices during importation have to be monitored and ensured, he said.

Medical Devices manufacturing guideline should be developed and the authority and or DGDA should have a technical affiliation with international tools in this regard. DGDA should come forward to resolve this regulatory barrier, Mr Paul observed.

The current situation indicates that becoming self-reliant with medical devices is not in his sight but with proper patronizing and encouraging environment it can be achieved, observed Director (admin) of Directorate General of Drug Administration Ayub Hossain.

He said as part of encouraging the manufacturer, they are giving limited permission (only for the required devices) for the import of the medical devices.

“We will soon adopt strategy to facilitate these entrepreneurs to keep our money in the country and also to save valuable money of the people.”