When the lockdown because of the Covid-19 pandemic was announced, one of the biggest concerns was the availability of ventilators, and because of this many experts felt that India would be one of the worst-affected countries, Union minister Piyush Goyal had said earlier this week. However, “using the lockdown phase of about 10 weeks or so, this country has demonstrated… and I must thank all of India’s industry for coming forward proactively to make India self-sufficient in a variety of ways… to make India ready to fight this pandemic,” the Union minister for railways, and commerce & industry said while delivering the keynote address at the 184th annual general meeting of the Bombay Chamber of Commerce and Industry, one of the oldest industry bodies in the country.

An empowered group of secretaries’ (EGoS) panel—tasked with the responsibility of ensuring availability and production of essential medical equipment along with their procurement, import and distribution—had estimated that the country would need 75,000 ventilators by June, it was reported. And in three months, India had manufactured 60,000 ventilators.

A recent Invest India report, “Helping India Breathe: Ventilator Manufacturing During Covid-19” says that the Covid-19 crisis has “triggered a wave of design, manufacturing, and innovation in India. In ventilators, for instance, almost a whole new domestic industry has been created in these times of turmoil”. Indian industry, including big manufacturers and startups, collaborated swiftly and joined hands with engineering and technological institutes from across the country to boost production”. The national investment promotion and facilitation agency says this is an indication of the country’s manufacturing strength. “The increased production allowed India to manufacture 60,000 ventilators indigenously, despite a 21-day lockdown and a ban on the import of ventilators. The machines built were not only lifesaving but also priced very competitively to ensure that the largest number of people could benefit from them,” the report says.

In March, when the lockdown happened, government hospitals had an estimated 8,432 ventilators; India traditionally imported ventilators primarily from Europe and China, the report says. But by May, there were 19,398 ventilators countrywide. How did this happen?

Not just manufacturing prowess, ramping up ventilator production is also a fascinating story of collaboration and Indian innovation at work, the report elucidates. In February, there were only eight ventilator manufacturers and 2,500 ventilators were manufactured that month, which rose to 5,500-5,750 in March. In March, EGoS placed orders for 60,884 ventilators with HLL Lifecare Limited, a public sector undertaking under the aegis of the ministry of health and family welfare, the central procurement agency during the Covid-19 crisis. Of these, 59,884 were placed with domestic manufacturers, and the balance were to be imported.

Accordingly, many major domestic players were given orders to manufacture ventilators. These included Bharat Electronics Limited (in collaboration with Delhi-based Skanray Technologies) who had to manufacture 30,000 ventilators; Noida-based AgVa Healthcare (in collaboration with Maruti Suzuki Limited) who were given an order for 10,000 ventilators; and the Andhra Pradesh MedTech Zone (AMTZ), who were to make 13,500 ventilators.

Since then, over a dozen entities have boosted the ventilator manufacturing capacity of India. These include large-scale automobile and Information Technology (IT) companies as well as universities and independent startups, and even These ventilators are mostly low-cost and affordable that complement more expensive ventilators available in fewer numbers. The report also talks about National Aeronautics and Space Administration (NASA)-licensed firms replicating the Ventilator Intervention Technology Accessible Locally (VITAL) prototype developed by NASA’s Jet Propulsion Laboratory. Three Indian companies were selected and licenced to manufacture NASA’s coronavirus ventilators—Alpha Design Technologies Pvt Ltd, Bharat Forge Ltd, and Medha Servo Drives Pvt Ltd.

Collaboration

Let us talk about Skanray. Industrialist Anand Mahindra had said that Mahindra & Mahindra (M&M) would start making ventilators. To make a full-fledged mechanical ventilator for use in intensive care units (ICU) for Covid-19 patients, M&M approached Skanray, for help to designing “a simpler version of the ventilator”. The focus was on “incorporating easily available components, and easy to use controls for paramedics with remote guidance from doctors”. To reduce imports and development time, M&M picked automotive components from its vehicles. “The heart of the ventilator which controls all the functions was borrowed from the Marazzo”, a compact multi-purpose vehicle, as were the control knobs. The Jawa motorcycle’s classic round instrument cluster was used to display parameters like volume of ventilated gases, FiO2 percentage and mandatory error messages, the report says, while the power backup battery was taken from the Treo, Mahindra’s e-rickshaw. And thanks to assistance from Mahindra Logistics, the first working prototype was made within seven days.

According to Maruti Suzuki chairman R.C. Bhargava, the government had been approached the company to make ventilators. Since the auto major did not have the technology and know-how, it partnered with the two-year-old AgVa Healthcare. Maruti used its resources and know-how to rapidly scale up production, Bhargava had told Fortune India earlier. State-owned Bharat Heavy Electricals Limited provided electronic chips for the ventilators. And HP partnered with Redington 3D in India, to produce 120,000 ventilator parts for AgVa Healthcare. “As these components have complex designs and fine tolerance, it would have taken four to five months to manufacture these quantities using the conventional process. With HP 3D printing technology, these parts were printed in just 24 days,” the report said.

Auto major Hyundai Motor India also collaborated with Air Liquide Medical Systems, a leading French global ventilator manufacturer based in Chennai, which was one of the few global companies with a manufacturing facility for ventilators in India. Hyundai brought to the table its large-scale manufacturing ability. To de-bottleneck the supply chain, Hyundai identified “alternate vendors capable of meeting volume and timeline requirements evaluated the constraints faced by existing vendors to help them ramp up production and ensured timely placement of domestic and overseas orders” report says. Hyundai’s manufacturing engineering members took stock of the production system, layouts, and employee capabilities “with an objective to increase the production volume substantially to meet the current requirement”.

From auto majors to students, everyone lent a helping hand. The report mentions Zulqarnain, a first-year student of Industrial Design Centre at IIT Bombay, who was visiting his hometown in Kashmir when the lockdown. When Zulqarnain realised that there were only 97 ventilators in the Valley, he teamed up with his friends from Islamic University for Science and Technology (IUST), and NIT Srinagar. With assistance from Design Innovation Centre (DIC) at IUST in Pulwama, they developed Ruhdaar a low-cost ventilator using locally available materials. Zulqarnain shares that the prototype cost only ₹10,000. The report also talks about the Sree Chitra Tirunal Institute for Medical Sciences and Technology, which tied up with Wipro 3D in Bengaluru to jointly build a prototype of an emergency ventilator system based on artificial manual breathing unit (AMBU). Then there is the team from IIT Roorkee which collaborated with another team from AIIMS, Rishikesh to create the low-cost, portable Prana-Vayu ventilator, which does not require compressed air.

Innovation

For Dynamatic Technologies, the mission was to develop a low-cost and scalable solution that could run directly

from an oxygen tank”. The company’s engineers along with doctors and scientists developed the concept of a mechanical ventilator which does not need electricity to run and would work “directly off the pressure from an oxygen cylinder,” the report says. The team developed PranaVent, made 3D printed prototypes and then developed tooling “for mass production with an entire supply-chain ecosystem”. “This product is the result of a confluence of engineering, medical science and entrepreneurship,” the report says, adding that the company is ready to produce 42,000 mechanical products per month.

The report also talks about the contribution of startups and their innovation. Ethereal Machines came up with Amaya, a ventilator splitter, which could help administer breathing to two patients simultaneously. Nocca Robotics, founded by two IIT-Kanpur graduates in 2017 and incubated at the Startup Incubation and

Innovation Centre, IIT Kanpur, designed and developed a fully functional invasive ventilator, the NOCCA V310 ICU ventilator. Then there is Biodesign Innovation Labs which came up with RespirAID, an emergency and transport ventilator that provides intermittent positive pressure ventilation to patients with respiratory illnesses, and to those who need immediate stabilisation with sedation and intubation. It has collaborated with medical equipment manufacturers to mass-produce the product for India and abroad.

Not just startups, the Indian Railways, too, developed a low-cost ventilator at its Kapurthala Rail Coach Factory, called Jeevan, the report says. Then there is the Council of Scientific and Industrial Research and its constituent lab National Aerospace Laboratories in Bengaluru, which have developed a non-invasive Bilevel Positive Airway Pressure (BiPAP) ventilator called SwasthVayu, in just 36 days.

“The dynamism depicted in the case studies presented in this report not only represents India’s entrepreneurial zeal but also sets the path to the country becoming a global exporter of ventilators,” the report concludes.

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