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The world known to us before the Covid pandemic has now drastically altered. In a post-pandemic era characterized by rapid technological advancements and a globalized economy, international collaborations play a pivotal role in addressing complex challenges. On July 15, 2020, leaders convened the 15th India-European Union Summit. To coordinate efforts and fortify the India-EU Strategic Partnership over the ensuing five years, they approved this "India-EU Strategic Partnership: A Roadmap to 2025" as a shared roadmap. The Europe India Centre for Business Industry (EICBI) is all set to hold the Europe India Leaders Conference 2024 at the European Parliament in Brussels on the 6th of March. The theme of the Medical Equipment sector in the EU-India corridor will be thoroughly explored. The EU-India Leaders Conference is EICBI's 5th major engagement at the European Parliament and the 30th major conference in Europe. The conference will have a panel discussion on companies that have successfully collaborated or have potential collaborations on the medical equipment projects between the EU and India, allowing the panelists to share their insights and engage in different discourses about medical equipment industry, collaboration opportunities and financing.
The European Union and the Republic of India, two "unions of diversity" that share the same values of democracy, the rule of law, and human rights, are equally convinced of the need to maintain effective multilateralism and the rules-based international order in a complex international setting. (MEA, 2020).
Among various initiatives, the Europe India Centre for Business and Industry (EICBI) is one such independent, nonpartisan organization which fosters business opportunities between India and the UK/EU in a number of sectors. In order to inform Indian businesses about the business opportunities in the UK and EU and vice versa, the Europe India Centre for Business and Industry was established. The organization's goal is to increase investment and trade between India and the European Union/UK and to give businesses and entrepreneurs a platform to join the India-EU/UK trade community. The organization, led by seasoned professionals, also offers all the foundational assistance needed for businesses to grow and succeed in the EU, UK, and India.
Among the various sectors demanding collaborative efforts, healthcare remains not only crucial to EICBI’s goals, but also stands out as a critical domain affecting the well-being of millions. The collaboration between the European Union (EU) and India in the medical equipment sector represents a significant step toward enhancing healthcare infrastructure, fostering innovation, and ensuring better patient outcomes for all at this critical juncture. In the Union Budget 2022-23, Rs. 86,200 crore (US$ 11.3 billion) was allocated as a budget for the pharmaceutical and healthcare sector. The ‘Make in India’ initiative provides an opportunity to create a ‘step change’ in Indian healthcare, especially in the medical device industry.
Historical Context:
The collaboration between the European Union and India in the medical equipment sector has its roots in historical ties, shared values, and mutual interests. Companies such as Siemens and Philips in India for the design, production, and testing of medical equipment, as a global delivery centre, and as a market for such products. According to the respondents, the entry of large multinationals into India in the medical devices segment as well as the emergence of world-class corporate hospitals in India, where such tests can be carried out are likely to drive these outsourcing possibilities. During Free Trade Agreement (FTA) Negotiations, to strengthen economic and trade relations, discussions on a free trade agreement between the EU and India began in 2007. However, disagreements over a range of topics, such as tariff reductions and market access, made progress sluggish. But lately, it has revived into a highly dynamic one. India-EU relationship encompasses almost every aspect, including trade and investment, politics, economics, security, the environment, innovation and research, education, and culture, all of which are supported by close interpersonal relationships. When it comes to goods, the EU is India’s biggest trading partner, with over $100 billion in trade. As India has a sizable service industry worth roughly $40 billion, the European Union is a significant investor in India, having made over 91 billion dollars in total. Another significant source of innovation and technology is the EU.
Over the years, both entities have recognized the importance of leveraging each other's strengths to address common challenges in healthcare.
Increased ties with a nation like India, which has a burgeoning private healthcare sector, the emergence of world-class corporate hospitals, a sizable pool of medical manpower, and a young population across a range of segments, could be beneficial to the EU member states with their aging populations, rising costs and overburdened public healthcare systems complements India's dynamic healthcare landscape, offering a unique opportunity for synergistic growth.
Union Minister, Mansukh Mandaviya said the market size of the Indian medical devices sector is likely to reach USD 50 billion in the coming years from the current USD 11 billion. He further emphasized that to make healthcare affordable, the government is targeting to increase the share of generic medicines to 50-60 percent from the current level of 14 percent alongside localization of medical devices.
India is the 4th largest market for medical devices in Asia, among the top 20 markets globally. The size of the Indian medical devices market is estimated at $11 Bn, and is expected to grow to $50 Bn by 2025 the sector has been growing steadily at a CAGR of 15% over the last 3 years. The medical devices sector in India is projected to reach US$ 50 billion by 2030. (Medical Devices Industry in India – IBEF, n.d.)
The advent of AI: “Artificial Intelligence (AI) has the potential to transform healthcare in various ways. It can turn large amounts of patient data into actionable information, improve public health surveillance, accelerate health responses, and produce leaner, faster, and more targeted research and development".
Be it in the effective diagnosis and management of Chronic Obstructive Pulmonary Disease Diagnosis (COPD), Diabetic retinopathy screening, Cancer Screening, and TB Diagnosis. AI and its uses have shown to be beneficial in addressing India's COVID-19 crisis. This new technology has proven useful in monitoring the COVID-19 pandemic, screening COVID-19 cases, containing the virus, tracing contacts, enforcing social distancing and quarantines, tracking suspects, treating and remotely monitoring COVID-19 patients, developing vaccines and drugs, and more. India saw the largest increase in the use of artificial intelligence (AI) during COVID-19 times, according to a global study done by PwC India (Press Trust of India 2020a). Approximately 73% of pharmaceutical and healthcare organizations used AI in the past year, according to the survey.
Thus, India and the European Union both have the potential to develop joint certification programs for AI-based medical solutions to establish quality standards and ensure compliance with ethical and regulatory requirements. Additionally, creates a framework for mutual recognition of certifications to facilitate the global deployment of AI-driven healthcare solutions in the medical industry.
Telemedicine and its Future Prospects:
Telemedicine is the delivery of healthcare services from a distance, by use of information and communication technology. The term “Telemedicine” coined in the 1970s means “Healing at a distance” literally. There were no statutory regulations until 2019 as India lacked official guidelines for telemedicine. For the first time, the government of India released telemedicine practice guidelines for Registered Medical Practitioners on March 25, 2020, amid the COVID-19 outbreak. The coronavirus disease of 2019 (COVID-19) has significantly increased the use of telemedicine in India. Amwell, Doctor on Demand, MDlive, and Babylon are just a few of the many electronic applications (e-applications) related to healthcare consultations that have flourished worldwide as a result of the need for risk-free contactless communications between a doctor and patient.
A set of interviews conducted with respondents in the sector of medicine from India and the EU both revealed that telemedicine, particularly teleradiology, is one of the most promising fields for developing bilateral ties. The main drivers of this trend are the lack of qualified workers and the introduction of e-health initiatives in several EU nations. Since EU authorities do not consider India to be a data-secure nation, Indian companies do not currently offer telemedicine to the EU market. For these reasons, they forbid the outsourcing of patient data to India for telemedicine. However, conversations with executives and practitioners at two of the top Indian telemedicine organizations showed that these limitations on data protection are anticipated to be lifted eventually by EU authorities as more people become aware of Indian providers, their capabilities, and the associated costs. It becomes clear how much cheaper outsourcing telemedicine is. Secondary sources support this opinion stating that several Trade Commissions from EU member states have recently expressed interest in outsourcing telemedicine work to India.
Besides, India is a big country in terms of area, and many of its towns and villages are situated in isolated rural areas. The rural areas are home to about 70% of India's population. Even though most patients come from rural areas, 75% of qualified consulting doctors work in urban centers, 23% in semi-urban areas, and only 2% in rural areas, according to a recent survey by the Indian Medical Society. There are primary healthcare providers with limited experience available. Furthermore, it takes longer to get to urban healthcare facilities. Because of this, there is a need for these services, which everyone should have access to. These issues may be resolved by telemedicine, which could also save patients money on treatment-related expenses like travel and other expenses. Hence there is an insufficient healthcare facilities in remote and hard-to-reach places. Difficulties retaining physicians in remote areas where they are essential for patient care and public health education. Additionally, telemedicine can boost productivity by enabling medical professionals to treat more patients in less time.
Furthermore, the European Union (EU) and India are collaborating to tackle shared public health issues, including antimicrobial resistance (AMR) and both communicable and non-communicable diseases. Health and food security are paramount global concerns, and the rising threat of Antimicrobial Resistance (AMR) poses a significant challenge. Recognizing the urgency of this issue, India and the European Union (EU) have embarked on a collaborative journey aimed at addressing AMR comprehensively as part of the 2025 roadmap. Opportunities have arisen to strengthen bilateral cooperation on antimicrobial resistance (AMR) in veterinary medicine, animal health, and the environment through several co-organized events. Simultaneously, at the EU-India Leaders' Meeting on May 8, 2021, the partners emphasized their shared goal of working together to enhance global health security and better prepare for and respond to health emergencies worldwide, including through strengthening and reforming the WHO according to the European Parliament.
Key initiatives in the EU-India AMR Partnership:
Establishing systems for exchanging information on AMR patterns will allow for real-time monitoring and the early identification of new threats. This is known as data sharing and surveillance networks.
Regulatory Harmonization: To ensure responsible use, efforts are being made to align the regulatory frameworks for the use of antimicrobials in agriculture and healthcare.
Research Association: Establishing cooperative research consortia to combine resources and knowledge in the creation of novel antibiotics and diagnostic instruments.
Joint training programs are being implemented to improve the abilities of veterinarians, researchers, and healthcare professionals who are involved in the management of antimicrobial resistance.
Hence, governments from different nations are supporting innovation in a variety of ways, such as by funding innovation parks, supporting networking and branding, supporting data interfaces, supporting the medical industry, and promoting national industries through international investment, skill development, strengthening factor conditions, lowering prices, supporting start-ups, and regulatory support for both the national industry and all supporting industries. These countries include Brazil, China, France, Germany, Italy, Japan, Malaysia, Norway, Singapore, South Korea, Switzerland, and the United States of America. However, removing the current limitations on sending clinical data and patient information to India for services like teleradiology, teleconsulting, tele-imaging, and medical coding is a crucial point to bring up in the negotiations. The Indian government needs to advocate with concerned EU governments to allow this kind of outsourcing outside of the EU. Both can work together to not just harmonize policies related to AI in healthcare, privacy, and data security but also e-healthcare ensuring that regulations are aligned and support cross-border collaborations.
This year, concentrating on the automotive and medical equipment sectors in the EU-India corridor, the fifth summit of the EU-India Leaders Conference is scheduled for the European Parliament in Brussels on 6thMarch, 2024. Based on their ten years of experience in promoting trade relations between the UK and India or the EU and India, they are optimistic about the affluence of these relations.
(Ira Bikram is a research fellow at Europe India Centre for Business and Industry.)
References:
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