South Africa will work if business makes it work. This was the point of departure for the opening address to the SAMED 2022 Conference by Business Unity SA (BUSA) president Professor Bonang Mohale. His forceful interpretation of the conference theme – “Purpose driven medtech: partnering to reform healthcare” – was delivered to an audience of 200 SAMED members and stakeholder representatives. SAMED’s flagship annual event in September addressed a rich agenda that encompassed all aspects of medtech, medical devices and IVDs, making the discussions relevant to organisations of all sizes and portfolios. Expert speakers, delegates and SAMED-YES youth beneficiaries deliberated on regulatory and market access topics, ethics, governance and sustainability, diversity, inclusion and the buzz word, localisation. Healthcare quality and the purpose and value of medtech to delivering care and developing a sustainable youth and country provided the broad context.

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Prof Bonang Mohale traced South Africa’s decline from an economy that had delivered 43 consecutive quarters of GDP growth under Presidents Mandela and Mbeki – peaking at a rate of 5.1% in 2007 – to a nation broken by state capture.

He blamed the nation’s current state on corruption, a lack of political will among the country’s leaders, and the state’s sheer incapability. A measure of the last was the many lives that could have been saved in the 2022 KwaZulu-Natal floods if government had merely cleared the stormwater drains.

Then Prof Mohale turned his gaze on the private sector.

He not only emphasised that public sector corruption needed private sector collaborators but remarked on the passiveness of business in the face of outrageous tender processes at Transnet and Eskom. Nobody “batted an eyelid”, he commented, as the exorbitant cost of Transnet’s train carriage contract grew . . . and grew to R54bn. The Zondo Commission had shown that business had a lot to answer for in aiding and abetting state capture. And now the sector faced a challenge in terms of regaining its voice and its integrity.

Prof Mohale shared priorities for action that the business sector had put to President Cyril Ramaphosa, a list headed by the burning issue of youth unemployment. Then he reminded conference delegates that they, too, needed to step up and take responsibility.

Companies don’t need government’s permission to pay SMMEs promptly, to address issues of gender in a country where women are paid 75% of the male rate for equal work, to advance transformation and achieve diversity and inclusion, he said.

During question time, Prof Mohale was asked about the future of National Health Insurance and responded: “Government in 15 years couldn’t fix rolling blackouts – what are the chances of it achieving NHI? We support NHI, but we must run it as the private sector because only we understand project management . . . they (government) just don’t have the skills.”

Regarding youth unemployment, a panel of youth development organisations active in the health and social care sector, identified health as a “sunrise economy” for job creation. Health businesses including medtech companies are creating jobs for young people and funding community-based development.

Discussions recognised the special value young people bring to organisations, like enthusiasm and solution-orientated creativity. They fulfil vital roles – reduce patient waiting times at clinics, implement preventative care, deliver drugs to patients, work in medtech companies and support other healthcare professionals.

The conference’s localisation discussion focused on the development and manufacturing of medical technology. Panel members included Nimrod Zalk (the dtic), Dr Michelle Mulder (SA Medical Research Council), Colin Leshou (Gauteng Small Enterprise Development Agency), and Jeremy Wallis (CSIR). The discussion indicated:

  • Various publicly funded mechanisms support local manufacturing without a focus on medtech.
  • Support exists both for medtech innovation and the production of routine medical devices.
  • The path to innovation is not simple and regulatory aspects pose obstacles.
  • The COVID-19 experience was more than a medtech wake-up call. It led to important new capacity – such as the mRNA Hub for vaccines – and growing enthusiasm for localisation.

Mr Leshou commented that the lack of SEDA funding for small medtech business might be a case of “a reluctance to fund what you do not understand”. He expressed a desire to collaborate more closely with SAMED to further develop SEDA’s support for small medtech businesses.

Sandra Ligia González, Executive Secretary for the Inter-American Coalition for Regulatory Convergence: Medical Technology Sector led the discussion on how harmonisation of regulatory requirements will reduce hurdles and costs for advancing access to medtech – a sentiment echoed by Dr Dimakatso Mathibe, SAHPRA’s Senior Manager: Medical Devices.

Health technology assessments got a fair share of the limelight during a session that featured Wesley Solomon, NHI Information System Specialist at the Department of Health. Speakers and delegates acknowledged that HTAs play an important role in evaluating the suitability and feasibility of medical technologies but that this must be done under the auspices of an appropriate and sustainable HTA agency for South Africa. Wesley encouraged collaboration with SAMED on developing the HTA framework for medtech.