Abstract 

Background: The development of affordable healthcare technologies is hindered by 'valleys of death' in the innovation cycle, impeding progression from concept to clinical application. This challenge is particularly acute in low- and middle-income countries (LMICs), where context-specific solutions are crucial.

Objective: This study aims to explore strategies for navigating innovation valleys in medical device development, with a focus on creating sustainable and affordable healthcare solutions for LMICs.

Methods: A mixed-methods approach was employed, combining case studies of successful frugal innovations, stakeholder interviews, and analysis of innovation ecosystems. The Frugal Biodesign Process, developed at the University of Cape Town, served as a framework for analysis.

Results: Key findings include: (1) Context-specific design and local manufacturing significantly reduce costs while maintaining functionality, as demonstrated in the development of a low-cost prosthetic hand. (2) Collaboration between academia, industry, and government is crucial for bridging innovation valleys. The UCT MedTech adopts this approach, facilitating the development of a novel tuberculosis diagnosis device. (3) Risk-averse climates and dependence on imported technologies remain significant barriers to innovation in LMICs.

Conclusion: Navigating medical device innovation valleys requires a systemic approach that prioritises locally-oriented solutions. This strategy not only advances affordable healthcare but also stimulates local economies and strengthens healthcare infrastructure. The ongoing development of a frugal mechanical ventilator illustrates the potential of this approach to yield cost-effective, context-appropriate solutions.

Implications: This research underscores the need for targeted interventions throughout the innovation lifecycle to support the development and adoption of appropriate health technologies in LMICs
 

Biography 

Professor Sudesh Sivarasu is the DSI/NRF South African Research (SARChI) Chair in Biomedical Engineering & Innovation and is the Director of UCT’s Biomedical Engineering Research Centre. He is a professor of biomedical engineering at the University of Cape Town, Department of Human Biology. He is the creator of the innovative FrugalBiodesign™ methodology and has established award-winning labs under UCT MedTech, producing ground-breaking medical technologies. His research focuses on developing health technologies for low-resource settings, and he has supervised over 75 students in their post-graduate academic journey. Dr Sivarasu has an extensive patent portfolio with over 67 patent applications across various countries, and his innovation has led to the launch of 4 start-up companies from UCT's MedTech laboratories and several open-source innovations used over 16 countries. He was part of the South African National Ventilator Project, which led to the production of 20,000 ventilators during the COVID-19 pandemic.  He is leading the efforts on medical devices for future pandemics in the recently formed National Institute for Pandemic Preparedness and Prevention (NIP3). Dr. Sivarasu is an accomplished author with over 125 peer-reviewed publications and has received numerous awards, including the UCT Deputy Vice-Chancellor’s Award for Innovation, NSTF TW Khambule Award and 22 other awards in 4 different continents. He is an elected member of the Global Young Academy (GYA) and South African Young Academy of Science (SAYAS), to which he served on the Exco and also as a the Co-Chair edited the textbook on ‘Medical Device Innovation for Africa’. 
https://www.linkedin.com/in/sudeshsivarasu/  
https://health.uct.ac.za/medtech 
https://health.uct.ac.za/bmerc