Biodesign in India: Setting the Stage for
Needs Driven Innovation and Scaled
Implementation in Healthcare
Anurag Mairal, PhD
Director, Global Outreach, Byers Center for Biodesign
Adjunct Professor, School of Medicine
Core Leadership, Center for Innovation in Global Health
THE INDIA DIALOG, STANFORD UNIVERSITY, FRIDAY FEBRUARY 24, 2023

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Why do we need innovation in healthcare in India?
What role does Biodesign framework have in
enabling future of innovation in healthcare?
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India: An Economic Growth Story

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…Driven by a Demographic Dividend
https://kennaworldstudies.weebly.com/unit-2/217-population-pyramid

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India’s Sustained Economic Growth Depends
on a Healthy Nation
5
Disease burden = 2% of GDP growth per year

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Heart Disease
Diabetes
Cancer
Respiratory Conditions
Neonatal and Pediatric Health
Maternal health
and
Pandemics and Epidemics
Mental Health
6
Cumulative Impact
by 2030
$2 Trillion
https://www3.weforum.org/docs/WEF_EconomicNonCommunicableDiseasesIndia_Report_2014.pdf

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India Socioeconomic Growth Engines
Smaller Cities and Rural Communities
disproportionately Impacted
7

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While India has dramatically
increased its share of government
health expenditure
(from 30% to 50% over the last
decade)
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India Still Lags Most of the Top Economies in
Healthcare Spend

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Need a Reimagined Healthcare System
sickcare to
healthcare to
health and wellness

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US$200B/Year
“Gap” in the Investment in Health
Can it be Filled?

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Around 20% of consultations on 1 Mg are actually
done by an AI doctor. They’re just as accurate as a
panel of six doctors.”–Gaurav Agarwal, 1mg
Role of Technology Innovation in Filling the Gap

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Stanford Biodesign Framework

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2019
2019
2017
2018
2007
Policy paper
(entrepreneurs)
Central policy
discussion
Stanford India
Biodesign
Founder’s
Forum
Innovator’s
Garage
State policy
discussion
Stanford Biodesign in India: 2007-Present
2022
Training
leaders Engagement of
ecosystem
Enablement of
start-up scaling
Enablement of
policy
Creation of
ecosystem

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Health Technology Innovation has Taken Root in India
20+
Medtech Innovation
Programs Created
Since SIB, 2007
1000+
Innovators Working
on New Health
Technologies
$1B+
Invested in Health
Tech Innovation by
the Government
“The [Indian government’s] ‘Make in India’ campaign has actually
worked for medical devices.”–Puncham Mukim, Investor

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Current Government deployments:
• 8 districts of Tripura
• 10 districts of Himachal Pradesh
• 22 districts of Punjab.
NEWBORN HEARING SCREENING

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Neonatal Resuscitation: Windmill Health
17
Commercially
distributed by
National Technology
Award 2017

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Forus Health: Mission Preventable Blindness
Present in more than 8 states
both for adult and neonatal
retinal imaging
AP has the largest Tele-
Ophthalmology project in the
world using only Forus
products: 115 centers, 13
districts and 2.2 million
patients served

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● STEMI Goa program - 2 districts in 20 primary health facilities
● STEMI Maharashtra program - 12 districts in 144 primary health
facilities
● STEMI Telangana program - 22 districts in 60 primary health facilities
● STEMI Odisha program - 4 districts in 16 primary health facilities
● More than 50 health facilities through NGOs, Wish Foundation,
Jagdamb Pratishthan
Timely detection & management of ST-elevation myocardial infarction (STEMI)
4
STATES
315
FACILITIES
514K
DIAGNOSED
9K
STEMI
38
DISTRICTS
961
HCW TRAINED

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COVID Has Accelerated Technology Innovation in India
$2B+
Raised by
100+ Healthcare Startups
2021
$316M
Raised by
91 Healthcare Startups
2020

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Role of Indigenous Health Technologies
During COVID Pandemic
• Ventilators and other respiratory equipment
• Oxygen Production
• COVID-19 tests, swabs, pulse oxymeters, masks
• Telemedicine adoption
• Digital health interventions

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BUT…
>90%
Of Innovations Are Dealing with Challenges in Reaching
Commercial Scale

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Scaling Innovative Health Technologies
in India: The Challenges Innovators Cite
• Talent
• Product Development and Manufacturing Ecosystem
• Regulatory and Policy Uncertainty
• Clinical and Technical Evaluation Capacity
• Funding at the right time, right size, right type; cash flow and sales cycles
• Market Development and Clinician Training: Fragmented, Slow Adoption of Innovations
• Distribution Model/Capacity
• Access to Public Health Markets
• Business Models: Product vs Service; Partner or Do It Yourself
• Rreimbursement vs Out of Pocket

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Founders Forum Learning Helped NHA Design
Market Access Program

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India’s Healthcare Innovation Ecosystem is Building!
Advisory Support:
IIT Hyderabad Center for
Healthcare Entrepreneurship
Rheumatic Heart Disease
Awareness Campaigns
AIM PRIME Playbook – A
practical guide to science-
based entrepreneurship

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Subcontinent-Scale Training in Needs-Driven Innovation

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Policy Framework for Supporting Translation

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Global Partnerships and Market Access
• WHO/GAVI-like engagement in health technology solutions for LMIC
• Global health technology industry partnerships for market access