War-time Self-Sufficiency in Medical Supplies Urgently Needed

Those who think that the COVID-19 crisis will end within three weeks or even three months are deluding themselves. Governments and societies that do not understand this bare fact will see their front-liners suffer or perish, and their healthcare systems collapse; and this will be followed by new waves of infections.

The world will need an incredibly huge amount of face masks, personal protective equipment (PPE), face shields, sanitizers, disinfectants, medical gloves, ventilators and other medical supplies over the next 18 months, at least.

What we then have to consider is that the world will be competing for the same supplies, and more and more, they will do so in a manner reminiscent of the gunboat methods of the 19^th century. What I fear, where Malaysia is concerned, is that there are not enough leaders in the current government who understand this breadth and width of this crisis.

Health Director-General Dato’ Noor Hisham Abdullah, for one, is aware of the global dynamics at play when he detailed the remaining supply that we have of the following items:

• N95 Surgical Masks – 37 days
• 3-Ply Surgical Masks – 47 days
• Protective Head Covers – 52 days
• Face Shields – 25 days
• Boot Covers – 78 days
• Isolation Gowns – 23 days
• Protective Coveralls / Jumpsuits – 19 days

But manage beyond, creating and securing sufficient supplies through what I conjure as “war-time production”, will require a whole-of-government approach. The country needs to rapidly produce the needed medical supplies domestically, by hook or by crook. This is urgent and getting more so by the day.

Let’s take a simple example. N95 masks are crucial for front-liners who deal with Covid-19 patients directly. Before the Covid-19 crisis, Malaysian importers were procuring these at around US 20 cents or so per piece.

GLOBAL GUNBOAT RACE FOR MEDICAL SUPPLIES

In recent weeks, these importers have been informed that the price is now USD$1.5 to USD$2 per piece. The jump in price is one big problem in itself. But what should shock us most into realizing how bad the global situation actually is, is that the importers also learned that buyers from North America are paying cash at the factory gate—and to the tune of USD$3 per piece.     

The same goes to 3-ply surgical masks, PPEs and ventilators. Horror stories of “gunboat” procurement on the tarmac of China’s airports by various countries are now quite known. Malaysia will very soon be facing major shortages of crucial items such as these if nothing is done now to increase domestic production.

In our attempts to assist, my team came to learn that in some hospitals in Johor, front-liners dealing with Covid-19 have no access to N95 masks. The diminishing availability of PPEs in various hospitals nationally is common knowledge now, especially after Dato’ Hisham’s candid and courageous admission.

We fail our healthcare front-liners if we fail to supply them with sufficient medical items. Many of these items are technically not complicated things to produce, and our factories can be geared towards breaking this growing supply bottleneck.

To push my point further, we can no longer avoid considering how such supplies are to be secured in the post-Covid “new normal” as well. I encourage all to read the 10-page guidelines drawn up by Dato’ Dr. Amar-Singh HSS et al. for general practitioners and those working in out-patient clinics settings, including dentists. These same guidelines are applicable to traditional medicine practitioners, masseurs, chiropractors and other related professions.  

As you read through these guidelines, you will realise how much more medical supplies Malaysia will need in order to protect our neighborhood GPs and dentists, especially if we assume, as the authors suggest it wise to premise, that all patients and accompanying persons are Covid-19 positive.

We are racing against time. Now more than ever, the government must get its priorities right. There are many UMNO leaders, such as Shahrir Samad, Asyraf Wajidi etc., already criticising the Minister of International Trade and Industry and Senior Minister for the Economic Cluster. I don’t usually agree with UMNO leaders. But, in this instance, I do agree with them.

The MITI Minister should set clear guidelines and proper Standard Operating Procedures (SOP) about re-opening certain sectors, especially those that have been under MITI oversight; and he should do so only after proper consultation with the Health and Security authorities. MITI has no capacity to be the single approving authority for sectors previously not under its watch. 

With a clear federal guideline and SOP, the enforcement of such instructions should also be delegated to local authorities. It is they who have detailed knowledge about the street-level actors involved in these affected sectors. They are also the ones who have the enforcement capabilities to ensure compliance.

Producing medical supplies to cater to our pressing needs is a matter of life and death. And I say this loudly and with a strong sense of urgency, to highlight what the full negative consequences of our failure to act, and to act fast, can mean.

So far, Proton has committed to produce 60,000 face shields to be given out free while Top Glove has committed to produce 110 million masks a year. Notion VTec Bhd, which is involved in precision-machined components, and SGGM, a food packaging company, are switching lines to produce PPEs. Condom producer Karex has assigned two of its lubricant lines to the making of hand sanitizers.

More players should be roped in.

A KEY ROLE FOR THE STATE TO PLAY

I know of a few businesses who are still hesitant about converting their production lines towards producing medical supplies.

The first point I wish to make to them is that the demand for medical supplies is not going to go down anytime soon, and rather than wait for global market signals to switch strategy, they should realise early that the home demand is strong, and it will grow ever stronger. Being early in reacting to new market dynamics is simply good economic sense, in any case. It merely requires some boldness on the part of the stakeholders.

Second, there is a strong belief, built over the last two decades when China become the manufacturing hub of the world, that China can ramp up production of anything to meet any level of demand from anywhere at any time. Imagining the Chinese manufacturing juggernaut as a competitor you can’t take on, they are unprepared to invest. In the long run, they assume, you cannot but make losses.

Here is where the State has to step in. It needs to amplify supply in the short term, and adopt a policy of creating a national stockpile, and that way, help jumpstart the national production capacity for key medical items.

The Government has an important role to play in our present economic situation. It can put into place strong incentives to encourage the growth of such necessary economic activities. This is not unlike taking a leaf from the playbook of industrial policy. If there is a need, they may draw lessons from the Defence Production Act that the United States conceived during the Korean War in 1950.

Steady signals in that direction coming from the Government would encourage the banks to step up support and help incubate a large medical supply industry in Malaysia.  

The leaders in GLCs and GLICs should be able to rise to the occasion as well, once they realise the grim realities of the global gunboat race for medical supplies that has now started. 

To get everyone to understand the urgency of the matter at hand, the Prime Minister and MITI Minister as well as all other economy-related ministers should run a single war room to report to Malaysians each day on the production figures for N95 masks, 3-ply surgical masks, PPEs, face shields, sanitizers, disinfectants and medical gloves. 

In the War on Covid-19, the healthcare front-liners fight our battles for us. PPEs, masks and these other items are the weapons they need.

To send our army to war badly armed and badly supplied is a grave injustice. To avoid that, Malaysia must act now.

Photo credit: Malay Mail