Engineering, procurement and construction company EPCM Holdings is producing low-cost ventilator units − bag valve mask units − for delivery to several African countries in light of the Covid-19 pandemic.

“In our fight against the Covid-19 virus and our determination to protect humanity, our team of multidisciplinary engineers and medical experts have invested in the rapid development of a low-cost, low-tech, mechanical ventilator system to support the increasing supply shortages facing Africa and beyond,” the company says.

The bag valve mask units are designed and produced with the company’s in-house three-dimensional (3D) printers. Essential design specification of the units includes a rechargeable battery-powered electric motor, in-line filters and a heat and moisture exchanger.

EPCM's design objective was to develop a fit-for-purpose product using readily available materials that comply with Medicines and Healthcare Products Regulatory Agency design specifications and South African Health Products Regulatory Agency (SAHPRA) regulations.

EPCM CEO Tom Cowan tells Engineering News that these units are “extraordinarily simple, providing the most basic functionality that is needed in a ventilator”. Benefits include simplicity, robustness, levels of redundancy and self-maintenance. They are also “ultra-low-cost” – at a tenth to a fiftieth of the price of premium ventilators.

Citing the Journal of Global Health, from June 2014, Cowan notes that the vast majority of patients, even in developed countries, are ventilated for a short duration and require the minimal settings that most ventilators can provide.

Moreover, the majority evidence-based manoeuvres do not require complex ventilation strategies and can be provided with a basic ventilator, which the company’s units aim to do.

The company is well positioned to undertake this project, with Cowan highlighting its multidisciplinary team of engineers and medical experts, large-scale industrial fabrication ability and large African distribution footprint.

These ventilators can be produced from the company’s various workshops in South Africa. As an essential supplier and critical repair on essential services provider, the company has the necessary permits to operate during the country’s lockdown period.

Given that the demand for ventilators in South Africa and Africa is still accelerating, the company cannot quantity how many of these units it expects to produce. However, the demand for ventilators in general is expected to outstrip the capacity that the whole industry can provide, Cowan says.  

The company expects demand for its units will mainly be in the poorest parts of rural areas in Africa. In this regard, Cowan affirms that EPCM will have the capacity to fulfil this demand, through its three workshops and numerous large industrial partners.

Therefore, while the company does aim to contribute to the Covid-19 shortage alleviation, its main aim is to produce ventilators for the poorest regions in Africa in a post-coronavirus world.

To date, the company has produced three prototype units and it has received pre-orders from Mozambique, Ghana and Libya.

In South Africa, there are more stringent regulations around medical approvals, and the company is currently in ongoing discussions and approval processes with the departments of Trade, Industry and Competition and Health, SAHPRA and other foreign regulatory approval agencies for these units, Cowan informs.

He highlights obtaining regulatory approvals as one of the biggest challenges in undertaking this ventilator project, along with securing a good supply chain for critical parts.

EPCM is looking to fabricate critical parts locally rather than importing these.

Cowan also mentions that apart from the ventilators, EPCM is also producing face shields using its in-house 3D printing capabilities. These too are used to help protect healthcare workers against infection of Covid-19.