Enabling Inclusive Technological Change through Transformative Policies: Frugal innovations from medical device manufacturing firms in South Africa

The lack of appropriate and affordable medical devices to serve the needs of developing
countries is a global health concern; a need felt even more acutely during the COVID-19
pandemic. In recent years, the growing medical device manufacturing sector in South Africa
has drawn policy attention, with some studies highlighting its significant potential to
contribute to South Africa’s National Development Plan 2030. The prompt deployment of
funding and home-grown technologies by the South African government during the
pandemic to address medical device and diagnostics shortage through local manufacturing
reaffirms the country’s capabilities. This study explores firm-level innovation processes
through a fresh lens. It adapts the heuristics of an ‘institutional triad’ to highlight the
institutions, interactions, and tensions between the three stages of innovation –
generation, production, and diffusion – which are influenced by different policy domains.
Further, it explores the ways in which the harmonisation of policies can enable South
Africa’s medical device manufacturing sector to reconcile the twin objectives of industrial
growth and social development, including lowering its own healthcare cost. Empirical
evidence from three case studies demonstrates that, despite facing many constraints and
challenges to innovate, some small and medium enterprises (SMEs) engaged in medical
device manufacturing in South Africa have high levels of innovation capabilities and have
successfully brought various frugal innovations to market. Frugal innovations in this study
are fundamentally new products – they are not adaptations or stripped-down versions of
products initially developed for Western markets. The evidence suggests varying levels of
involvement of the state in the three case studies presented. However, much more
proactive support, particularly to innovative SMEs, would be needed to enable more
inclusive technological change where both economic and social goals can simultaneously be
achieved.