By Svetlana Khristoforova
Cooperation among BRICS countries in the healthcare sector has produced tangible results in recent years. Experts point, for example, to successes in combating viruses.
In March 2022, the BRICS Vaccine Research and Development Centre was established, and joint work is underway on vaccines against the tropical fevers Marburg, Lassa and West Nile.
There is also a BRICS Tuberculosis Research Network. The exchange of medical technologies is developing actively. At Russia’s initiative, a Special BRICS Working Group was established in 2023 to address issues related to the development and production of innovative radiopharmaceuticals. In addition, the group operates an expert platform known as the Health Coalition.
“Today, cooperation among BRICS countries in the production of medical technologies is no longer limited to diplomatic memoranda – it is already a fully functioning system. Its foundation is a shared understanding that critically important medical products, from simple consumables to sophisticated diagnostic equipment, should not depend on geopolitical storms.
”The members of the group are striving to create their own reliable internal framework, and, it must be said, they are gradually succeeding,” notes the Head of the International Department of the International Development Division of the Pirogov Russian National Research Medical University of the Ministry of Health of Russia, Margarita Isaakova, in an exclusive interview with TV BRICS.
Issues of cooperation in the field of medical technologies are of strategic importance for BRICS. The exchange of experience, technologies, human resources and scientific expertise makes it possible not only to build an independent ecosystem but also to advance more rapidly in the most promising areas.
Experts identify among them cellular technologies, personalised medicine, nuclear medicine and the fight against antimicrobial resistance. At the same time, each country is capable of making a significant contribution to joint developments.
“China and India possess powerful manufacturing and industrial capabilities, while Brazil has a strong tradition in public health systems and production through public laboratories,” says a digital health researcher in the Unified Health System (SUS) of Brazil and Master of Nursing Management, Vitoria Davi Marzola, in an interview with TV BRICS.
Russia, meanwhile, has traditionally been strong in nuclear medicine and radiopharmaceuticals. In addition, India is a recognised global leader in the production of affordable generics and biosimilars, while China has excelled in medical software and artificial intelligence systems.
Brazil has a strong medical engineering school, and South Africa serves as a natural bridge to the African continent with well-developed clinical infrastructure.
Other BRICS members are also capable of making substantial contributions to the development of medical technologies.
The United Arab Emirates is actively investing in digital healthcare and medical infrastructure; Iran possesses significant expertise in pharmaceutical production and biotechnology.
Egypt is actively developing its pharmaceutical industry and strengthening its position as one of the leading producers of medicines in Africa and the Middle East; while Ethiopia and Indonesia represent important markets for the deployment of affordable medical solutions and the expansion of public health programmes.
BRICS countries are not merely cooperating in the field of medical technologies. Their primary objective is to create resilient logistics chains in order to improve access to high-tech medical care. Increasingly, discussions are focused on the formation of a unified BRICS healthcare architecture. This is reflected, among other things, in the development of industrial cooperation.
“Here, BRICS countries are moving beyond simple trade towards genuine technological partnership. Mechanisms have already been launched that make it possible to develop a molecule in one country, synthesise it in another, package it in a third and register it simultaneously in several jurisdictions. This is what full-cycle technology transfer looks like,” notes Margarita Isaakova.
Today, BRICS countries are working on harmonising requirements for the quality and safety of medicines. Step by step, a common regulatory environment is taking shape. This is important to ensure that research results obtained in one country are recognised in others.
In recent years, specialists note, landmark meetings of BRICS regulatory authorities have taken place, where mechanisms for accelerated mutual recognition of clinical data were discussed.
Common approaches to registration dossiers and inspections of production facilities are now being actively developed. According to Isaakova, such harmonisation used to take decades, whereas the process has now accelerated considerably. This enables BRICS countries to work in the field of breakthrough medical technologies.
Biosimilars of monoclonal antibodies
More than a decade ago, specialists began speaking about the dawn of the era of biosimilar monoclonal antibodies (mAbs) in oncology. Advances in molecular biology made it possible to identify the most sensitive targets in tumours of the lymphatic and haematopoietic systems. This formed the basis for the development of a new generation of medicines – monoclonal antibody-based therapies.
These are intelligent proteins created in laboratories that function like highly precise missiles or targeted markers for the immune system.
Monoclonal antibody medicines locate a specific diseased cell and attach themselves to it, after which they either destroy it directly or mark it for destruction by the body’s immune cells, acting as a kind of “special forces unit” for the immune system. At the same time, mAbs are effective not only in cancer treatment but also in the treatment of severe arthritis and multiple sclerosis.
Initially, however, the production of such complex medicines was extremely costly. Pharmaceutical companies around the world, therefore, began developing biological copies of monoclonal antibodies, known as biosimilars, capable of significantly reducing the costs of highly effective and safe treatment for both governments and patients.
Today, cooperation between Russia and India in the field of biosimilar monoclonal antibodies is developing actively within BRICS. According to Isaakova, their cost may decrease many times over in the foreseeable future, making treatment accessible to much broader segments of the population.
Radioisotopes
Specialists identify nuclear medicine as another of the most promising and rapidly developing areas of cooperation among BRICS countries. This primarily concerns the production of radioisotopes, where Russia, with its advanced nuclear infrastructure, occupies one of the leading positions and supplies a significant share of the group’s needs.
Radioisotopes are radioactive substances introduced into the body to detect diseases, particularly cancer, or to treat them from within. They are microscopic “beacons” or “precision-guided bombs” used, among other things, in PET diagnostics (positron emission tomography), an advanced radionuclide medical imaging technique.
The development of BRICS cooperation in nuclear medicine is being driven by the work of the Nuclear Energy Platform of BRICS countries and partner states. The initiative is aimed at creating a unified technological and strategic space for the development of nuclear energy, including nuclear medical technologies, within the group.
“Some countries provide technologies, others supply equipment, while others establish local production cycles,” says Isaakova.
“Therefore, perhaps the main achievement is the creation of a scientific and industrial conveyor capable of transforming a laboratory idea into a mass-produced product within the group, bypassing traditional barriers.
“The main breakthrough lies not so much in achieving specific results as in creating a structural foundation for healthcare sovereignty and establishing conditions for technology transfer and joint development,” Vitoria Marzola said in an interview with TV BRICS.
Key challenges and prospects
However, experts speak not only about the joint medical and technological breakthroughs of BRICS countries, but also about the difficulties that still need to be overcome. Marzola divides these challenges into several groups.
Regulatory issues: differences between healthcare authorities hinder harmonisation and the joint approval of technologies and intellectual property issues: patent-related barriers continue to restrict the full exchange of technologies.
Technological and economic asymmetry: there are significant disparities between countries in terms of innovation capacity and infrastructure; and limited manufacturing integration: BRICS countries still demonstrate a relatively low level of integration into global value chains.
Isaakova identifies two additional significant obstacles to BRICS cooperation in medical technologies: the “last mile” logistics problem and, somewhat surprisingly, the language barrier.
The issue is that biological medicines, cell-based products and many vaccines require the strictest adherence to the cold chain, sometimes at temperatures as low as minus 70 degrees Celsius.
BRICS countries encompass vast territories with difficult-to-access infrastructure – rural areas of India, regions of the Amazon in Brazil, and remote areas of South Africa, Ethiopia and Indonesia. The cold chain is often broken during the final stage of delivery.
“No matter how much is invested in joint production, if the final product is spoilt during transportation, all those efforts are wasted. Coordinated investment in refrigerated hubs and specialised transport is essential,” Isaakova said.
Nevertheless, in spite of the many challenges, experts view cooperation among the group’s countries in the field of medical technologies with considerable optimism and even see BRICS as one of the potential global centres for the production of medical technologies.
“It is possible that BRICS countries will strengthen their position as a global strategic hub for the production of medical technologies, helping to expand access, reduce inequalities and enhance international health security,” Marzola said.
Technological development will require not merely an increase in production volumes but qualitative structural changes – further regulatory integration and the establishment of joint manufacturing of high-tech and diagnostic equipment.
In the near future, experts expect the emergence of joint ventures among BRICS countries that will combine the best capabilities of each member: powerful radiation sources from Russia, electronics and software from China, affordable consumables from India, biotechnology expertise from Iran and investment opportunities from the United Arab Emirates.
Another promising area for cooperation, according to Isaakova, is bioprinting and regenerative medicine.
Active research is already underway into the creation of personalised implants using patients’ own cells.
In the foreseeable future, experts predict that BRICS countries may establish production facilities capable of printing cartilage and bone tissue, followed by more complex structures. This would represent a genuine revolution in orthopaedics and maxillofacial surgery.
However, the most important achievement of BRICS cooperation in healthcare may ultimately be the reduction in costs – and therefore the increased accessibility – of cutting-edge medical technologies, not only for the 40 per cent of humanity living in BRICS countries but also for the entire Global South.(TV BRICS/NAN)
Edited by Ismail Abdulaziz
