Ventus: Bangladeshi researchers’ innovation offers hope to ease ventilator shortage
Three Bangladeshi researchers worked seven consecutive years to develop a low-cost, locally built mechanical ventilator that could help make life-saving respiratory support more accessible across Bangladesh
Coronavirus first reached Bangladesh in early March 2020. As infections surged, the fragility of the country's healthcare system became exposed. During those lockdown months, one phrase surfaced on social media feeds and fueled widespread fear: ventilator shortage.
By then, developed countries, desperate to meet their own needs, had stopped exporting ventilators. Meanwhile, Bangladesh's hospitals had an inadequate supply of these artificial breathing machines. The consequences were inevitable. Hundreds of lives were lost for want of just a little air.
The country has moved beyond the darkest days of Covid-19, but the shortage of ventilators in its hospitals has not truly ended. This lifeline remains beyond the reach of most institutions when it is needed most.
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Three Bangladeshi researchers dared to dream of changing this reality. They developed Ventus, a mechanical ventilator built entirely with locally developed technology. They worked tirelessly for seven consecutive years. Without any government funding, they financed and advanced the research on their own. After overcoming numerous obstacles, they finally achieved the long-awaited breakthrough.
The researchers successfully completed its initial clinical trial. They believe the ventilator could mark the beginning of a remarkable transformation in the country's healthcare sector.
They also claim that, subject to approval, Ventus could be used not only in healthcare institutions but also as a device for personal use.
How the story began
Dr Kazi Sefayet Enam of the Department of Cardiology at Dhaka Medical College Hospital spent most of his professional life in intensive care units (ICUs). During those years, he witnessed a harsh reality at close quarters: countless patients could not remain in intensive care for as long as necessary simply because they could not afford it.
The life-saving medical equipment used in ICUs are extremely expensive, while their operational cost is also beyond the reach of ordinary people.
That experience led him to wonder whether such devices could be manufactured locally at a lower cost. Bangladesh's successful pharmaceutical industry served as an inspiration. The acute shortage of ventilators during the coronavirus pandemic made that idea even more urgent.
"I used to work with ventilator machines in the ICU. I began thinking about whether this complex device could be replicated in a somewhat simpler form. Then Covid-19 arrived, creating panic across the world. Major countries had banned ventilator exports while the situation in Bangladesh was only deteriorating. I then discussed the idea with engineer Boazid Muktadir Shuvo," Dr Enam said.
Dr Asif Ur Rahman, an ICU consultant at the National Institute of Neurosciences and Hospital, subsequently joined the initiative. At the time, importing components from abroad had become almost impossible. Shuvo therefore began building the ventilator using equipment and components available locally.
After several months of work, they developed their first prototype, which they named 'Spondon'. A trial of the device at Dhaka Medical College Hospital generated considerable optimism among doctors and specialists.
However, that promising beginning did not reach completion. Although Bangladesh has clear regulations for pharmaceutical production, there is no effective framework governing the research, manufacturing and approval of medical devices. Opposition from certain corporate organisations compounded the problem. As a result, the Spondon project could not move forward.
The researchers, however, did not quit. The project convinced them that it was possible to build an effective ventilator using locally developed technology. Their research continued, even though it remained outside public attention.
The initial clinical trial of Ventus was conducted on 13 July. After obtaining all necessary ethical and institutional approvals, the device was tested on a brain-dead patient. Following the trial, a 13-member specialist medical board reviewed the results and declared it successful.
The researchers are now considering further improvements to the device before seeking final approval.
Affordable, reliable
A ventilator is an artificial breathing device. Put simply, when the lungs of a critically ill patient can no longer function properly, the machine helps the patient breathe.
The technology is complex, and the machines are extremely expensive. And obtaining an adequate number of ventilators remains a major challenge for most hospitals in Bangladesh.
"We decided to develop a low-cost, portable device. Conventional mechanical ventilators are very heavy and contain numerous modes. Each mode is used for a particular type of patient. However, not all of those modes are always necessary for treating the majority of patients in our country. What we needed was a ventilator equipped with a few essential modes that could effectively keep a critically ill patient breathing," Dr Asif Ur Rahman said.
Ventus has initially been designed with three ventilation modes. One of these modes is already fully functional, while the software for the remaining two has been completed. They will be introduced gradually following the necessary testing and evaluation.
"We are still in the trial phase. There is still a long way to go before it becomes a fully consumer-grade product. However, our dream is to see this ventilator, developed through our own innovation, being used in Bangladesh's ICUs. We do not want the government or the people to spend vast amounts of foreign currency importing these machines."
The device can operate under three different conditions: using ambient air, with the assistance of an oxygen cylinder, or with high-pressure oxygen supplied through a central oxygen line or an oxygen plant.
If a hospital has an oxygen plant, the device can use that supply. If no oxygen plant is available, it can operate using an oxygen cylinder. Even if neither is available, it can use ambient air to help the patient breathe.
"A healthy adult normally breathes between 12 and 18 times per minute. Each breath requires an average of around 500 millilitres of air. We designed the Ventus-1 prototype so that it can use ambient air to provide patients with the necessary respiratory support without relying on an oxygen plant or cylinder. No specialist expertise will be required to operate it. Once a breathing tube is inserted into the patient's airway, the device will begin operating automatically at the press of a button," Dr Asif said.
According to the researchers, many advanced conventional ventilators are equipped with additional programmes, multiple ventilation modes and complex alarm systems. In emergencies, selecting the appropriate settings can therefore take time.
Because of its comparatively simple design, Ventus can begin providing effective ventilation more quickly, reducing delays in removing accumulated carbon dioxide from the patient's body.
"We are not saying that Ventus is better than other expensive ventilators. However, for certain specific purposes, it is capable of competing with them and delivering effective performance," Dr Asif said.
Designed with marginalised people in mind
The principal motivation behind the development of Ventus was to serve the country's marginalised and disadvantaged population. The researchers want people in remote areas to have immediate access to ventilator support.
"Suppose a farmer is harvesting paddy in a field. He suddenly collapses and stops breathing. There will not be a mechanical ventilator available at the union level. There may be no oxygen cylinder or oxygen plant nearby either. At that critical moment, the greatest challenge is to provide the patient with respiratory support. Ventus is primarily designed to perform that task. It will use air from the surrounding environment to provide initial breathing support and try to keep the patient alive until they can be transported to a distant hospital," Dr Asif explained.
In his view, the ventilator could play an effective role in the government's plans to strengthen the capacity of hospitals across the country.
While importing an advanced mechanical ventilator may cost between Tk2 million and Tk3 million, Ventus can be manufactured using local technology at a fraction of that price.
"It is possible to build this ventilator for Tk100,000. Adding all three modes would cost no more than approximately Tk250,000 to Tk300,000," Dr Asif said.
He believes the production cost could fall even further if the device is manufactured on a larger scale. Its relatively low cost could make ventilators more widely available in district- and upazila-level hospitals.
He also said that, after completing all necessary tests and securing the required approvals, Ventus could potentially be used at an individual level. In certain cases, this could spare patients from remaining in intensive care for days and incurring excessive costs.
The researchers' long-term ambition is for the ventilator to become a device suitable for personal use.
Looking to the future
Dr Enam knows that Ventus still has a long journey ahead. Although the initial clinical trial was successful, the device must pass through many more stages before it can become a fully developed medical product suitable for regular use.
"We are still in the trial phase. There is still a long way to go before it becomes a fully consumer-grade product. However, our dream is to see this ventilator, developed through our own innovation, being used in Bangladesh's ICUs. We do not want the government or the people of this country to have to spend vast amounts of foreign currency importing these machines," he said.
The researchers are also well aware that the road ahead will not be easy. In a country such as Bangladesh, transforming a medical technology of this kind into a practical product requires long-term funding and institutional support.
"This type of work requires substantial funding and effort. Everything we have done so far has been financed by us. No one has provided us with any funding. I have almost given up my chamber practice and now spend the entire day working on this project. But it will no longer be possible to move forward using only our own money. Government support will be necessary," Dr Asif said.
They hope the government will take appropriate steps to advance innovation.
"If the government takes the initiative to connect us with a major technology company, this project could progress much further. We will share our knowledge and technology, while the government can play a coordinating role. Funding and component shortages would then no longer be obstacles, and it would be possible to develop more advanced versions of the ventilator," the researchers said.
