The coronavirus crisis has highlighted the need for transnational collaboration to produce socially useful goods—an idea aerospace workers in the UK hatched decades ago.

The coronavirus crisis and shortages in ventilators have challenged the claim we have entered a ‘post-industrial society’. As the EU Observer reported last month, ‘EU countries have reported shortages of ventilators, personal protective equipment and testing kits—especially in Italy, Spain, the Netherlands and France where there are very high coronavirus patient loads requiring intensive care’.

Traditional global supply chains have proven unreliable. In the Netherlands, 600,000 face masks imported from China were defective. In Belgium, 100,000 proved useless, even containing animal faeces. Germany lost about six million masks at a Kenyan airport. Global outsourcing has seriously hampered local production of ventilators in the United States.

Breathing machines

In response to the production crisis, teams of inventors, frontline health professionals and other networks involving governments have used a diversity of innovation and production platforms to compensate for catastrophic failures, of both the market and established planning mechanisms. These platforms represent networks of innovators who can design, test and develop prototypes and mass-scale production.

As Dr Daniel Horn explained in the New York Times, ventilators are ‘mechanical breathing machines that are the crucial lifesaving tool when a patient’s lungs fill with fluid, making it very difficult for the lungs to oxygenate blood’. In the US, a volunteer team based at Massachusetts Institute of Technology rapidly brought together engineers, physicians, computer scientists and others to develop ‘a safe, inexpensive alternative for emergency use, which could be built quickly around the world’. The projected cost of this system was only $100.

Doctors are key, as they develop performance specifications for designers. At top US hospitals medical professionals found themselves receiving ‘phone calls from tech leaders asking for ventilator specs’.

Missiles to ventilators

In Italy, one hospital responded by direct production of substitutes. At Maggiore Hospital in Parma, doctors used a 3D printer to modify scuba masks, so that they could be hooked up to oxygen. Dr Francesco Minardi said the hospital’s quick fix could be compared to wartime triage. Earlier, the government ordered Siare Engineering, Italy’s sole ventilator manufacturer, ‘to quadruple monthly production, even deploying members of the armed forces to help meet the new quota’.

The governor of New York, Andrew Cuomo, argued that the need for ventilators could be compared to that for missiles during the second world war. Yet missile-to-ventilator conversion has occurred in Israel. The platform there brigades the defence ministry, the government-owned Israel Aerospace Industries and Inovytec (a medical-device maker). A missile-production facility has been converted ‘to mass produce ventilators and offset a shortage’. The ministry claimed that ‘dozens of ventilators were tested and assembled’ with ‘rapid retooling of the missile production line … completed in days’.

In Sweden, similarly, an incumbent corporation has been a critical platform. The carmaker Volvo has converted production at its Tuve factory in Gothenburg to make protective visors. It aimed to make 1,000 such visors daily, with 3D printers facilitating a quick production change.

Potential barriers

There are three key potential barriers to using novel production platforms. First, there are knowledge barriers, as with the specialised capacities required to design, develop and produce ventilators from scratch. The efforts at MIT and Maggiore Hospital illustrate how these can be addressed: various specialists create teams to overcome knowledge gaps. Diverse teams of experts tied to incumbent political actors—hospitals, governments, medical suppliers, defence and automotive firms—have advanced ventilators.

Secondly, supply-chain shortages can create bottlenecks for delivery of key components. Stefan Dräger, chief executive of Drägerwerk (one of the world’s largest ventilator producers), explained: ‘We source different parts that we need for production from suppliers around the world. A lot comes from Europe but also from the US, Asia, Australia and New Zealand … These supply chains must not be interrupted under any circumstances.’ If they were, he added, ‘the whole world has a problem’.

As new companies get in on the act, they can compete with established producers for the same components. Nevertheless, some component suppliers might ramp up production. Bottlenecks can ease as new, simplified or different kinds of components are used (as the MIT and Maggiore efforts suggest).

Both knowledge and supply-side barriers can be addressed by middle-range upstream firms. As Stephen Phipson, chief executive of the engineering trade body Make UK, explained, ‘We already have companies that build other people’s designs for them—everything from alarm systems to signalling systems for trains. These are the companies you need, which can place components on circuit boards, do the wiring, testing and assembling.’

A final barrier is competition among nations for scarce health products. While some call for economic-nationalist solutions, other believe in cosmopolitan global solidarity. Neither approach is sufficient unless one figures how out to solidify domestically anchored solutions backed by co-operative networking and conversion. As each nation deepens its own capacities, it will facilitate leverage of new transnational joint ventures to ease production gaps.

Political mobilisation

Innovation and production platforms often stem from political mobilisation. In Italy, the politics has come directly from within the medical community. In Israel, self-reliance is part of the national state security culture.

In the US, workers and corporate groups have filled a federal political vacuum. General Electric employees in Massachusetts have protested against layoffs and demanded job- and health-saving ventilator production. American business leaders have been mobilised by Stop the Spread, a non-profit campaign. At least 1,500 corporate executives supported the campaign, which led to a potential General Motors ventilator project in co-operation with a medical firm.

We need a diversity of labour, business and other actors to promote the new politics of production. History offers examples of relevant attempts—such as the 1976 Lucas Alternative Plan advanced by aerospace workers in Britain, seeking to convert the company from falling arms sales to socially useful products, and the Mondragon industrial co-operatives in Spain.