Read the Conversation

EF: Could you tell us about the history of Gabler Medical and your international footprint today? 

RG: My father, Alfred Gabler, founded Gabler Medical in 1963. He was a German immigrant who came to South Africa after World War II. My father's background was technical; he was an instrument maker with a specialized qualification in Germany. He entered the medical field in Cape Town by being the branch manager for Dräger’s affiliate. Eventually, he decided to start his own business, leading to the creation of Gabler Medical, which focused on capital equipment, starting with suction equipment and equipment mounting systems. I joined the company in the mid-80s and have been running it since then. It has grown a lot over the years. 

EF: What priorities are you working on today? 

RG: As a company, we have three main business units: two manufacturing units and for distribution. For distribution, we represent several multinational companies and distribute their products in South Africa. Our original manufacturing plant focuses on capital medical equipment, which ties back to my father's original business. This business has grown significantly over the years, expanding its product range. The second business focuses on surgical sutures, produced in a separate factory in Cape Town. Our factories are in Cape Town, and we are focusing on growth in each area. 

Our core strength is manufacturing. While we do represent multinationals, distribution is not our main business. Given the small market, it makes sense to diversify. This strategy proved effective during COVID-19 when some divisions virtually shut down, but others generated good revenue. Having multiple pillars allowed us to survive and grow despite economic challenges. During COVID, our capital equipment and medical manufacturing businesses were crucial. Without them, we would have struggled, as our surgical and hospital access divisions were severely impacted due to the reduction in elective surgeries. 

We focus on expanding our footprint and market share in South Africa. The local market is now more supportive of local manufacturers. Historically, there was a strong preference for imported products, but this preference is changing. The medical technology master plan and government initiatives are now emphasizing local manufacturing. We see significant opportunities for growth in this environment. The country must grow its local manufacturing industry to become less dependent on imports. COVID highlighted South Africa's challenges in obtaining products during supply chain issues, as stronger economies tend to secure limited supplies first. For both our manufacturing divisions, there's potential for growth in the South African market, driven by the National Health Insurance plan and the master plan. Our growth strategy focuses on local expansion, creating a sustainable business, generating employment, and earning foreign currency through exports. Our products are competitive in quality and price with Western products, fitting into a niche between first-world quality and second-world pricing. We don't compete with low-cost Asian manufacturers but offer first-world quality at more affordable prices, creating significant export growth potential for our business. 

EF: Given the unprecedented times we faced, how did this impact the development of the med-tech master plan and our understanding of the importance of having local manufacturing capacity for these types of events? 

RG: The pandemic was a surreal time. Despite being on lockdown, our business and factory kept running because medical device manufacturers were considered key industries. Our staff needed special permits to travel. The shift to doing business online became crucial during COVID. Our manufacturing of oxygen therapy products was in high demand, especially from the UK, which was setting up pop-up temporary hospitals. Our oxygen flow meters and emergency suction equipment business grew substantially. In South Africa and internationally, our core business kept us very busy. 

What's exciting is that many innovators emerged during this time. Thanks to our network and long-standing market position, we teamed up with a group called Umoya. They designed an oxygen device during COVID-19, invented by Dr Craig Parker who works at a state hospital in the Eastern Cape. This solution bridges the gap between the two resource environments and extends the care available at small hospitals and clinics. We teamed up with them to bring the product to market, and we manufactured the medical device with an incredibly innovative design. During COVID-19, there was a severe shortage of ventilators and other equipment for patients with breathing problems.  OxERA was designed to work with the normal low-flow oxygen supply available next to any hospital bed using a standard flow meter. This device significantly raised patients' oxygen saturation levels, making it ideal for those patients who needed oxygen to recover from COVID but didn't require a ventilator. Most hospitalized COVID patients needed oxygen to help them heal, and our product was perfect for this—low in oxygen consumption, affordable, and didn't require any complex machinery. 

Unfortunately, the regulatory process delayed our product's release by about nine months, preventing it from saving more lives during the pandemic's peak. The OxERA device only entered the market during the second wave of COVID. Our product was designed and ready for the market during the first wave of COVID, even reutilizing parts that were already approved, yet the approval process was delayed. Our product was used in other African countries around South Africa. However, India faced a dreadful crisis with oxygen supply shortages, and we couldn't get our product into India as our South African regulatory approval was not accepted in India. While we are pleased that our product was used in Southern and Central African countries, regulatory constraints prevented it from reaching more people. The world needs to learn from this pandemic and not let regulations prevent life-saving products from reaching those in need. Our product was simple, made from tried and tested medical-grade components. While regulatory approvals aim to protect patients, they sometimes take too long, and they can cost lives instead of saving them. 

EF: What strategies do you have to position yourself as a partner of choice?  

RG: Regarding product sales and distribution, we are the go-to partner because we manufacture cost-effective, high-quality products. The health master plan focuses on developing a more favorable infrastructure for South African and African manufacturers. Countries need to collaborate more to be more cohesive; some countries require CE or FDA certification, while others accept our South African SAHPRA qualifications. What I hope the Med Tech master plan will achieve is a foundation for a common quality certification approach across Africa. In Europe, the CE mark covers all countries, so a German manufacturer doesn't need separate certification for France. We are already positioned as a strong partner, and a cohesive healthcare strategy in the African market can bring a significant opportunity to patients across the region.  

Medical crises have led to an overreaction in regulation, resulting in delays in bringing quality devices to market. The current regulatory processes have slowed down the industry's progress. Regulatory bodies are often under-resourced, causing long lead times. This problem isn't unique to one country; it affects MedTech development worldwide. There needs to be a clear plan to move forward and avoid regulation becoming a stumbling block or bottleneck to market access. We need a strategy to ensure that regulation doesn't hinder healthcare and MedTech development across the continent. 

EF: Looking back, what are the things you are most proud of that you have accomplished within the company, and what will you be hoping to celebrate in the upcoming years? 

RG: In the South African landscape, very few companies in the medical device space can celebrate 60 years. Leading the business for nearly the last 40 years is something to celebrate. Some businesses might be absorbed into larger organizations, but only a few have the history and continuity we have. I can celebrate that we have created a business with the infrastructure to survive and thrive for 60 years, and we are still in a growth phase. 

When I took over, the business had about ten people. Now, we have 160 employees. I'm proud to have created a business that has grown and provided employment for many families. Our manufacturing focus has allowed us to employ and train people in a country with significant unemployment. We've contributed to growth in employment and on-the-job education, adding to the skill sets of our people. The difference between us and a multinational distributor is that we create employment opportunities for those who might not have the education to work in an office environment. We provide jobs for people who otherwise might not find employment, which is crucial in South Africa. I'm also proud that we have expanded beyond just medical equipment manufacturing. We now manufacture consumables and distribute multinational products. We have developed skills in distribution, equipment manufacturing, and consumable manufacturing. Our company is stable and has a bright future. 

Posted 
July 2024
 in 
South Africa
 region