Affordable
dialysis worldwide?
Q+A with John Knight of Ellen Medical Devices
about the world’s first low-cost dialysis system
Professor John Knight, a children’s kidney specialist, is the
Managing Director of Ellen Medical Devices and a senior researcher
at The George Institute for Global Health. He speaks to POF
about Ellen Medical’s Affordable Dialysis System (the world’s first
low-cost dialysis system), discusses how IP is supporting their
business strategy, and potential investment opportunities…
Inspire October 2020
Q: What is the background
and mission of Ellen
Medical Devices?
6 Ellen Medical Devices is owned
by The George Institute for Global
Health which is a large Australian
medical research institute. The
George Institute consistently
ranks number one in the world for
research impact. We undertake
large scale clinical trials and
epidemiological studies and have
a particularly strong interest in the
translation of our research into
practical policy changes that will
improve the health of people. The
George Institute has had a direct
impact on the health of hundreds
of millions of people around the
world as a result of the research that
we’ve done. Along with Australia,
we have offices in India, China and
the UK and a network of experts
and collaborators throughout
the world, including in the US.

In 2010 we discovered there were
around 10 million people in the
world who needed dialysis for
kidney failure, but only approx.

Vincent Garvey, as he came up with
2.6 million people were receiving
a brilliant breakthrough invention.

dialysis. The sole reason many
Vincent asked the George to form
couldn’t receive dialysis is because
a partnership with him – and Ellen
they couldn’t afford it. Here in
Medical Devices was founded. We
Australia, dialysis costs around
set about building a prototype at the
$85,000 per patient per year. The
start of 2017 and have been going
Australian community picks up the
from strength to strength over the
full cost through the taxation system, last three years. We’ve now reached
and so all Australians can access
the stage where we have a robust
the treatment. Unfortunately that’s
system which is ready to test with
not the case in many developing
patients, which we hope to do for
countries and so many cannot
the first time at the end of this year.

access treatment. The need for
Q: What are the key
dialysis is growing around the world
because of the growing epidemic
differences between the
of diabetes and high blood pressure
Ellen Medical Dialysis
which can cause kidney failure.

system and other machines
The numbers we found in 2010 are
on the market?
likely to be 50% higher today.

There are two forms of dialysis.

The George Institute published
There’s hemodialysis (HD) which
our findings in The Lancet in 2015
purifies the blood and is the most
and as a follow up, announced our
US$100,000 Affordable Dialysis Prize. common form of dialysis. For HD
you need to attach yourself to a
We received entries from all over the
machine for five hours a day, three
world with innovative approaches to
days a week – obviously a very time-
low-cost dialysis. The international
judging panel unanimously awarded
consuming process. In Australia,
the prize to an Irish engineer,
about 70% of patients are receiving



Q: How is IP supporting
your business strategy?
Protecting our IP is critical for the
success of the company. As with all
medical treatments, unless there’s
a reasonable return on investment,
there are no sustainable clinical
outcomes. The expertise of the POF
team has been a wonderful help
to us as we protect our innovative
ideas in many different countries
around the world. Very soon, we’re
going to be looking for a commercial
applications are being evaluated
in different countries around the
world, and our first patent application
in the US has been allowed and
a patent will be granted shortly.

We want to make an impact
on the health of millions of
people, particularly some of the
most disadvantaged people in
the world, while creating and
running a sustainable business.

Having properly protected IP
is essential to achieve that
success for our company.

Q: When will the Affordable
Dialysis machine be
available to market and
what are the next steps?
We discovered that in
2010 there were around
10 million people in
the world who needed
dialysis for kidney
failure but only approx.

2.6 million people were
receiving dialysis.

partner who can help us roll our
dialysis system out globally. The ideal
commercial partner will be a major
player who’s already active in medical
devices, and has a global footprint,
sales forces, clinical support
teams and warehouses in different
countries around the world, and
who could deliver our system to the
clinics, working in local languages.

There’s already been a huge amount
of interest from the international
medical devices community.

Obviously, whoever partners with
us would want to be able to rely on
the fact that the IP is protected and
our patents are strong. We’ve now
reached the stage where the patent
We expect to have approval by
the Australian Therapeutic Goods
Administration (TGA) in two years’
time and for our treatments to
be available in the clinic shortly
thereafter. The TGA is the regulator
in Australia who approves all drugs
or medical devices. They usually
take 12 months to approve a
medical device, but they’re running
slower now because of COVID. So
we are now looking at early 2023
if everything goes according to
plan. Australian approval is critically
important because many developing
countries rely on the judgments
of the TGA for local approval.

We have reached the point now
in the development of this project
where we are actively seeking
conversations with potential
investors as commercial partners.

We’re very proud that we’ve raised
approx. $5.4 million in capital to
support this company. The George
Institute has put in a significant
amount of money, and we were
fortunate to find some critically
important private philanthropic
donors earlier on. Our two key
sponsors have been the New South
Wales Government, through NSW
Health. The other funder who also
gave us more than AU$2 million is the
Paul Ramsay Foundation, who had
the vision to understand very early in
the process what we were trying to
do, and to invest in our company. We
will always be grateful to them all.

Anyone interested in talking to
Ellen Medical Devices about
investment opportunities should
contact John Knight at The George
Institute on +61 2 8052 4300.

Inspire October 2020
this form of dialysis. It’s more
expensive than the other dialysis on
the market, which is called peritoneal
dialysis (PD). To start on PD, a
surgeon will insert a silicone tube
about the size of a drinking straw into
your stomach which has a connector
on the end. The patient is taught
to connect a two-litre bag of fluid
containing some salt and some sugar
to the connector, and hang it up on a
hook. Then by gravity the two litres
of fluid drains into your stomach and
all of the waste products in your body
can diffuse out into the fluid. This
procedure can be safely performed at
home. Recently there’s been a global
trend towards PD but for historical
and also for commercial reasons,
HD is still much more common,
partly because it is also much more
profitable than PD for the supplier.

PD bags are made in a large factory
– there’s just one for the whole of
Australia and NZ. The manufacturing
process is quite expensive and the
bags of fluid which weigh 2kg each
are shipped on trucks to the patient’s
home. Vincent realised there was an
opportunity to simplify this process
if you could use water from the tap.

So his invention is in two parts. The
first is a small pure water distiller
which can sit on the kitchen table
and can use water from the tap
(or rain or river water). It boils the
water and cools it down and makes
it into distilled water of sufficient
purity for medical purposes. The
second part of the invention is a
plastic bag full of a concentrate of
salt and sugar. Instead of weighing
2kg, it only weighs 120 grams. So,
we can make the bags with the
concentrate very inexpensively and
provide them to the patient. The
patient can fill the bag with water in
their own home and then use it for
PD. The benefits are you save on
the shipping costs and save on the
expensive centralised manufacturing
costs, and in volume you can drive
the price down to roughly five
times less than current prices. This
would reset the price point for this
treatment and make it available to
millions of people around the world
who are currently missing out.

Our system will also work very well
for urgent dialysis – for example for
the many Covid-19 patients who
have experienced kidney failure, or
for children with kidney failure due
to dehydration, for whom a few days
of urgent dialysis can be lifesaving.

7