The Brazilian Engineers Who Created an Open-Source Ventilator

“Don’t tell my wife.” 

That’s what Marcelo Knörich Zuffo told Raúl Gonzalez Lima after he spent $3,000 dollars on a haphazard set of equipment ranging from microchips to plastic tubes to motorcycle batteries. 

It was March 19th and the COVID-19 pandemic had yet to really reach Brazil, but Zuffo and Lima—both engineering professors at the University of São Paulo—had seen the news reports of overflowing hospitals in Italy. It was only a matter of time, they thought, and something had to be done. 

That something was INSPIRE, an open-license ventilator that can be assembled using relatively easy-to-find parts in just two hours and is based on open-source microcontrollers. It has the same functionality as many conventional ventilators, including the ability to regulate both the frequency of respiratory cycles and the ratio of oxygen to atmospheric air. And, while the standard market price for ventilators in Brazil is around $3,000, INSPIRE comes in at $200. 

Both Zuffo and Lima are no strangers to developing medical technology. Zuffo has spent his career researching and designing advanced data visualization software for diagnosing pediatric cancer. Lima primarily researches biomechanics and electrical impedance tomography, a medical imaging technology often used to analyze lung ventilation. 

What is new is their unlikely friendship. While the two both knew of and respected one another, they had never collaborated on a project and hardly even spoken before INSPIRE. In some ways, the two couldn’t be more different. Zuffo is talkative and loud; Lima is quiet and reserved. What joins them is their sense of purpose and belief that they can make a difference.

“I’m working on getting him to talk more,” Zuffo joked. “But seriously, I think it was our destiny to be brought together. Our friendship is beautiful because we believe technology should be available for the benefit of everybody.” 

The two can still remember the thrilled look on each other's faces when INSPIRE was approved for general use by Brazilian health authorities over the summer. The ventilator is already being used in hospitals to treat critically ill patients with COVID-19. With 1,000 more ventilators on the way, Zuffo and Lima hope to help remedy a chronic shortage of ventilators in Brazil, one of the countries worst affected by the pandemic. 

The path to inventing INSPIRE has been far from easy. The two have been working 12 hours a day and often skipping weekends—but they also aren’t alone. 

“Initially Raúl and I sent an email to staff members asking if anybody would be interested in helping,” said Zuffo. “Within hours we had 40 volunteers who had signed up. Now, we have a multidisciplinary team of 250 volunteers consisting of staff members, alumni, graduate students, and retired professors.” 

“We’ve received hundreds of thousands of reals in donations,” he added, referring to Brazil’s currency. “The response has been incredible. It gives me hope.” 

To help with manufacturing, the Brazilian Navy even dedicated Zuffo and Lima a 150 soldier battalion to assemble ventilators. The project is getting attention outside of Brazil as well. A few months ago, the U.S. Government donated $200,000 to INSPIRE and offered to help the project through the FDA certification process. 

Now, the pair are working to get their ventilator to lower-income countries where prohibitive costs or overwhelmed health infrastructures can make traditional ventilators a rare sight. That’s why, for example, they designed INSPIRE to operate off of motorcycle batteries and not require compressed air. 

Even more fundamentally, they designed INSPIRE to reflect their own vision of the future: a future in which technology is designed for humanity and not just for profits. 

“In the end, this project is about democratization,” Lima said. “Lives are on the line. In Brazil, research shows a serious picture. The average mortality rate for COVID-19 in an ICU ward here is 60 percent. If a hospital uses novel protocols and technology for ventilation, that mortality rate halves to 30 percent.” 

“People in Brazil, but also around the world, deserve to have access to this type of technology,” he added. “It can literally be the difference between life and death.”