Preventing 1.3 million Deaths a Year is Inexpensive and Easy

And Thanks to One Dedicated Man, Now Possible

Technology, particularly technology in medical care is very expensive.  Costly research, expensive machines, new facilities all cost in the hundreds of millions.  But it is possible to prevent a huge number of deaths at almost no additional costs.

When people in America, Europe and other advanced nations get an injection, we do not think that the needle could give us a life threatening disease.  But in parts of the world that is exactly what happens.

Some 1.3 million people die every year because of the re-use of syringes, according to the World Health Organisation. That's more than malaria kills, Koska points out. "This is not mosquito-borne disease. This is man-made," he said. There are 23m transmissions of hepatitis, which cost $119bn (£74bn) every year in medical and lost production costs. In Africa, around 20m injections contaminated with HIV are given every year. In the developing world, every syringe is used on average four times. That's Russian roulette, he says.

How is this is happening?  Here is a stomach churning description.

"The village quack has one syringe for 200 people," he said. "I've seen him take it out of his hair, use it and then stick it back in the roof of the hut where the insects are."

How to keep it from happening.?  Well one could institute an education program costing millions, if not tens of millions and hope that the training would accomplish the goal of a health worker disposing of a syringe after a single use.  That would be partially successful.  Or one could simply invent a self-destructive syringe, one that is inoperable after one use.  That would fix the problem.  And Marc Koska did just that.

It took years of studying the problem and learning about plastics, before he hit on his design, in which the plunger breaks as soon as it is pulled back for re-use. He has now sold 3bn of them and last month, he finally signed a contract with the world's biggest syringe-maker to produce his auto-disable design.

There is little cost to implement the program but that doesn’t mean it will be implemented

There is a commercial conundrum at the heart of the problem. At 3p each, syringes are very cheap to make. They are manufactured by a small number of big companies which use them as a loss leader – they package the syringe together with blood bags or catheters and charge more. Although auto-disable syringes are now as cheap to make, it involves changing over the production process, which is expensive. Companies also sell fewer syringes in the long run – because people get well.

But plans and programs are coming into being that will do just that.  And more than a million people annually will avoid a horrible death, countries will save hundreds of millions and the solution will have been very, very cheap.  Sometimes throwing money at a problem is not the answer, sometimes throwing compassion, dedication and brain power can be much more effective.

Twenty-seven years ago, he (Koska) was kicking his heels in the Caribbean after a privileged upbringing, looking for something interesting to do with his life. "I had first-class honours in beach bumming," he said. "Then in May 1984, I read an article – in the Guardian as it happened – predicting in the future, syringes would be a major transmission route for HIV. Immediately I knew that was my calling."