Radioscope: It's My Story: Injecting Life BBC Radio 4, February 17th
This is the tale of an Englishman's crusade to save millions of lives - by inventing a syringe which can be used only once. It starts 20 years ago with 23-year-old Mark Koska drifting through life as a professional yachtsman and skier, when a newspaper article about the possibility of non-sterile needles becoming a major transmitter of HIV sparks his imagination.
With no medical training but plenty of creative and practical skills he sets about designing a syringe which cannot be reused.
In his autodisposable (AD) model the plunger locks and breaks, ensuring its useful life is over, unlike ordinary disposable versions which, in reality, are often reused.
Design in hand, he sets about ensuring his version is easy to use and can be readily manufactured for the same price as unsafe syringes. No-one is interested and no financial backing is forthcoming until years later in 1999 when the World Health Organisation finally acknowledges the extent of infections from dirty needles. Its figures estimate 22 million cases of hepatitis B, two million cases of hepatitis C and about 250,000 cases of HIV are generated each year by unsafe injections.
We then hear from a doctor with Program for Appropriate Technology in Health, a non-governmental organisation based in Seattle, US, who testifies that the extent of the problem was well known among WHO public health workers in the 1970s, 1980s and 1990s. For decades they knew at least 50 per cent of vaccination campaign injections were unsafe, he says. As to why the organisation didn't push the safe needle message harder, we hear a mealy mouthed reply from a WHO representative about the greater expense of AD needles back then and an admittance that "the WHO response could have been both quicker and stronger".
AD syringes are now used in all WHO and UN-sponsored vaccination programmes and competition among manufacturers, including Koska's enterprise, Star Syringe, is fierce. Unlike most of its competitors Star Syringe is licensed to local manufacturers in 15 countries in order to keep costs down and provide local jobs.
In Nigeria, which has one of the worst records of unsafe injections in Africa, we join Koska for the opening of a centre whose grand patron is the president of Nigeria, Olusegun Obasanjo. One Nigerian father says he buys syringes himself to ensure his children get safe vaccines and he always oversees any such procedures.
In Pakistan, where Koska is also promoting his needles, unsafe syringes are a far greater problem than in Africa. While HIV is not such a big problem, hepatitis B and C are big killers - 14 million people are thought to be infected - and 60 per cent of these are attributable to reused needles. Koska hears accounts of syringes being washed in warm water and repackaged; of "new" needles which are blood-stained and wet; and hospitals spending 12,000 rupees (about €1,500) per hepatitis patient while doctors save just three rupee by giving unsafe injections.
Designing a safe syringe was the easy bit, he says: the real challenge is eradicating poverty and raising awareness. But tragic situations can be tackled with simple solutions, and by committed individuals.