From April 30, the government has made it mandatory for all health centres to use non-reusable syringes.
Of the 5 billion medical injections administered in India every year, 62 per cent are unsafe — a startling figure that brought Marc Koska, inventor of non-reusable K1 syringes, to India.
His UK-based charity SafePoint spearheaded a campaign across the country in November last year, which propelled the government to make the use of Auto Disable (AD) syringes mandatory in all public health centres from April 30.
Koska’s campaign, which involved over 10,000 radio and 5,000 television advertisements and endorsements from such public faces as Kiran Bedi and Mark Tully, emphasised the urgent need to prevent blood-borne diseases transmitted through unclean syringes that kills more that 300,000 people a year.
It was this significant move in medical circles, ironically led by a non-Indian, that finally set the health ministry in motion. “It was, in fact, a 2005 study commissioned by the government that revealed these shocking figures. Yet, four years after, the ministry took no action. After I decided to reach out through public information, as I had done in a number of countries in Africa like Nigeria and Ghana, Health Minister Anbumani Ramadoss finally agreed to meet me and agreed to issue a mandate,” says Koska.
In keeping with the mandate, it is now compulsory for public health service centres across the country to switch over completely to AD syringes complying with ISO standards for all medical purposes, and not merely for immunisation programmes. These syringes become dysfunctional after a single use, ensuring that they cannot be reused on another patient. Maharashtra, Delhi, Karnataka and Gujarat have begun the switch, and other states are gradually coming forward. Gujarat, in fact, has embraced the mandate to adopt “safe” medical practices after the massive Hepatitis B attack in Modasa in February that took 53 lives.
Koska, however, says Tamil Nadu has not been as forthcoming, a claim the state government refutes. State Health Minister Thiru M R K Panneerselvam was busy campaigning for elections, but Dr Sukumar at the state’s Directorate of Medical Education, speaks up. “There has been absolutely no opposition to the use of AD syringes in our government hospitals. At the moment, the government is in talks over this policy because it will incur some extra expenditure,” he says. On an average, an AD syringe costs 50 paise more than its regular counterpart.
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Tamil Nadu also said a consignment of AD syringes sent to Tamil Nadu by the Centre in May 2008 was found to be defective. The syringes, imported from Spain, (brand BD Solo Shot IX), reportedly had rusted needles and dust in the cylinders. Koska says he’s been encouraging state governments to buy AD syringes from Indian companies and not import. But part of the supply issue stems from the dearth of suppliers. Of the 30-odd syringe manufacturers in India, only four or five companies produce AD syringes. The largest of them, Hindustan Syringes and Medical Devices (HMD) with a 60 per cent market share, reports no significant increase in tenders since the April 30 diktat.
Rajiv Nath, HMD’s joint managing director, says, “The elections have disrupted the process in some cases. Some institutions are taking more initiative than others.” AD syringes account for 5 to 20 per cent of HMD’s annual capacity, of which 60 per cent is exported. Though the shift has been slower than expected, Koska is positive that other states will play by example, and once the demand for AD syringes significantly increases, more manufacturers will join the move.
At the moment, not using AD syringes is not a punishable offence. All the same, Koska has taken his own measures, gathering video evidence that he may consider making public if required. As he confesses, this is a personal movement for him. In a few days, he will be home in Sussex, England, settling back into business at Star Syringe, his medical technology firm. But SafePoint’s campaign has just begun.