Marc Koska: The Man Who Saved 9 Million Lives

Unlike many oth­ers, Marc never for­got his dream; as a young adult, he was always on the lookout—and one day he stum­bled upon it. “Years went by and I didn’t really set­tle into any­thing because I was still wait­ing for my big moment,” he recounted. “Then in May 1984, I read a news­pa­per arti­cle that dis­cussed the fact that reused syringes would be a major trans­mis­sion route for HIV. That was exactly the bit that I was look­ing for.” Marc was 23 at the time.

A Widespread Crisis

Marc spent the next two and a half years sim­ply research­ing the prob­lem itself. The issue was that in many third-world coun­tries syringes for dis­pens­ing drugs to treat dis­eases would be used more than once, in a very mis­guided effort to save money. Although it was widely known by med­ical author­i­ties that such a prac­tice was dan­ger­ous and con­tributed to the spread of dis­ease, incred­i­bly noth­ing had been done about it.

“In the prob­lem areas, you have either a skilled or unskilled med­ical prac­ti­tioner blindly giv­ing an injec­tion to some­one; and the injec­tion is so valu­able that the per­son basi­cally trusts the practitioner—being ‘sec­ond to God’ (which I’ve heard many times)—to do the right thing, but in fact it’s not,” Marc said.

The pre­dic­tion from the arti­cle that Marc read in 1984, hor­ri­bly enough, ended up being cor­rect. The World Health Organization esti­mates that unsafe injec­tions are respon­si­ble yearly for 230,000 HIV infec­tions. Additionally they are the cause of 1 mil­lion hepati­tis C and 21 mil­lion hepati­tis B infec­tions. But the worst sta­tis­tic of all is that unsafe injec­tions annu­ally cause 1.3 mil­lion deaths—more than malaria.

Marc cer­tainly had his work cut out for him.

He con­ceived the solu­tion as an inex­pen­sive syringe that could be used for only one injec­tion and then dis­posed of. Knowing noth­ing at all about how syringes were made or how his poten­tial solu­tion could be imple­mented, he stud­ied up on every rel­e­vant patent and syringe design. He vis­ited a mul­ti­tude of syringe fac­to­ries and stud­ied plas­tic injec­tion mold­ing tech­nolo­gies in depth. He fol­lowed syringes all the way from man­u­fac­tur­ing to end use and waste management.

All the while he was con­duct­ing this research he needed to eat and have a place to live, as no one was pay­ing him. “I was self-funded,” said Marc. “You know, I was just a kid and I was doing some dec­o­rat­ing, some house­work and rough build­ing work sim­ply to keep it going.”

At the end of the two and a half years, the penny dropped. “I had an epiphany while read­ing all the patents that existed from other peo­ple. That insight was that the syringe had to be made on exist­ing machin­ery, it had to be made for the same price, and it had to be used in exactly the same way so that there would be no train­ing bar­rier. When this all came together, the design for me was very easy. It took lit­er­ally a minute to real­ize what it had to look like and do in order to deliver to those three criteria.”

That design is inge­niously sim­ple. The syringe looks like any other you may have seen, with one very notable excep­tion: once the med­ica­tion has been injected and the plunger has been pushed all the way to the bot­tom of the tube, if some­one tries to pull the plunger back out to reload the syringe, it locks and breaks off, ren­der­ing the syringe useless.

Of course, it’s one thing to have such a big idea—it’s quite another to get it actu­ally done. Marc labored for the next 15 years, butting up against vested inter­ests and fixed method­olo­gies, to actu­ally begin pro­duc­ing syringes.

But through per­sis­tence his plan came to fruition. Since 2001, 1.8 bil­lion K1 syringes have been sold from Star Syringe, the com­pany Marc founded, and mil­lions are used every day, pro­vid­ing sin­gle, safe doses of med­i­cine that do not infect patients in the process. As a result, 9 mil­lion fatal infec­tions have been pre­vented, sav­ing an astound­ing 9 mil­lion lives.

Click on any image above to see a larger version.

The Second Problem

When the syringes were being pro­duced, how­ever, Marc encoun­tered a whole other prob­lem. “Once I had bro­ken through the bar­rier of mak­ing the prod­uct, I thought we would be able to start a steam­roller going and it would have its own momen­tum,” he related. “I thought that gov­ern­ments would nat­u­rally go, ‘Oh, this is cheaper than using a syringe that trans­mits dis­ease and which costs a lot of money.’ But it turned out, after even a few years of sales and sell­ing it to UNICEF, that no one was actu­ally telling the pub­lic there was a dan­ger in reusing syringes. It’s a lit­tle bit like putting a safety belt in a car and not telling any­one what it’s for. So I then had to go out and give the infor­ma­tion to the pub­lic, because they had no idea that they had to demand this product.”

The result was the founding—once again by Marc—of the SafePoint Trust, a non-profit orga­ni­za­tion ded­i­cated to edu­cat­ing mil­lions through­out the world on the need for clean injec­tions, with a goal that the over 40 bil­lion injec­tions given every year are given safely. The SafePoint mes­sage is deliv­ered through exist­ing net­works in com­mu­nity edu­ca­tion and health­care, tak­ing advan­tage of estab­lished infra­struc­ture. Another arm of the orga­ni­za­tion, SafePoint Films, makes ded­i­cated short films (one to three min­utes) that spark reac­tion, inform and change behav­ior. The first film was made in May 2007 in India and has been endorsed by for­mer pres­i­dent Dr. A.P.J. Abdul Kalam for nation­wide dis­tri­b­u­tion as part of an inten­sive safe-injection cam­paign in India.

“SafePoint has deliv­ered the mes­sage into two coun­tries so far: Uganda, where we’ve done very well and have changed the law, and now India, where we’ve changed the law on a pub­lic health­care basis,” Marc stated. “So all pub­lic hos­pi­tals and clin­ics have to use an auto-disable syringe whether it’s made by me or not.” To put this achieve­ment into per­spec­tive, pre­vi­ously 62 per­cent of all injec­tions given in India were unsafe.

SafePoint was for­mally reg­is­tered in 2006 as a char­ity in the UK, but its work has long been estab­lished in its focus regions of India, Indonesia, Vietnam, East Africa and Pakistan.

Recognition and the Road Ahead

Marc has now cer­tainly been rec­og­nized for his work. In 2006 he was made an esteemed Officer of the British Empire (OBE) by the Queen, in recog­ni­tion of his out­stand­ing con­tri­bu­tion to global health­care; while last July he was a fea­tured speaker at the TED- Global con­fer­ence at Oxford—a renowned yearly event that hosts top inno­va­tors in many fields from all over the world.

But as he him­self will tell you, there is much more to be done.

“We still only rep­re­sent a very tiny por­tion of the mar­ket,” he said. “What’s yet to be done is to get the big boys involved so that whether it’s through my prod­uct or not, we cre­ate a much bet­ter mar­ket for these syringes and get them being used whole­sale, across the whole scene, ensur­ing that every­one receiv­ing an injec­tion is not being betrayed.”

What Marc—and the rest of the world—is faced with is the frus­trat­ing fact that, although the major movers such as the World Health Organization, UNICEF and the UN rec­og­nize there is a prob­lem with unsafe injec­tions, we are still years away from the needed res­o­lu­tions, changes in pol­icy and man­dates being passed. “Preventable tragedy makes me angry, to be honest—as I’m sure it does you,” con­cluded Marc. “It’s a ter­ri­ble waste, and there’s still so much more to be done.”

And as long as there is a need, Marc will be there doing it.

For more infor­ma­tion on Marc, his life and activ­i­ties, please visit his web­site at www.marckoska.com.

For fur­ther data on Star Syringes, see their web­site at www.starsyringe.com.

To learn more about SafePoint Trust, visit www.safepointtrust.org