Healthcare to get a shot with 'auto-disable' syringes

MUMBAI: The country’s healthcare delivery system is set to get a safety shot, with a government mandate on the use of auto-disable syringes (AD) coming into effect in end-April. A legislation signed late last year requires all central government hospitals under CGHS to use only auto-disable (AD) syringes to avoid the spread of disease. 

AD syringes are designed for a single use, with a lock that prevents reuse and eliminates unauthorised packaging or even resale. In a study conducted in 2005 by the Union government and Indian Clinical Epidemiology Network, 62% of injections were found to be unsafe because of the reuse of syringes.

Marc Koska, CEO and founder of SafePoint Trust, a UK-based charity organisation that advocates the use AD syringes, especially in developing countries, said, “It costs 10% more to make a conventional syringe into an AD syringe. The price in the market is not too different either. A conventional syringe costs Rs 2, while an auto-disable syringe costs Rs 2.50.”

However, despite the deadline being just a few days away, Mr Koska said only five states have placed orders for AD syringes so far: Maharashtra, Karnataka, Andhra Pradesh, Uttar Pradesh and Gujarat.

The sting — for the government as well as manufacturers — is in the heavy costs. Industry observers say only one manufacturer in the country makes AD syringes. Moreover, in government tenders, conventional 2 ml syringes sell for 90 paise while ADs sell for Rs 1.5.

JM Narsing Rao, managing director of Sangam Healthcare Products told ET, “The design for AD syringes is patented and we will have to pay a lot to buy the rights to the patent. From a manufacturing standpoint it is only the addition of another mould to the process. The rest of the machinery remains the same.” None of the developed countries have mandated the use of AD syringes, he said, adding his company would shift to AD syringes if mandated.

However, Mr Koska clarified that patent holders are willing to share their designs for free or at a nominal cost. “It's true that none of the developed countries have mandated the use of AD syringes. They count on the system to work well and not reuse syringes. In developing countries, however, where the risk of disease prevalence is much higher, many countries have found it to their advantage to shift to AD syringes,” he said.

Narendra Jain, secretary of the All India Syringe and Needle Manufacturing Association (AISNMA) said the capacity for manufacturing conventional syringes in India is at around 1,000 million units per month, whereas the capacity for AD syringes is almost nil, incurring huge foreign exchange expenses on imports.

“It will almost be a monopoly of one or two companies in India, which is unfair to all other manufacturers. On the contrary, it will also attract the MRTP (Monopoly of Restricted Trade Practice) Act,” he added.

The change-over from manufacturing conventional to AD syringes will involve considerable investment for every unit, which in turn will be an additional burden for the country, without the added benefit of an increase in production capacity, he said.

According to AISNMA, the syringe market in India is currently worth Rs 2,000 crore and is growing at 10%.

Per capita consumption in India, he said, was low, with a person takes 7-8 shots per year on an average. In rural areas, reuse of conventional syringes is common.

In the US, it is at an average of 28 syringes per person per year. "If the government can control the reuse of conventional disposable syringes, this figure can see a four-fold increase," Mr Jain said, adding, the law has been misinterpreted.

"It is only for immunisation programmes, but has been misread as being for all types of syringes. The government should clarify that they do not plan to ban conventional syringes."