India has been thanked multiple times by various countries and world leaders for its role in global vaccination. And why not. India does not only have the world's largest vaccine manufacturer, it is home to one of the world's largest syringe makers that is, currently, the key to meeting the shortage of syringes in the world.
In late November, a mail from UNICEF popped up in the mail inbox of Rajiv Nath-helmed Hindustan Syringes & Medical Devices. The agency desperately and swiftly required syringes for children. They were to be smaller than usual and were to break if used for a second time in order to prevent spreading of diseases. "I thought, 'No issues'. We could deliver it possibly faster than anybody else," said Rajiv Nath, as mentioned in a report in New York Times.
He had already put in millions of dollars in preparing his syringe factory for the demand for coronavirus vaccination. While countries are scrambling for vaccines, the jostle to acquire syringes are afoot too. US and EU officials have already said that they don't have enough vaccine syringes. Brazil restricted exports of the same in January. Japan, last month, said that it might have to discard millions of Pfizer-BioNTech vaccine doses if it could not procure enough syringes in time.
Ingrid Katz, the associate director of the Harvard Global Health Institute said that countries were not fully prepared to get this particular type of syringes.
The world needs somewhere between 8-10 billion syringes for coronavirus vaccines alone. Earlier, before COVID-19, only 5-10 per cent of 16 billion syringes were used for vaccines. While countries pumped in billions of dollars into developing vaccines, little investment has gone to expand syringe manufacturing.
Moreover, not all types of syringes can do the work. For eg, for maximum output from a vial of Pfizer vaccine, a syringe must carry an exact dose of 0.3 mm. It must also have low dead space - the minute distance between the plunger and the needle after the dose is fully injected - to minimise waste.
When it comes to syringe supply, India is not a big player. But Nath sees a big opportunity. He invested nearly $15 million to mass-produce speciality syringes. In May, he ordered new molds from suppliers in Italy, Germany and Japan to make a variety of barrels as well as plungers.
Nath added 500 workers in his production line that produces 5,900 syringes every minute. With off days included, the company churns out nearly 2.5 billion syringes in a year. They plan to scale it up to 3 billion in July, as mentioned in the NYT report.
Hindustan Syringes has been supplying UNICEF syringes for its immunisation programmes. In late December when WHO cleared Pfizer for use, UNICEF was looking for a syringe that would meet WHO specifications. Hindustan Syringes' product was the first, as mentioned in the report.
The company would ship 3.2 million of those syringes to UNICEF soon. It has already sold 15 million syringes to the Japanese government, kept 400 million for India's vaccination drive. Nath has offered to produce 240 million more, including for UNICEF and Brazil.
Nath's company relies on a syringe design by British inventor Marc Koska, and its ability to produce all the components in-house. The needles are made of stainless steel from Japan. The strips are curled into cylinders, welded at the seam, stretched and cut into tubes. The jabs are dipped in a silicone solution.
The upfront costs are exorbitant and the profit is marginal. Making syringes is a frugal operation. Nath's operations have no shareholders, and no interference. He likes it to remain a family business.