BALLABGARH, India – In late November, an urgent email appeared in the inbox of Hindustan Syringes & Medical Devices, one of the world’s largest syringes manufacturers.
It was from UNICEF, the United Nations Children’s Organization, and it was desperately looking for syringes. Not everyone would. These syringes need to be smaller than usual. They had to break when used a second time to prevent the spread of disease from accidental recycling.
Most importantly, UNICEF needed them in large quantities. Now.
“I thought no problems,” said Rajiv Nath, the company’s executive director, who invested millions of dollars in preparing his syringe factories for the vaccination attack. “We could possibly deliver it faster than anyone.”
As countries scramble to secure enough vaccine doses to end the Covid-19 outbreak, a second mess for syringes unfolds. Vaccines aren’t too useful if health professionals don’t have a way to inject them into people.
“Many countries have been flatfooted,” said Ingrid Katz, deputy director of the Harvard Global Health Institute. “It seems a fundamental irony that countries around the world are not fully prepared to get these types of injections.”
According to experts, the world needs between eight and ten billion syringes for Covid-19 vaccinations alone. In the past few years, only 5 to 10 percent of the world’s estimated 16 billion syringes were intended for vaccination and immunization, said Prashant Yadav, a senior fellow at the Center for Global Development, a Washington think tank and expert on health care supply chains.
Wealthier nations like the United States, Britain, France and Germany have pumped billions of dollars in tax dollars into vaccine development, but little public investment has been made to expand syringe manufacturing, Yadav said.
“I’m not only concerned about the total syringe manufacturing capacity, but also the capacity for the specific syringe types,” he said, “and whether the syringes are already in the places where they are needed.”
Not all syringes in the world are suitable for this task.
For example, to maximize the performance of a Pfizer vaccine vial, a syringe must contain an exact dose of 0.3 milliliters. The syringes must also have small dead space – the infinitesimal distance between the plunger and needle after the dose has been fully injected – to minimize waste.
The industry has come up to meet demand. New Jersey-based Becton Dickinson, a major syringe maker, said he will be spending $ 1.2 billion over four years to expand some of the capacity to fight pandemics.
March 6, 2021, 6:57 p.m. ET
According to Fitch Solutions, a research company, the United States is the world’s largest supplier of syringes by sales. The United States and China export with total annual shipments of $ 1.7 billion. While India is a small player worldwide with an export volume of just $ 32 million in 2019, Mr. Nath of Hindustan Syringes sees a great opportunity.
Each of his syringes costs only three cents, but the total investment is considerable. He invested nearly $ 15 million in mass production of specialty syringes, which is roughly one-sixth of his annual sales before orders were even in sight. In May he ordered new molds from suppliers in Italy, Germany and Japan to make various barrels and plungers for his syringes.
Mr. Nath added 500 workers to his production lines who manufacture more than 5,900 syringes per minute in factories covering 11 acres in a dusty industrial area outside New Delhi. Excluding Sundays and holidays, the company produces nearly 2.5 billion a year, but plans to scale to three billion by July.
Hindustan Syringes has long had UNICEF vaccination programs in some of the poorest countries, where syringe reuse is common and a leading cause of fatal infections, including HIV and hepatitis.
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In late December, when the World Health Organization cleared Pfizer’s emergency vaccine, Robert Matthews, a UNICEF contract manager in Copenhagen, and his team had to find a manufacturer that could make millions of syringes.
“We went, ‘Oh, honey!’” Said Mr Matthews as they searched for a syringe that met WHO specifications and was compact for shipping. The product of Hindustan Syringes is the first.
According to UNICEF, the company will soon begin shipping 3.2 million of these syringes, provided further quality checks are carried out.
Mr Nath has sold 15 million syringes to the Japanese government and over 400 million to India for his Covid-19 vaccination, one of the largest in the world. More are on the horizon, including UNICEF, for which he has offered to produce around 240 million more, and Brazil, he said.
At the company’s # 6 plant, machines coated with yellow paint hum as they spurt out plastic barrels and flasks. Other machines from Bergamo, Italy assemble each component, including needles that are monitored by sensors and cameras. Workers in blue protective suits inspect trays full of syringes before unloading them into boxes that they hand carry to a packing area next door.
To increase efficiency, Mr. Nath relies on a syringe design from Marc Koska, a UK inventor of safety injections, and his ability to manufacture all of the components in-house. Hindustan Syringes makes its needles from stainless steel strips imported from Japan. The strips are rolled up into cylinders and welded at the seam, then stretched and cut into fine capillary tubes that are mechanically glued to plastic hubs. To make the bumps less painful, they are dipped in a silicone solution.
The syringe business is a “bloodsucker,” said Nath, where upfront costs are astronomical and profits are marginal. If the demand for his syringes drops in half over the next few years, he’ll lose almost all of the $ 15 million he’s invested.
It is clearly an economical operation. The blue carpet in Mr. Nath’s office looks just as old as his desk or the glass chandelier on the stairs that his father furnished in 1984 before he handed the company over to Mr. Nath and his family.
A family business is exactly how they like it. No shareholders, no interference, no worries. When Mr. Nath needed money in 1995 to increase production and buy lots of new machines, he looked for private capital for the first time. If that had been the case today, he said, he would not be able to follow his stomach and make his syringes on this enormous scale.
“You have a good night’s sleep,” said Mr. Nath. “Better to be a big fish in a small pond.”