‘Yacht Bum’ On Break From Job In St. Croix, Invents Life-Saving Syringe
Marc Koska (left) attends to a patient
CHRISTIANSTED – “Solutions are easier when you understand the problem,” says Marc Koska, who has devoted decades to understanding one of the most stubborn yet preventable problems in public health: disease transmission via unsafe injections.
In 1984, on a break from a job in St. Croix, Koska was moved by a Virgin Islands newspaper story warning that HIV would spread through reused needles.
“I thought, ‘That’s my calling,’ ” he says. “I wanted to get involved in a big intervention of a big problem.” Koska was then 23, a self-described “yacht bum” who lacked a university degree and knew little about the medical world. He spent the next three years supporting himself with odd jobs in his native England while educating himself about disease transmission, medical devices and the reasons why people reuse needles.
He then set to work designing a syringe that could only be used once. He devised a simple locking feature, a ring inside the syringe that prevents its reuse. If someone tries to refill the syringe after its first use, it breaks. The device Koska invented—the K1 auto-disable syringe—came on the market 14 years after he first started testing prototypes of his design.
The K1 syringe is now manufactured in 10 countries, and some 4.5 billion have been sold since 2001—saving countless lives and helping earn Mr. Koska, now 54, an Order of the British Empire award in 2006.
Through his nonprofit, SafePoint Trust, he campaigns for safe injection practices around the world. Using the same syringe or needle to inject more than one patient is among the most common dangerous medical practices; it can result from inadequate supplies or ignorance about the consequences.
The World Health Organization, or WHO, formally endorsed the use of single-use syringes in February and has urged every country to use them exclusively by 2020. It estimates that of the 16 billion shots administered annually world-wide, hazardous injections lead to 1.3 million deaths a year.
A 2014 WHO study found that in 2010, unsafe injections led to as many as 1.7 million hepatitis B infections, 315,000 hepatitis C infections and 33,800 HIV infections.
Misuse occurs globally, including in the U.S. The Centers for Disease Control and Prevention have identified more than 50 U.S. disease outbreaks linked to “deficient” injection practices between 2001 and mid-2014, including a 2007 hepatitis C outbreak in Nevada traced to syringe reuse at an endoscopy clinic.
Koska’s K1 (“K” for Koska, “1” for one use) syringe isn’t the only single-use or “smart” syringe on the market, but it is among the most affordable. He designed it to be produced on existing equipment with “very, very tiny modifications,” he says, keeping manufacturing costs down.
The price of each syringe is between 4 and 5 cents; according to the WHO, ordinary syringes can run between 3 and 4 cents each, and other single-use syringes can cost double that. “It’s not just about designing a better product,” Koska says. “It has to make sense on an economic basis.”