Marc Koska

The SafePoint Trust
United Kingdom

The SafePoint Trust aligns all actors in the healthcare system around safe injections.

Focus: Health
Geographic Area of Impact: Global
Model: Leveraged non-profit
Number of Direct Beneficiaries: Over 4 billion safe injections in 40 countries
Annual Budget: USD 727,000 (2013)
Percentage Earned Revenue: 0% (2013)

The Social Problem
Each year, 17 billion injections are given around the world, more than 7 billion of which are unsafe. An unsafe injection occurs when a needle or syringe is reused between patients without sterilization. The transmission of hepatitis B and C and HIV are particularly common: in Africa, for example, 20 million medical injections contaminated with blood from HIV patients are administered each year. According to the WHO, unsafe injection practices are one of the top ten biggest killers in the world, conservatively estimated to account for more than 1.3 million deaths and USD 535 million in unnecessary health-related costs each year.

Innovation and Activities
Marc Koska spent years researching syringe manufacturing before inventing the K1 in 1996, the first auto-disabled syringe, which physically prevents re-use by locking the plunger in place after the first use. To facilitate adoption, Marc ensured these syringes could be produced using existing machinery, with minimal additional training required, for just one cent more per unit, and founded Star Syringe which licensed the technology to 14 licensees who have collectively produced over 4 billion auto-disabled syringes. Although the direct sales approach achieved widespread conversion to auto-disabled syringes in the immunization market, where bulk buyers like UNICEF and GAVI adopted a ‘safe injection’ policy and thereby forced manufacturers into compliance, vaccinations represent only 10% of shots administered annually. Because there are no institutional buyers in the curative market, representing the other 90% of shots administered annually, market penetration stalled.

Recognizing a different model was required to achieve universal adoption in the curative market, Marc created the non-profit The SafePoint Trust in 2006 with the goal of aligning all actors in the healthcare system around safe injections. Through effective advocacy and research efforts, The SafePoint Trust has catapulted safe injections to the top of the international health agenda, and on 23 February 2015, Margaret Chan, DG WHO announced a new global policy on injection safety.

The WHO’s global policy announcement is coupled with a campaign to force universal adoption based on an approach first piloted by The SafePoint Trust in Tanzania in 2011. The operation is called the LifeSaver campaign and works with all stakeholder groups to drive accountability through the system. National Health Ministries must mandate the exclusive use of auto-disabled syringes in their country or risk reduced funding from donors; global manufacturers have to bring 100% of their syringe production into compliance by 2020 or lose access to those markets as governments ban imports of reusable syringes; and health care workers receive clear incentives through positive reinforcement and a SMS-based rewards system developed by Hewlett-Packard that allows patients to give redeemable points to health workers administering safe injections.

The Entrepreneur
Marc Koska enjoyed a successful career as a broker in a major financial institution when he first learned about the spread of blood-borne diseases through unsafe injections in the 1980s, at the height of the HIV/AIDS crisis. He decided to devote his career to solving this problem and has received honorary doctorates from Brighton University and the University of Sussex. He has received multiple awards, including The Economist’s Innovation Award, the Fogarty Institute for Innovation’s Tech Award, and he the Order of the British Empire for his contribution to global healthcare.