Transcript: Marc Koska – Inventor of the K1 auto-disable syringe (Max#39)

Music

Kevin: Welcome to Maximise Potential the podcast to educate and motivate through a range of original interviews designed to help you maximise your potential. Brought to you in association with the award winning recruitment group Jenrick.

Welcome back to episode 39 of the Maximise Potential Podcast. At one time or another we have all probably been inspired by an article or a television program which prompted us to say something like ‘I really have to do something about that’ yet no matter how sincere we are with that statement in the cold light of day and with our daily responsibilities firmly back in the forefront of our mind our intentions to serve the greater good often take a back seat. However in today’s Maximise Potential interview we have an individual who did not allow the noise of daily life to dampen his desire to act upon an article he read and has since 1984 devoted his entire adult life to solving a problem of global significance. Without funding, training or experience Marc Koska set himself the target of eradicating the spread of disease and death through unsafe injections which count for more global deaths each year than malaria. Here is Marc to share the highs and lows of his incredible journey whilst giving us a wonderful insight into his approach to life in general.

Music

Marc Koska I would like to welcome you to the Maximise Potential podcast.

Marc: It’s an absolute pleasure to be here.

Kevin: We are going to go on a bit of a personal journey with your life today. I am sure it is going to jump between what you are doing right now which is something quite wonderful in terms of the influence it has all over the world. We are here to explore the events to leading up to that as well because that is a huge part of this journey and really now it is over to you. Where shall we start today? Do we start as a child? Or do we start off now and work backwards? How do you want to do this today?

Marc: I don’t know that is a very good way to frame it. I think you know if we look at where we are today I have only just really assembled all the ingredients if you like to allow me to have a devastating effect, to have a really big impact is still just around the corner. Luckily I feel very confident in the next couple of years it is going to bring all the results I ever dreamed of so a really good time to do a talk like this.

Kevin: That is interesting so even after all of the years you have put into this, all of the results that you have seen of this, you still feel like you are at the tip of the iceberg, you feel like this is still the beginning of the journey.

Marc: Yeah because the influence that one the product and the campaign, the information campaign has had is still in single figures percentage wise around the world. So even though you know it looks good as a one man band you know conquering the world you can easily write a decent headline about it ‘Man saves millions of lives’. You know the truth is we have barely started so. I think that starting now is probably a good thing because it’s you know we are at a very exciting point. We are just going to go through a C change from single figure penetration to you know 20 – 30% of developing world penetration and that is going to happen in the next three years and that is very exciting.

Kevin: It is lovely to hear and I think you like lots of other people just it must be just continually resetting your goals every single time by the sounds of it because you have had a number of goals to work towards but you immediately are coming across as the sort of person that as soon as you have hit that one goal you are then immediately thinking about the next one.

Marc: Maybe I was setting a new goal a week before we hit it I don’t know. But it never feels I sign off one sheet of paper and move to the next it always seems like one sheet of paper if that makes sense.

Kevin: So take me back to a young Marc Koska. We spoke briefly before we even started recording today about where if you like where your first understanding of yourself and what you wanted your life to be started from and I think that is worth really going back to.

Marc: I think I must have been about six and I was really starting to be self questioning I suppose in a way of why am I hear, what are we doing, ooh wow I am a human being, ooh wow I’m on planet earth, ooh wow this is exciting what is my life going to be about. And the answer came much more as a concept no English words, but as a concept I felt that I was here to try and find a large issue that I could be an intervention for. A large problem.

Kevin: And as a concept when you are using this word concept do you mean it was more of a feeling inside yourself.

Marc: Yeah it was a feeling because I didn’t have any experience to position a thought against if you like. So it was just something that stayed with me and it is still in me now and it is very much the core of me. I suppose it is quite grounding you know I felt I arrived. That was a really good thing to find out and it has been part of me ever since.

Kevin: And when you think back to that night where do you feel it, what does it conjure up? Do you get the goose pimples on the back of the neck? Is it a warm feeling. I mean I am trying to help other people understand that maybe they have had those concepts that they do actually understand more about themselves than they probably realise but you took the time to listen. You took time to ask the questions as well.

Marc: Well it is certainly not goose pimples, it is nothing physical. If I can use the parlances it is a spiritual thing and it is calm and quiet, it is very reassuring. But I think you are right it is a very good way of describing it you do have to listen. You have to listen really, really carefully and you know we live in a world which is very, very busy and it is very, very noisy and do we have time to think and what is our purpose. You know a lot of us, including myself now and again, go off on these really weird tangents which is just a complete waste of time and resources and energy and a load of rubbish because we think that’s what we want but it isn’t. But it seems normal to me to listen to those very quiet instructions.

Kevin: And that is a great lesson for others to consider within their own lives. And so where did that central guidance, where did that concept then start taking you.

Marc: So I was very interested in this intervention issue. I was very interested in where there issues that could be solved or helped in any way and my radar was out, I was on the side of the stream looking for those kind of issues coming flooding past.

Kevin: And then probably one of the key moments in your life happened and you picked up an article.

Marc: Yeah I was 23 years old and I went down and bought the newspaper, it was the Guardian. So I read this newspaper article and bang in the middle of it was one sentence which said – “one day syringes, disposable syringes would be a major cause for the spread of aids because they would be reused.” And they are being reused and they will continue to be. I found that astounding. I sort of stopped, re-read it, re-read it again – wow is that really what I think it is. And to me it was you know the green light for what I had been looking for.

Kevin: Incredible the concept from when you were six suddenly made sense in that article. And then it just started from there.

Marc: Yeah I knew instantly that that was what I was going to do and what I wanted to do. Both those characteristics. From that moment on I have been fulfilled in as much as I have found what I wanted to do. And now as we started off the interview you know I am now in the position where I believe that fulfilment on getting the project delivered is much more real now than ever before.

Kevin: And yet you were not trained in this field. You weren’t a pharmaceutical professional, you had not gone to university to study this.

Marc: Yeah and I think that’s a blessing. I think not being, I had no background at all other than I can look at it from the side of the stream rather than in the stream.

Kevin: That is the key.

Marc: Yeah it probably is. So I went on this fantastic journey of learning all about the problem and learning as much as I possibly could. One thing that was very clear to me was that you know, I think there was a statistic at the time that said that 99% of all businesses failed in the first three years and I found that a fascinating thing. So I got out of the stream and had a look at that. What I had to observe, or what I observed was the 1% that make it was that one had really understood the problem far deeper and far more intelligently than the 99. There was no difference in intent, maybe no difference in product but it was just the way they sold it. It didn’t have the right quality to fit into the market gap and the gap is the problem. And I think so many times, I suppose using our analogy again that is the quiet moment in a business, is really understanding the gap that you are going to fill and the gap that wants to be filled. Whereas so many of these others miss. Not because they are any different but just because they are aimed a couple of degrees off the gap and they haven’t really understood who they are trying to aim for.

Kevin: Tell me how you understood it.

Marc: Well I didn’t know anything about where the gaps might be so I had to look at everything to try and work out where the gap was. If you sort of imagine my arms are spread left to right and so on my right hand side we have got kids in Africa being immunised, on my left hand side we have got the production of polypropylene out of oil and you’ve got you know 20 other areas in the middle. So what I was looking for was the gap. And after looking at all of those for about three years I suddenly woke up one morning with the light bulb on and this is what I was thinking – I’ve got to design a product, because up till then I hadn’t thought of solutions at all I was just interested in problems. And I would have to design a product that had the ability to be made on existing machinery or if it was new machinery that it was mimicking the old stance and no R&D costs were involved in making a new mould for example or assembling machine or packaging or sterilisation. So made on the same equipment, used in the same way so that the nurse didn’t require any training otherwise that would be a major barrier and thirdly it had to cost the same to manufacture as a normal syringe. Syringes are very, very price sensitive which we may touch on in the future of this talk but those three elements just to go over them again – I woke up one morning and I realised that my design had to be incorporated into the traditional way of making a disposable syringe which had been around 30 years at that point. It had to be made for the same cost and had to be made in a way that didn’t require further training when being used. So that was my design brief if you like.

Kevin: You submerge yourself for three years just understanding the problems that the market was facing and you hadn’t designed anything in that three year period.

Marc: I refused to design because I didn’t have the right to design anything, I didn’t know what I was designing. I didn’t know what the gap was. What I didn’t want to do was presume the gap. Because if I presume the gap I am going to be in the 99%. I wanted to know what the actual gap was and then if I knew what the actual gap was I stood a chance. Maybe three of us would go through that gap and we would fight it out between us. I didn’t mind that as long as I had given it, as long as I had found the gap. To be honest the gap boiled down to the manufacturing process. When I looked at the supply and demand of this industry and every industry is set up the same way you know these microphones are beautifully designed but someone has got to buy them. And someone has got to then talk about them and other people have to buy them you know it is just a traditional cycle for any product.

When I looked at the syringe market I realised that unless manufacturers, because they are made is such vast volume for no margin, literally no profit.

Kevin: Well I think you have lead us on nicely. Let us put the syringe market in perspective here because I think that will help everybody really understand then why the three elements that you highlighted are so relevant.

Marc: There are about 15 billion syringes made on the planet every year. You know that equates to 10 each per person on average. We’ve got numbers are suggested in America that the market is around 46 syringes per person per year in America. Understandable if you think about some people are unfortunate enough to be bed ridden or being under treatment or diabetic or in hospital and any of those would require multiple use of syringes. So even though you or I might not have had an injection for ten years there are people unfortunately who are having many of them for curative purposes and they create that average. In Africa or in Asia in the developing world the average is somewhere around five per person per year. So there are around 600 factories in the world. Probably half of those are below the ISO manufacturing standard on what we would say sort of backstreet type mum and pop type organisations. The other half probably have some form of accreditation nationally or internationally and there are a big four manufacturers, multinationals who are the top of the tree. So Becton and Dickinson, Trumo, B Brown and Cavideon. And these big four are the only ones really who have multiple factories, that are in different locations and they make on a huge scale.

It is dominated by Becton and Dickinson, they are the largest syringe manufacturer in the world and anywhere between a third and a half of all syringes are made by them. And they are incredibly successful. They walk the talk. They have done exactly what they said on the packet they would do and they are number one by a long, long way.

Kevin: And yet even though there is all this volume but price is such a major issue with syringe, or cost should I say is such a major issue with syringes.

Marc: Yeah I mean historically syringes have been used by doctors and by the health care profession as the most commonly used form of delivery of drugs. It is a very efficient way of getting drugs into the body and used quickly. The stomach for oral medicine is a challenge and oral medicines are being formulated to get through the stomach lining and be absorbed. But that is quite a challenge compared to putting it straight into the blood stream. The blood stream route is a lot easier and has far fewer absorption challenges because it is direct. So syringes are the most commonly used piece of medical equipment on the planet. And as such they are not really valued economically they are valued more as a loss leader, as a market share gainer and as a brand carrier. All manufactures of syringes make other products or sell other products. So they will use their brand, let’s say it’s the Crown brand of syringes, so they will put a crown on their syringe and they will sell that as widely as they can. For instance if the Crown brand wanted to make ingress into you know Vanuatu, the smallest island I can think of they would go to Vanuatu and say to the Ministry of Health, we have got a great deal for you we are going to supply you all our syringes at cost or for nothing, we have got some excess supply we want to supply our brand to Vanuatu. The Crown brand then gets used by all the doctors and nurses who respect it because it is a good product and then when the Crown brand catheter or scalpel or infusion set arrives it is respected as well. However the other products will be loaded with a proper margin whereas the syringe has no or very small margin and that is your typical sort of loss leader procedure which takes place.

So it is a pretty good strategy for the disposable industry to come up with. Make a brand hold it, hold market share and sell other higher margin products into it. And nothing really wrong with that except syringes are reused and the solutions are limited by its loss leader characteristics. So one would think let’s make more syringes but as we have said the equipment is very expensive so equipment makes volume in stages. So if you buy a new machine you might make another 100m units. A machine would make anywhere between 50, one line, so it is made up of say 10 different stages and that line might cost you $2 – 3m and it might make 50 – 100m syringes depending on the capacity of that line. So you have to have a market step of 100m units to justify buying a new line. So we are really caught between supply and demand in the situation that we are in at the moment of taking an industry with quite sophisticatedly made product but a very basic product. It is one that is reused, proven is reused around the world a number of time and it is causing a devastating toll on the world. So the challenge that I was setting myself was could I design something, could I design a system which would make a wholesale change to that industry and manufacturing capacity is one of those issues. And actually if I was a manufacturer of syringes which I am not you know I would probably be against changing to auto disable as well because economically it is a really tough pill to swallow. You are changing an industry that works fine, that is selling all your higher margin products every day and you are making good profits on those and the syringe has its role in that procedure. But you know what we are asking everyone to be is Mother Theresa all of a sudden and talk to the Shareholders on that Mother Theresa issue of look we think we should do a whole load of good and we will do it by doubling our capacity, making twice the number of syringes on which we are probably going to make very little return but that is going to do some good in the world. And of course Shareholders don’t have that characteristic.

Kevin: Can I just ask the fundamental reason why there is so much reuse is there a basic reason, is it just the fact they have only got a certain quota of syringes that they can have. I am a bit lost with that bit.

Marc: I am a bit lost with that bit as well. I don’t think there is a one sentence answer to that. There are many constitute parts to why it occurs. In Tanzania where we have a fantastic relationship with the Ministry and they are above the call of duty, they are fantastic. Tanzania for the listeners is just on the cusp of changing over nationally to what we call auto disable syringes. Generic name of the product that I designed. The situation last year was that for 45m population they were only importing, they don’t make any in Tanzania they were only importing 40m syringes. So it was less than one per person per year and yet as I think we have already said the average use, the average consumption is around five per person per year. So they need 220m syringes and they are buying 40. But why don’t they order those syringes? They are cheap 220m syringes is going to cost around $6m. And for a country with a GDP of 5/600 bucks per average per person that isn’t a fortune to spend $6m especially when the $6m would save them $60m in health care costs. So you have got to look at the whole chain on a very holistic basis, is that a logical step which the Ministries around the world should unite on and bite the bullet, spend a little bit of insurance money, because they are going to ensure that their costs are lower the following year by stopping secondary and tertiary infections from being spread.

How is that going to happen? That is my job to galvanise them into that sort of action and put them all together. But will they do it on their own? No. We have to have again using the word holistic action from the manufacturers through to the funders, to the buyers, to the distributors, to the end users which is the medical staff. And the end clients we have got to make the clients aware so we have to create a push and a pull market. It is not a push market; it is not a pull market it is a bit of both. That is going to be the end gain here.

Kevin: I am going to step back so that we can move on. And the reason I am going to step back a bit is so that you can help people understand the fundamentals of actually how your syringe works.

Marc: So I got a syringe in my hand. What I wanted to do was to try and understand if we could just put something quite simple into the design which would dovetail, parallel the manufacturing process. I designed a valve mechanism which would lock and then give way and break so that the product was rendered useless at the end of one injection. The other thing then we had to have a trigger point in the barrel which would activate this mechanism and so really the trick was in how do we make, it is a ring, an annular ring that runs around the inside of the barrel wall and could we make one which wouldn’t disturb the plunger going forward but would disturb the plunger coming back. So obviously we made a ramp, so it was a gentle gradient going forward a very acute angle coming back.

Kevin: How many designs did you do before you reached this one?

Marc: One.

Kevin: I thought you were going to say that.

Marc: When I first came up with the solution in 84 I actually drew about ten different ways of doing it. We went ahead with one in the first phase. How many prototypes were there? 100s. You know there were lots of different ways of fine tuning this because I didn’t know that on the end of the valve there is an angle. What should that angle be? Well it looked right at 17.3 but was it probably not. Probably ended up at 17.9. I don’t know. There was at least a year of prototyping and changing every single week and remoulding it.

Kevin: Incredible and yet you then came out with a product that had been tested, that fitted a gap and not only fitted a gap from the market perspective but also from a humanitarian perspective. Was it just then everybody went great Marc, you are the saviour of this.

Marc: I couldn’t keep the door shut, there were just so many people quing to get in the door.

Kevin: Exactly or was all of a sudden did you find brick walls appearing all over the place that you just couldn’t understand why.

Marc: Brick walls everywhere, didn’t really understand it. The first manufacturer that took a license was in Brazil and the deal was that in Brazil there was a law that had been drafted that said from the appearance of an auto disable syringe that fitted their needs 180 days later that would become mandated in the country for imports or local production. This company were making 400m syringes a year and they were willing to change them all over to the design K1. So I went to Brazil a lot and we converted the factory and it was all working. And we were about 20 days from launch and we got news that the mandate had been frozen, the factory had mysteriously been bought and when I went down there about three months later to look in the factory gates it was a green field, it had been bulldozed into the ground and the capacity had been destroyed. So it was a massive wakeup call that there were forces out there that really didn’t want this product to exist.

Kevin: Wow what did that do internally for you when you saw that happen?

Marc: Inside it galvanised myself you know I thought now we have got a real fight on our hands.

Kevin: Did it really is that how you responded to it?

Marc: Oh yeah. Well I was pissed off of course, absolutely furious that this opportunity had slipped by. You know it would have done a lot of good and saved a lot of people. At the time there was a world bank report in Brazil that said that something like 36% of all HIV cases in Brazil had been caused by the reuse of syringes. And HIV is nothing in terms of numbers compared to other issues that occur through this. Hepatitis is far more virulent and leads to far more death and destruction if you like than HIV. So if that was the tip of the iceberg it was awful. Who do we think might help us? Who do we think are going to be the enemy? You know it was an amazing wakeup call.

Kevin: And so where did it take you from that point?

Marc: The real breakthrough came when I met a family in India called the Nath family through a guy that I had met in Germany on my travels who introduced me to this family that he knew who would be his syringe manufacturer in India and privately held company absolutely ethical, fun loving family and it was just complete fit. We found that care and that vision in this company called HMD, Hindustan Medical Devices.

Kevin: And how did you feel when you saw that first batch of finished products ready to actually be used?

Marc: That wasn’t my breakthrough point. My breakthrough point was a few months later in the year 2001 because I knew we had made them, I knew we had sold some but the time I was overwhelmed was a little bit later on, a few months later when I was in Cambodia when I was taken to an immunisation camp and I saw our product being used for the first time and that was really special to see it actually used on a baby having a BCG injection was very, very special.

Kevin: I am assuming there were numerous times when you felt as though you were getting close to that six year old dream but at that point was it when it really hit home that I feel like I am living that concept that I saw in myself at six years old.

Marc: Yeah it wasn’t manufacturing, manufacturing is just a mechanical process but seeing the intervention, seeing that that kid without any knowledge, his mum or the baby had no knowledge of what was behind that simple five second process was lovely, that was really lovely.

Kevin: And where did it go from there?

Marc: HMD coming on board meant that we could go for the top independent manufacturers around the world and all of a sudden we had ten other licensees who were all privately held in different parts of the world. And that gave us momentum and that gave us some numbers and starting to sell you know 2 – 300m products a year started to put you on the map.

Kevin: Once you proved that your product could be manufacturered with very little upgrading required with existing machinery surely being able to plonk that thesis and that case study on the desk of the head of the World Health Organisation should have lead to them creating a global change to legislation and saying to everybody this is the change we are making. Is that not how it works or?

Marc: Well that was my impression of what the World Health Organisation should be doing. The first tenner of the Hippocratic Oath is first do no harm and syringes kill more people than malaria. Syringes transmit 23m cases of hepatitis every year. That doesn’t make any sense at all. Why you would sit back and just allow that to happen. And the reuse of syringes is blamed for over $100bn worth of additional burden in the world health care and loss production and that doesn’t make any sense at all. Why wouldn’t the industry double the price of their syringes with unilateral effect and say look tough shit we are making a better product it’s protecting you its insurance against anyone else re-infecting anyone in the world and that at least, that door at least is closed once and for all. That would be the logical step.

Kevin: So why do you think this hasn’t happened?

Marc: I’ll answer that in a minute but let’s just fly back 20 minutes because I missed answering a question you said why does this occur? Does it occur for lack of supplies? Does it occur because healthcare workers are ignorant, do they not know germ theory, do they share their toothbrush with the strangers in the village and then not apply that same principle. Of course they don’t and also every country I ever go to there is Coca Cola and if you ask for a Coca Cola in a restaurant it comes with the cap on and they open it on your table because they are proving to you it is a fresh bottle. So it is a seal of approval so why isn’t that seal of approval come across in healthcare with the use of syringes. It’s a question I can’t give you a one word answer to but I think it is bound by many different aspects and I will give you an example on it. I was fortunate enough to meet an amazing nurse who was 24 years old in India and she was working in a private facility, one of the big private chains which probably better quality than anywhere else in the world. She would look after four patients and when an injection was given to a patient it would be literally a sticker would go on the tray which was barcoded and that meant that the tray had to have all the constituent parts of say health care was taken to that patient, was delivered and then barcoded back out again. And that barcode related to the patients digital records so they knew exactly what that patient had been given, when, by whom and everything was above board. Now do we expect that sort of healthcare in the public system? Of course not they don’t have the wherewithal or the money or the resources to deliver in that basis. But she had witnessed Primet in India and then, and this took a while to understand and get out of her, because she had to get married she changed from the private system where she could be sacked at any moment to the government system and started working in the public sector. Because in the public sector in India you have a job for life and you have a pension and so therefore you are worth more to be married. So that meant that she was now working in a public system where she knew what good healthcare looked like and yet despite her best efforts and despite a cupboard full of unused sterile syringes she was forced to use syringes over and over again. Now whether that came, I can’t really repeat what she said because it was quite personal, but whether that came from healthcare workers believing that if they do the job they have somehow absolved the patient of any harm, you know God complex type way.

We hear it from the public a lot doctor is second to God, we hear that in our society. And doctor has that magical quality of healing people. And so that trust is above and beyond what it should be. Certainly they wouldn’t trust someone coming up to them out in the street with a syringe they would run a mile but a nurse coming up to them in a hospital 50m away from the street they will accept so the white coat has a lot of effect here. Whether it’s because of supplies in the nurses case I just talked about certainly the supplies were available in the hospital and yet she wasn’t allowed to use them. Why were they saving up for a rainy day? Had the Sister in this ward been through times of austerity where they didn’t have a syringe for years on end and therefore was always saving some? I don’t know but none of it makes sense. None of it is defensible. It may be real but it is not defensible. And so there is probably 15 different reasons why syringes are used.

So now back to the World Healthcare Organisation why don’t they do anything about it. I think again that is a very complex situation and it contains lots of constitute parts. Are the World Healthcare Organisation going to run around and say that healthcare workers of the world are bad? Probably not. Probably not a good thing to say. They have that same challenge with washing hands and yet when I have talked to Ministers in developing world countries about hand washing programs it sort of ends up as well they stole the soap, you know they stole the soap from the clinic, we tried our best we bought everyone a bar of soap and they didn’t use it. And that always comes across with a lot of blame. So what we are doing today is we are learning from that and we are definitely saying that the patient is the most important person here. The World Health Organisation as an institution, as a beaurocracy has many problems. In our situation they do much more harm than good through inactivity. It would take nothing for Margaret Jan or any of her predecessors to sign one piece of paper that says one syringe is used for one injection and then safely disposed of. So it is an easy step to take. Why doesn’t it? I could give you 10 reasons straightaway. So is the solution very simple? Yep. Is the solution very simple? No. It is both.

Kevin: I can see that, I can see that. We talked about the frustrations. Talk to me about some of the highlights. You spoke about the first highlight where you saw your first syringe being used on a child and saving lives in the best possible way without the patient even being aware of it. What are some of the other highlights that you have had out of this incredible journey?

Marc: Well getting my OBE was pretty special. It wasn’t the actual ceremony Prince Charles was presiding and was an amazing experience to go to the Palace. It was actually arriving at the Palace which to me was quite mind blowing because I had my family with me and we were going to have a big dinner afterwards. You know that was a lot of recognition in one day. Very special nothing to do with the medal or the three letters it was all to do with arriving at the Palace with my daughters, my son was a bit too young to go but you know to share that day with them was lovely. That was really nice.

Other highlights Becton Dickinson signing a license with us. HMD going through a billion units hitting that target. Yeah I am very fortunate I have a highlight a week it is amazingly fortuitous or privileged position to be in.

Kevin: Where is next you said you are on the cusp of something? I am looking; you have devoted 27 years to this, 27. And if we put it in perspective your OBE was very much around 2006/7 sort of period so only a few years ago. It shows how much dedication you have put in to pursuing this course in your life and I think that is just worth helping people to understand that none of this was an overnight success. None of this was an overnight change.

Marc: Yeah but it is a big reward you know I view it as an apprenticeship. You know I suppose at 17.5 years without selling a syringe is a long time. Would I want it shorter sure of course. But was it worth it oh God it is worth 170 years to save one life, of course.

Kevin: So where is next for you?

Marc: I have a company called Star Syringe which owns all the patents and the licenses which is run beautifully by a small team. I have left Star now and I work at Safe Point which is my charity and it is an information charity so we concentrate on promoting large national campaigns to convert countries over to safe injections. And next is really a combination of those two coming together and we call this program Life Saver. The world doesn’t need to compete brand against brand of auto disable syringes yet. What it needs to do is create a viable market for the manufacturers and then they need to fight tooth and nail for that market. In the same way that they do today we need to upgrade the market and then allow them back into the ring and they can fight for market share again. And that conversion process is my game now and I really want to replace the word injection with safe injection. And we have evidence of this that when you give safe injections only in an East African hospital the length of the in patients stay drops from on average 7 days to 3 over a couple of year period and that is amazing and yet even though that is written up, even though that is published, even though we have told the World Health Organisation no one is shouting that from the rooftops. Rather than trying to defend them or attack them what I would like to say is it’s insane. It is a mad world and not everything goes the way that we think it should and that’s probably the role is to stop the noise, stop the madness and try and put a bit of sanity and quiet into it.

Kevin: Wow for someone that has already designed the syringe that can protect so many people you have had to take this so much further just to create the adoption. Just to prove that what you are doing is correct. Can’t believe that when you came into this journey that you thought that your job, your role was going to have to extend so far beyond coming up with the patented product.

Marc: No I probably didn’t think that. I did when we lost Brazil. When we lost Brazil I realised I entered a big grown up world that I hadn’t been aware of. Until then it was a bit, no but I did realise when Ebrass was destroyed you know that we were up against forces.

Kevin: What responsibilities do you feel are on your shoulders now?

Marc: That is a very good question. You know normally that is the answer, that is actually the answer to a question that I get asked quite a lot which is why did you keep going for 17.5 years. Why didn’t you stop? And the answer is because I had a responsibility to delivering the solution because I knew the solution would work. And I knew the solution would work because of the initial three years of studying the problem. There is no other possible solution for this issue and I would put my hat on that. So knowing that I think I am charged with, and I accept fully graciously and welcomingly that responsibility that actually the only group of people including me that are going to make this difference are that small select group that have understood this. And once you have understood you suddenly enter a realm of omission and commission. So in other words if you are standing on Beachy Head and your friend is just about to jump, if you push him you are guilty and if you let him jump you are guilty. So for me I am in that situation. I have no choice but to see this through and to reach a tipping point in the developing world because if I don’t well I have undone any good that I might have done. Someone could offer me another job and I couldn’t do it. I couldn’t do it until I have seen this one through. It’s very easy to think that you can absolve yourself just by designing a product. If that product was taken up by the industry phoosh then fantastic I would be on a yacht now being the big I am but as it is you know the job isn’t done so until you can tick that box I think you just wear that responsibility so yeah it is pretty simple. And the levels that you get involved in are fascinating and interesting. To get this move through in Tanzania we’ve teamed up with Hewlett Packard and Vodacom and you know syringe manufacturers, is been fascinating. It has been absolutely a brilliant adventure and one which I wouldn’t give up for the world even though it’s been stressful and painful and inconvenient at times its just one of those things that is great when it all comes together.

Kevin: Do you think the job will ever be done?

Marc: Yeah.

Kevin: Yeah. And your role within it?

Marc: Oh I think I am going to be probably by then a grandfather. No I think the next two – three years are going to be absolutely critical. If we can get, I am not saying Life Saver is perfect but it’s what we have got and if we can get Life Saver adopted in maybe five East African countries and then we can get momentum in India I think we have set the scene where we can avalanche into other countries.

Kevin: I am going to close off. You have shared an incredible insight into your world. As you probably realise from how I tend to finish our podcasts we are here to profile people like you, which likely or unlikely as it sounds are an inspiration to a lot of other people. As much as though whoever I speak to on this podcast always likes to shy away from actually hearing that themselves because they always look to other people for that inspiration. But I want to finish off by asking you what is your primary driver that has helped you achieve what you have and fuels you to achieve your goals of the future?

Marc: Well now you have hit right at the humble point. There is no big secret you keep going and you take your responsibilities as they come and you make the right choices. You know we have been offered in the past, a group came to us and offered us a load of money to stop and we said no. Without even thinking about it, it was more money than I could probably have ever spent and would have been very wealthy but it is just not what this is about. This is a different journey to many that are taken but it is not different, you know there are lots of people on this sort of journey I think, I hope. So it is just those two things. You just keep going and there is no choice to give up or change or weaken because so many people rely on the knowledge and the I suppose commitment that I have. So turning away would be worse than carrying on.

Kevin: Marc Koska thank you very much for your time today on Maximise Potential.

Marc: You are welcome.

Music

Kevin: As I mentioned in my introduction I believe that we’ve all had similar moments to Marc yet the conviction that Marc has displayed to find a solution to this problem is a trait that really sets him apart from so many others. Marc’s story was peppered with so many business lessons, life lessons and also humanitarian lessons. However I think the key message we can all take away from this interview is that Marc Koska has genuinely shown us that one person can truly make a difference. As always you will find plenty of links on the webpage to enable you to learn more about Marc and the fantastic work that he is doing. And thank you once again Marc for sharing your incredible journey with us. We look forward to keeping our listeners updated with your progress and we wish you and Safe Point every success.

Before I sign off today I’d like to give a special mention to all our listeners who will be competing in the London Marathon in the next couple of weeks. Whether you are a first time runner or a veteran we hope you have a memorable and enjoyable experience on what is an extremely unique and emotional day. And for any of you considering a career move this year the Jenrick Recruitment Team are offering to give individual feedback on CVs to the listeners of the Maximise Potential podcast. So if you would like to receive tips and advice on how to make your CV as effective as possible please just email it to careers@jenrick.co.uk and I have also put a link to this email address on the webpage for this episode quoting Maximise Potential podcast in the subject line. And if you would like the feedback to be even more accurate please also indicate the types of jobs that you either are or will be applying for.

Here is ‘All there is’ from Xerxes to finish off with today. Thank you again for tuning in and we will be back soon with another interview on the Maximise Potential podcast. Thank you.

Music

About the Author

Hi, I'm Tom Burkinshaw, I co-produce the Maximise Your Potential Podcast and Website and my goal is to help as many people as possible be successful in life, careers and business, by offering free coaching and mentoring through a series of unique interviews from inspiring people who all display exceptional self-belief, mental toughness and desire to achieve. Thank you for taking the time to visit Maximise Your Potential!