>>Chrystia Freeland: Marc is holding now a great invention of his. And 1984 turns out
to be an important year for this entire panel. That's the year that Guy got his important
not grant, but contract from the government of Canada. It's the year that Marc -- and
correct me if I'm mistaken here -- read about how syringes were being reused and that was
spreading HIV. One of those heart-wrenching stories that we often read. But unlike most
of us, when Marc read this, he decided to change his life and do something about it.
And that's what he's been doing ever since, both founding a company producing syringes
which can't be reused, and also an NGO that spreads awareness of it.
Sitting next to him is Sipho Moyo. I'm so glad that Sipho is here, because so often
I think a lot of our discussion is going to be about Africa, and so often I moderate panels,
especially at conferences like this, where Western people talk a lot about the problems
of Africa in very wise ways and nod our heads. So it's good to have at least one actual African
here. Sipho has 18 years of development experience in Africa. She has worked all over the continent,
Tanzania, most recently Nigeria. She's in Johannesburg now.
She emphasized to me that she is not Dambisa Moyo, although she has some controversial
and sharp views herself and her father did teach Dambisa and their friends.
>>Sipho Moyo: Dambisa's father taught me. >>Chrystia Freeland: Dambisa's father taught
her. So we have connections here. And then, of course, famous to everyone who
lives in Britain, Dame Barbara Stocking. I feel I should curtsey when --
>>Barbara Stocking: Could you stop saying "dame"? It doesn't sort of going with Oxfam
somehow. Or just drop that one. >>Chrystia Freeland: Who is the CEO of Oxfam,
Great Britain. This is one of the world's most admired and accomplished philanthropies.
Four and a half thousand employees, a budget of three and a half million pounds, doing
huge and really important work around the world. And it's really important, making some
really important connections that we'll talk about, I hope, on this panel, about connecting
the dots between what businesses do in their business and how they can make the world a
better place, a little bit what we've been talking about with Guy.
How we're going to organize this panel is I'm going to ask our brilliant panelists questions
for about 15 minutes. I hope they'll all jump in and very kindly but forcefully disagree
with one another where they have reason to. Then we will have about 15 or 20 minutes for
questions, and we will end promptly at 5:00, I promise you dear Zeitgeisters.
So starting with Marc, talk to us a little bit, Marc, about -- I mean, the idea seems
so obvious that syringes which are reused can spread disease. And yet, you have found
it far from obvious and far from easy to actually have these non-reusable syringes be the ones
that are being used. So why is it so hard? What are the obstacles?
>>Marc Koska: I wish I knew. When I started in 1984, I thought I'll come up with a design,
two years later, I'll go traveling. But it actually has --
>>Chrystia Freeland: Tell us -- describe the design briefly.
>>Marc Koska: It's still a big problem. Basically, for the audience, the -- a normal syringe
can be reused because it's just a plastic barrel with a plunger in it. What I designed
after three years of research is this product. It looks like a normal syringe. And after
use, in the patient, it's discarded. If someone then tries to pick it up and refill it, the
action of pulling back the plunger makes it lock and break, and it can't be used again.
And the key to this was that it's made on existing equipment in the manufacturing systems
that exist. There are about 600 factories in the world.
So what I wanted to do was come up with a design which didn't force any change or extra
cost to manufacturers, can be used in the same way, and costs exactly the same as a
normal syringe. Thank you.
>>Chrystia Freeland: Now, if you doubt the importance of that syringes, I urge you during
the breaks to accost Marc and ask him to play you a video on his phone -- I'm afraid it's
not an Android; it's actually an iPhone -- of some scenes that you've taken -- some covert
scenes you've taken inside clinics. >>Marc Koska: It's still going on, today,
something like 60% of all injections in India are unsafe. The same system -- or the same
numbers are apparent in most developing world countries. And it's not really clear, there's
not one particular reason. >>Chrystia Freeland: People going in to get
immunizations for their babies? >>Marc Koska: Immunizations are not too bad
if they're U.N. run or NGO run, because there's a mandate for immunizations to be given with
these safe syringes. Those represent only a small percentage. The vast majority of injections
are not in any way safe if they don't use this or they don't use correct procedure.
So we end up with something like 1.3 million deaths -- World Health Organization number
-- being caused every single year, which is twice the amount of the death toll of malaria
even. And what angers me is, this is caused by a doctor or a nurse. This isn't, you know,
an innocent mosquito. This is actually being transmitted to the patients via a health care
worker. >>Chrystia Freeland: Do you find government
bureaucracies an obstacle? >>Marc Koska: Yes.
>>Chrystia Freeland: How and why? >>Marc Koska: There's a lot of corruption.
There's a lot of bribery. You know, there are more -- at the moment, there are more
normal syringe manufacturers in the world than there are safety syringe manufacturers
in the world. And they seem to win. I don't know how it works out, but they seem to keep
the status quo going where they're supplying, you know, sometimes unsterile products, but
they're in a package. They look sterile. And they're coming in at very, very underpriced
levels, so they're just flooding the market with these products.
It is particularly dangerous, because syringes are the most commonly used piece of medical
equipment in the world. So if you've got a base where disease is being spread from the
actual most commonly used medical product in the world, that's pretty perverse.
>>Chrystia Freeland: Now, Marc, if I were an African health minister and you came to
sing the virtues of your syringe, I might say to you, but, come on, you're selling me
this stuff. Aren't you just trying to make lots of money?
So what's your come-back? >>Marc Koska: Well, that is obviously true.
I do run a company, and we license these to 13 manufacturers now around the world and
make a couple of million of these units a day.
But it is absolutely true. And I think whether I directly profit or not, I'm not really -- don't
really have time to defend. What I want to do is change the scene quite dramatically.
I want to see if I can put into action an idea that I've got where we open-source good
ideas, where good ideas are no longer constrained under commercial reality.
And to the audience, you'll think I'm mad, because, obviously, you live in the commercial
world where it's dog eat dog and every margin counts. But, actually --
>>Chrystia Freeland: They're muzzled. It's a conference. They're not fighting.
>>Marc Koska: What I might profit out of this product does not matter. What matters is that
this reaches its humanitarian scale and it does its job and we eradicate that 1.3 million.
>>Chrystia Freeland: Marc, I think you're trying to think about ways to get around this
potential conflict, where you're selling a solution, but you also run a company that
wants to make money. How can you square that circle?
>>Marc Koska: Well, the idea that I'm working on at the moment is that we kind of eradicate
the company angle and we try and transfer --
>>Chrystia Freeland: Shut down your company? >>Marc Koska: Shut down the company selectively,
and I use that word very advisedly. Because this isn't a launch of the idea. This is just
a conceptual description of the idea. The idea would be that we somehow shut down the
company and we pass over the designs to an open sourcing system where we --
>>Chrystia Freeland: Going to go Google? >>Marc Koska: We go Google, we allow everyone
to manufacture the product. And as long as they meet constraints of quality and targets
of production, that, you know, somehow we reward them with an open source type royalty
rebate or something along those lines. >>Chrystia Freeland: How will that make you
more effective, you do think? >>Marc Koska: Well, I think it takes away,
one, the elephant in the room, the one that you mentioned, of, "Is he making money out
of it?" But also it allows me to be much more vocal and hold a gun to these ministers' heads.
>>Chrystia Freeland: Hold guns to the ministers' heads?
>>Marc Koska: I'm going to say, "Change, or you're part of the problem."
>>Chrystia Freeland: How -- you have to live. So how can you take the financial element
out of the equation? Do you need a sugar daddy to come in?
>>Marc Koska: Yeah, yeah. We're looking at exactly that. And sugar daddies, let's face
it, normally set up funds. And their ultimate reward is to save a life or to improve a life.
And if -- you know, if the dialogue goes along, look, if you gave me "X" million dollars and
I could save "X" million lives, would you be willing to do it? I think there are plenty
out there that want that. I think it only works with certain products.
They've got to be pretty well developed. They've got to have proven that they deserve a place
in the world and that they can be scaled and be just as effective scaled without any detriment.
And I feel this is a no-brainer, because we've got a market already out there. We've got
a manufacturing system out there already, and they are just making almost this product
but not quite. And the changeover is pretty easy.