By Ahmed Mora
I read in the leadership Newspaper edition of Friday, 26th May, 2017 on page 43 under “FEATURE”, the story with caption – “Is Nigeria Set to End Syringe Importation”?
The Akwa Ibom State Government, according to the story by Anyaora Thelma, will use the Jubilee Syringe Company to produce between 350 and 400 million syringes per annum at start up production and which is expected to raise to 1 billion Syringe by 2018, which is just next year. How the company, a Turkish concern can achieve this production level under a year from start of production, will be a real wonder to see. However, the Akwa Ibom State Government has done wonderfully well to initiate the company, which technically is a medical device plant for the production of a pharmaceutical disposable product. This kind of investment by State Governments are needed to ensure availability of basic pharmaceutical and medical device products for the nation’s many healthcare facility provider at the Primary, Secondary and Tertiary levels.
More to the point, the physical components of a disposable syringe made up essentially of a plunger from High Density Poly Ethylene (HDPE) and the barrel, made up from Poly Propylene (PP), all of pharmaceutical grade and the steel component – the needle, has 66% of these available as raw materials in Nigeria. The nearby Petrochemical Plant in Eleme, near Port Harcourt could provide the polymer components of the disposable syringe product.
Zaria Pharmaceutical Component (ZPC) Ltd, the producers of ZARINJECT, brand of disposable syringes, which is a wholly-owned Kaduna State Government company started production on 21st May, 1996 with an initial installed capacity to produce 135 million pieces of conventional disposable syringes in 2mls, 5mls and 10mls capacities was certainly the first plant to produce disposable syringes in Nigeria and the biggest at commissioning date. The initiation, project coordination of the plant started twenty – five (25) years ago in 1992 during the tenure of the Governor of the State, Alhaji Dabo Mohammed Lere of blessed memory. Installation and erection as well as start-up of the plant took some 28 months by the writer and who was later privileged to serve as the first and only pharmacist Managing Director and CEO of the company from 1997 to 1999.
There is also the First Medical and Sterile Products Ltd, another disposable syringes production plant which commenced operations around 2006 and which is located at the Calabar Export Free Trade Zone (CEFTZ), Calabar, Cross-Rivers State and where the writer served as the adviser and consultant throughout the stages of initiation and start-up operation. This 90 million annual capacity disposable syringes plant with FIRSTMED brand is the first in the country and indeed the West African Region to acquire the license and to produce the Auto Disable (AD) syringes in 0.2, 0.5, 1.0 and 2mls capacities.
With the use of cartridges, the plant, which is privately-owned can also produce conventional syringes for the higher capacities. This plant, in Calabar, unlike, ZPC in Zaria is still in full production of the products and marketing same to various healthcare facility provider centers in Nigeria, and for export.
However, it is the Integrated Medical Industries (IMI), Port-Harcourt, Rivers State that has the capacity to produce the largest output of disposable syringes in Nigeria with projection of 1.3 billion pieces of the product annually. Unlike the Kaduna State-owned ZPC, which has stopped production more than ten (10) years ago, the Port-Harcourt based IMI is producing successfully. However, while ZPC is producing only conventional syringes, IMI, like FIRSTMED in Calabar, though privately-owned is producing both conventional and AD syringes.
One common feature of the three plants – ZPC, FIRSTMED and IMI in Zaria, Calabar and Port-Harcourt respectively, is that they all use Engel model of injection moulding machines, which are fabricated at the Company’s largest plant in Linz, Austria. The mode of sterilization is also by the use of Ethylene Oxide Gas, while the needles are imported as bulk and unsterilized. Again, these ‘big three’, as I call them, and now Onna, in Akwa Ibom, cannot meet up the requirement of disposable syringes whether for prophylaxis (Calabar and Port-Harcourt); curative (Zaria, Calabar and Port-Harcourt) and diagnostic (Zaria) even at full capacities production. With a rough rule of thumb of four (4) syringes per head per year for the average Nigerian, plus the millions needed for immunization purposes, the capacities in the four plants still cannot be met. A few tips however will not be out of place as Jubilee Syringes rolls out its syringes, though the capacities and whether AD and/or conventional are yet unknown:-
The Akwa Ibom State Government to avoid the ‘mistakes’ of other States by trying to run the company directly with use of Civil Servants;
The big syringes producers in the country to form a Medical Device Association through which they can approach the Federal Ministry of Health (FMoH) and the Federal Ministry of Investment for discussions leading to preferences in procurement, enjoyment of certain waivers and conferment of some privilege;
Membership within the Pharmaceutical Manufacturing Group of the Manufacturers Association of Nigeria (PMG-MAN), will be of immense benefit;
Teaming up to ‘beat’ the imported varieties of disposable syringes through better use of packaging materials and ready availability as well as easy access by the healthcare practitioners;
Dialogue with producers of HDPE, PP and other raw materials within Nigeria towards procurement of pharmaceutical grade HDPE & PP and other items for the plants;
Proper planning of receipt of raw materials especially Ethylene Oxide gas used for sterilization of the needles. Ethylene Oxide can only be imported into Nigeria by ship and not by air. Delay in arrival of the gas could cause some anxiety on the part of production pharmacists within the plant. The lead time has to be properly worked out. Plant managers who may have successfully produced but cannot take the product out since the product has not been sterilized due to late arrival of Ethylene Oxide gas and tested, making the batches eligible for use by healthcare professionals on patients can be frustrating;
Proper ‘burning’ of the Ethylene Oxide gas after sterilizing is essential in order to avoid contamination of the area and thereby likelihood of causing environmental hazard especially in densely populated neighborhoods. However, the real danger is in the likelihood of gas explosion within the sterilization chamber due to inappropriate use of correct quantities/measurements of temperature, pressure and humidity. The use of a special suit is a most by every operator of the chamber.
As Akwa Ibom State joins Kaduna and Rivers States in the ‘club’ of producers of disposable syringes in Nigeria, as well as Cross-River which hosts no fewer than two (2) privately-owned plants all within the CEFTZ,Calabar, the stage is now set for a revolution in syringe manufacturing in Nigeria, and which was essentially started in 1992 in Zaria and in ZPC. Though the ZARINJECT brand of syringes produced by ZPC essentially from middle to the late 90s may be no more in the pharmaceutical market due to the closure of the plant, certainly, the results of the clinical trials conducted on the product in ABUTH, Zaria and OAUTH,Ile- Ife are case studies in the production of syringes in Nigeria and from which others can benefit from tremendously.
Mora is a pharmacist, and Professor of Pharmacy Practice, Dora Akunyili College of Pharmacy, Igbinedion University Okada, (IUO), Okada, Edo State.