Small businesses profile: Survival at the sharp end

Marc Koska's early adult years hardly marked him out as a typical business founder. While most would-be entrepreneurs would gleefully admit to striving for success from the start, Koska spent the years after leaving school crewing racing yachts in the Caribbean.

However, he does seem to have had the entrepreneur's ability to spot an opportunity. Living in the US Virgin Islands, he was doing a succession of odd jobs between regattas when a lawyer friend of the owner of the boat on which he sailed approached him about building a model to assist in a court case. The lawyer won the case and – with the model said to have played an important role in explaining the facts – Koska found himself increasingly in demand for models.

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That seems a long way from his current business of producing non-reusable syringes. But the experience of designing and building things has clearly stood him in good stead.

Koska, who grew up in Britain and now bases Star Syringe in East Sussex, was prompted towards his new direction during the AIDS epidemic in the mid-1980s when he was still in the Caribbean, although he insists that doing something to prevent the transfer of disease was always at the back of his mind as a possible career. "When I read about the Black Death at school, I was always interested in the rats," he explains.

Accordingly, his initial interest in AIDS was in how it would spread. Seeing the panic induced by the US media in particular, he set about doing something about it. "It all started in 1984 when I read an article about the transmission of HIV via re-used needles and syringes," he says.

Much of the attention surrounding reused syringes focuses on drug addicts, but Koska says this is a small part of the problem. The bigger issue is in the developing world, where various factors contribute to the average syringe being used seven times. This practice leads to 23 million infections, mainly Hepatitis B, a year.

There were already designs for auto-disable (AD) syringes, but Koska believed he could come up with something simpler and cheaper to produce. Star's K1 has a small ring etched on the inside of the barrel of the syringe that allows the specially-adapted plunger to only move in one direction. After one complete injection, the plunger automatically locks in place and breaks if forced.

Having been turned down by the large producers, Koska decided to organise his own manufacturing. The result was Star Syringe, founded in 1996 – 12 long years of "hard slog" after Koska had the original idea – with the backing of City financier Rupert Lywood, co-founder of the financial group, Matrix. He now produces the syringes in 15 different locations around the world, including three in China and two in Nigeria, through the Star Alliance. On 15 May last month, the company celebrated the production of the billionth syringe.

In the past three or four years, Koska and his small team have received several awards, including a Queen's Award for Enterprise in International Trade. They also seem to be winning over the large medical products companies that had previously spurned their idea. Koska is particularly cheered by the news that Becton, Dickinson and Company (BD), the US-based company that is prominent in syringe manufacture, is to produce Star syringes under licence – "an amazing vote of confidence," says Koska.

With 50 billion injections administered every year, the market for syringes is clearly enormous. And Koska is hoping that the BD move is a significant step towards making disposable syringes the norm. He likens the process of moving towards disposable syringes to the introduction of seatbelts in cars. "We had to have a celebrity to tell us to use them," he says, adding that once there was a level of acceptance that it was the right thing to do for safety reasons, the Government changed the law to require them to be used.

The solution to the problem of people being infected through second-hand syringes is a combination of having a suitable product and good information, he says. The reusing of syringes in the developing world is partly down to unscrupulous practitioners in the health field and partly due to ignorance.

To help deal with the issue, Koska has established SafePoint, a charitable trust that is working with the World Health Organisation and other bodies to educate children and healthcare workers in the developing world about how AD syringes can reduce the risk of infections. "One child dies every 24 seconds from unsafe injections," says Koska, who travels frequently to such countries as India, Pakistan and Indonesia to push the message through films and other campaigns. In 2006, he was awarded the OBE for his work in this area. "SafePoint is all about spreading the word to end-users and health policy makers about how to use syringes safely."

After more than 20 years, things are starting to come right for Koska. The business, now based in beautiful surroundings in the Ashdown Forest, is still small, with just nine people, including two engineers based in Germany and a brand manager who travels all over the world from his base in the Swiss Alps. But turnover has doubled to £1.5m in the past year and Koska sees the BD development as providing a significant boost.

Further innovations – including a cap to protect healthworkers from being pricked by the needles and a device to make delivery of the drug more accurate – should produce "very sensible profits," he says.

Not that the man who gave up working for an international financial group because it did not suit him, and who could never see himself in a large organisation, is showing any sign of becoming conventional. He retains a love of outdoor pursuits and is currently considering paragliding down East Africa's Rift Valley to help publicise the issue of unsafe injections.

Above all, though, he remains driven by the determination to rid the world of a practice whereby people who think they are being helped are having their lives put at risk. As Koska says, it "cheats the patient and the health giver of the sanctity of care."