On the scenic Kenyan coast, between 15th-century ruins and the vibrant city of Mombasa, a small factory is helping to achieve one of Africa’s biggest health care goals: self-reliance.
With fewer than 700 employees, Revital Healthcare produces 300 million syringes per year, enough to meet more than half of Africa’s routine immunization needs.
As governments around the world face the challenge of vaccinating millions of people amid the COVID-19 pandemic and severe vaccine shortages, Revit has shipped syringes to Sri Lanka, Sweden, the United Arab Emirates and Uzbekistan, and even sent 15 million syringes to India, said Roneek Vora, Revit’s director of sales and marketing.
“This is the first time that the African medical industry has exported syringes to India, and we know that India is a syringe manufacturing powerhouse,” Mr. Vora said. “This is a big deal for us – it breaks down a lot of barriers,” he added.
Revital has ambitious funding through grants and contracts from a number of donor organizations, including the U.S. Agency for International Development, the Save the Children Foundation, and several branches of the United Nations, and the company has big ambitions.
Many attempts at medical self-sufficiency in Africa have been hampered by limited funding, a lack of a robust regulatory system and the challenges of transporting drugs and vaccines. Against this backdrop, Revital’s success offers hope that an African company can produce essential goods — not only for the continent but also for export to other countries.
The company has a portfolio of 58 products, including rapid diagnostic test kits for a variety of infectious diseases, medical catheters, masks and a portable, non-electric device that delivers oxygen to newborns. In May 2022, more than 200 devices arrived in Ukraine.
But the syringes do help meet a pressing need in Africa.
Sub-Saharan African countries need 500 million syringes per year for routine immunization alone. These countries often experience outbreaks that require large-scale vaccinations in a short period of time. Syringes are often the limiting factor.
“The world invests billions of dollars every year to develop and deploy vaccines, but without simple syringes that cost pennies, vaccines and the associated investments will remain in vials,” said Surabhi Rajaram, a program officer at the Bill & Melinda Gates Foundation.
More than 80% of the syringes needed for vaccinations are made in Asia, Ms. Rajaram said. These syringes are often shipped by sea, so their arrival can be delayed by months.
During the pandemic, India and China restricted the export of syringes, leading to vaccine shortages in many countries, including some in Africa, and overwhelming immunization programs. “We never want to go through this again,” Ms. Rajaram said.
She said Revital’s proximity to the Mombasa seaport and international airport, as well as the road network connecting Africa’s landlocked countries, has reduced shipping time by 80 to 90 percent.
Revital, which has received about $4 million in funding from the Gates Foundation, makes so-called early-activation auto-disabling syringes that cannot be reused once the plunger is pushed into the syringe. Other syringes become ineffective only after the plunger is fully pushed into the syringe; this sometimes encourages clinicians to stop and refill the syringe before emptying it to conserve supplies. But this can lead to the spread of HIV, hepatitis B and C, and other diseases.
Revital is the only African company approved by the World Health Organization to produce the early activation syringe.
Funding from the World Health Organization requires that early activation syringes be sold within Africa, and the Africa Centers for Disease Control and Prevention has set a goal of producing 60% of the vaccines it needs by 2040.
“When we talk about vaccines, we talk about syringes, and we didn’t have the capacity to produce syringes,” said Dr. Jean Kaseya, the agency’s director general. “Now with Revital Healthcare, we can meet at least 50% of the demand.”
The company’s ambitions extend far beyond syringes. When the coronavirus pandemic arrived in Kenya in March 2020, “we had no medical masks, no vaccines, and no syringes,” recalls Vora. The company quickly increased production from 30,000 masks to 300,000 per day, becoming the largest mask manufacturer in sub-Saharan Africa.
In six months, the company increased its syringe production from 3 million to 30 million syringes per month.
Revital, which has received $2.2 million in funding from the U.S. Agency for International Development, is now aiming to become Africa’s largest manufacturer of rapid diagnostic tests, producing about 20 million kits a month, and the company is hiring 200 employees to meet that demand. About half of the kits are for HIV testing, and the other half are for malaria, hepatitis, dengue fever and other diseases. Opening in May.
Revital is also key to a larger initiative launched by Kenyan President William Ruto to produce medical supplies for outbreaks. In the event of a malaria outbreak, for example, other companies might produce rapid diagnostics, bed nets, antimalarial drugs and vaccines; Revital would assemble those supplies and deliver them to the outbreak zone.
The company was founded in 2008 with 60 employees and is still family-run. Mr. Vora is a third-generation Indian-Kenyan. His uncle is the company’s chairman. His cousins are in charge of finance and operations. Krupali Shah, who is in charge of research and development, is a close family friend. Women make up about 80% of the workforce, exceeding the Gates Foundation’s goal of 50%.
The factory, just minutes from Kilifi’s stunning beaches, operates around the clock, with workers working 12-hour shifts. While much of the work is automated, many workers spend hours in hot, thin-air rooms, where air conditioning or fans could compromise sterility, Ms. Shah said. Some machines emit a piercing screeching noise every few seconds. Workers were offered headphones but refused, according to a floor supervisor.
Mr. Vohra, whose great-grandmother was hearing-impaired and mute, said the company plans to hire more than 200 such women to assemble the syringes. So far, the company has hired about 40 women. On a hot December day, fewer than 20 were there.
Truphosa Atieno, 60, is hard of hearing and decades older than most of the other hard of hearing employees. A widow and single mother, Ms Atieno was a primary school teacher but said she was “making do” by selling honey, vegetables and sugar cane on the roadside when the pandemic closed schools.
In November 2022, she was hit by a minibus and was in a coma for three days. She suffered a fractured skull and elbow, and bruises to her ribs and fingers. However, she said she was eager to work again because she has four daughters, ranging in age from 16 to 29.
When she first started working at Revital, Ms. Atino lived in Yomvu, about 50 miles from Kilifi, and had to leave her home at 4 a.m. to get to work by 7 a.m. Now, she shares a room with 13 other women in Kilifi during the week and returns to Yomvu on weekends. She says she doesn’t make “enough money,” so she supplements her income by tutoring her children on her days off.
Other hearing-impaired women left the factories because they could commute from Mombasa for half that much, while the daily wage was about 600 Kenyan shillings (less than $5) per shift.
Others couldn’t meet their daily production quotas, or they didn’t like the ban on meat and eggs on the site. (The Walla are strict vegetarians.)
“One of the difficulties is adjusting to the culture here,” said Amina Mahmud, a project officer at a nonprofit in Mombasa that placed the women, adding that the company’s “expectations are high.”
