On Kenya’s stunning coast, about halfway between 15th-century ruins and the bustling city of Mombasa, a small factory is helping to achieve one of Africa’s greatest healthcare goals: self-reliance.

With fewer than 700 employees, Revital Healthcare produces 300 million syringes a year, enough to meet more than half of Africa’s routine immunization needs.

In the throes of the coronavirus pandemic, when governments were scrambling to vaccinate millions of people amid severe shortages, Revital supplied syringes to Sri Lanka, Sweden, the United Arab Emirates and Uzbekistan – and even sent 15 million syringes to India, said Roneek Vora, the company’s sales and marketing director.

“This is the first time in Africa that the medical industry is exporting syringes to India, even though India is a hotbed of syringe manufacturing,” Mr Vora said. “This was a very big deal for us – it broke many barriers,” he added.

Revital has generous funding from grants and contracts from numerous donor organizations, including the U.S. Agency for International Development, Save the Children Foundation, and several branches of the United Nations, and the company has ambitious goals.

Many of Africa’s attempts to become medically independent have failed due to limited resources, the lack of a solid regulatory system and challenges in transporting medicines and vaccines. Against this backdrop, Revital’s success gives hope that an African company can produce important products – 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 various infectious diseases, medical tubes, face masks and a portable, power-free device for supplying oxygen to newborns. More than 200 of these devices were delivered to Ukraine in May 2022.

But above all, the injections help to alleviate an urgent need in Africa.

Countries in sub-Saharan Africa need 500 million syringes every year just for routine vaccinations. And these countries are often hit by disease outbreaks that require mass vaccination in a short period of time. Syringes are often the limiting factor.

“Billions are invested every year in vaccine development and deployment around the world, but without a simple syringe that costs just a few cents, the vaccines and the associated investments remain in the bottle,” said Surabhi Rajaram, program officer at the Bill & Melinda Gates Foundation.

More than 80 percent of the syringes needed for the vaccination are manufactured in Asia, Rajaram said. They are usually delivered by sea, which can delay their arrival by months.

During the pandemic, India and China restricted the export of syringes, causing shortages in many countries, including in Africa, and straining vaccination programs. “This is a situation we never want to be in again,” Ms Rajaram said.

Revital’s proximity to Mombasa’s seaport and international airport, as well as a road network connecting landlocked Africa, has reduced transport times by 80 to 90 percent, she said.

With about $4 million in funding from the Gates Foundation, Revital makes what it calls early-activation auto-disable syringes that cannot be reused once the plunger is pushed into the barrel. Other syringes are disabled only when the plunger is pushed all the way through the barrel. This sometimes prompts doctors to stop and refill a syringe before it is empty to conserve supplies. But this can contribute 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 early activation syringes.

Thanks to grants from global health organizations, the early activation shots must be sold within Africa. Separately, the Africa Centres for Disease Control and Prevention has set a goal of producing 60 percent of the vaccines needed itself by 2040.

“When we talk about vaccines, we are talking about syringes, and we did not have the capacity to produce syringes,” said Dr. Jean Kaseya, the agency’s director general. “Now, with Revital Healthcare, we can cover at least 50 percent of our needs.”

The company’s ambitions go far beyond syringes. In March 2020, when Covid arrived in Kenya, “we had no surgical face masks, we had no vaccines, we had no syringes,” recalls Mr Vora. The company quickly increased production of face masks from 30,000 to 300,000 a day, becoming the largest manufacturer of these masks in sub-Saharan Africa.

Within six months, the company increased its production of syringes from 3 million to 30 million per month.

With $2.2 million from the U.S. Agency for International Development, Revital now aims to become Africa’s largest manufacturer of rapid diagnostic test kits, producing about 20 million a month. To meet this demand, the company is hiring 200 people. About half of the test kits will be for HIV and the other half for malaria, hepatitis, dengue fever and other diseases. The factory opens in May.

Revital is also the linchpin of a larger initiative by Kenyan President William Ruto to produce medical kits for outbreaks. For example, in the event of a malaria outbreak, other companies could produce rapid tests, bed nets, and anti-malaria drugs and vaccines; Revital would assemble the kits and ship them to outbreak areas.

The company was founded in 2008 with just 60 employees and is still family-owned. Mr Vora is a third-generation Kenyan of Indian descent. His uncle is the company’s chairman. His cousins ​​​​handle finance and operations. And Krupali Shah, who heads research and development, is a close family friend. Around 80 percent of the workforce is women, exceeding the 50 percent target set by the Gates Foundation.

Just minutes from Kilifi’s spectacular beaches, the factory operates 24 hours a day, every day, with workers working 12-hour shifts. Much of the work is automated, but many workers spend hours in hot rooms with little air – because air conditioning or fans can compromise sterility, Ms Shah says. Some machines emit shrill screams every few seconds. Workers have been offered headphones, but they declined, according to a department manager.

Vora’s great-grandmother was hearing-impaired and mute. He said the company plans to hire more than 200 such women to assemble the syringes. So far, the company has hired about 40. But on a hot day in December, there were fewer than 20.

At 60, Truphosa Atieno, who is hard of hearing, is decades older than most of the other hard-of-hearing staff. A widow and single mother, Ms. Atieno was a primary school teacher, but when the pandemic forced schools to close, she “lived hand to mouth” selling honey, vegetables and sugar cane on the side of the road, she said.

In November 2022, she was hit by a minibus and was unconscious for three days. She suffered a fractured skull and elbow and bruised ribs and fingers. Despite this, she says, with four daughters aged between 16 and 29, she is eager to get back to work.

When she started her job at Revital, Ms Atieno lived in Jomvu, about 80 kilometres from Kilifi, and had to leave home at 4am to be at work by 7am. Now she shares a room in Kilifi with 13 other women during the week and returns to Jomvu at weekends. What she earns “is not enough”, she says, so she supplements her income by tutoring children on her days off.

Other hearing-impaired women give up working in the factory because the daily wage per shift is about 600 Kenyan shillings (less than $5) and their commute from Mombasa costs only about half that.

Others were unable to meet daily productivity quotas or disliked the ban on eating meat and eggs on site. (The Voras are strict vegetarians.)

“One of the challenges is adapting to the local culture,” says Amina Mahmud, a project manager at a Mombasa-based nonprofit that placed the women, adding that “the company’s expectations are high.”