RIO DE JANEIRO, BRAZIL – In the large plant in northern Manaus, machines operate 24 hours a day at full capacity.
The automated production lines ensure minimum contact among the 400 employees, who did not have their working hours reduced during the pandemic. Quite the opposite: the demand for hospital supplies increased by 10%.
While states and the federal government are racing for syringes and needles to ensure vaccination against Covid-19, the Saldanha Rodrigues (SR) plant in Manaus, one of four that produce such supplies in Brazil, is operating at full capacity to supply the domestic market.
But all this reinforcement in production may not be enough to guarantee the acquisition of the required supplies to immunize Brazilians against Covid-19, that is, to administer the two doses of the vaccine to at least 70% of the population, with no risk of shortages throughout the campaign.
This is due to the fact that the Ministry of Health has limited vaccination to only one syringe model: the 3 ml with the screw tip, limiting national production to 1.5 million units per day. The national industry may fail to cope with the demand in time for the arrival of doses in all states.
“When the Ministry chooses only one syringe model like this, at short notice, it limits all companies’ production capacity, because the production lines take up to one year to be adjusted for a new mold. Some states will have a 3 ml syringe for the vaccine and others will not”, says the SR’s technical director, Tomé da Silva.
To understand the impact, in the two SR plants, in Manaus and in Pedro Juan Caballero, in Paraguay, the daily production capacity is of 3.5 million syringes of all models. Considering only the 3 ml model specified by the Ministry of Health, it drops to 500,000 per day. Considering the four advocated models used by the National Immunization Plan, it reaches two million per day.
He argues that daily production in the country could reach six million syringes per day, should the Ministry of Health’s technical specification authorize the use of the four volumes of syringes used by the National Immunization Plan in vaccination campaigns conducted in past years: 0.5 ml, 1 ml, 3 ml and 5 ml. The syringes would be combined with different tip models and needles to adapt to each need.
“This would increase production to about 100 million per month. In three months we would attend the demand for the whole country. This will expedite the vaccination process and prevent shortages in states,” he suggested. “We were saying this and the government wasn’t listening, that’s the truth.”
Syringe manufacturers argue that Brazil can guarantee supplies for the vaccination of 150 million Brazilians without depending on imports or restrictive trade measures, relying only on domestic production.
According to SR’s director and president Luiz Antonio Saldanha Rodrigues, domestic industry is able to produce 1.2 billion syringes and needles per year in the four plants installed in the country.
According to him, the measures adopted by the federal government to acquire supplies – which range from export restrictions to the administrative requisition of 30 million syringes and needles from Brazilian companies – are unnecessary.
“It is an ineffective measure. It’s a government precaution, but the truth is that there’s no shortage of syringes in the market. And plants are prepared to meet the increased demand, because no one will be given 300 million doses in a day,” justified SR’s director, recalling that the Ministry of Health’s vaccination calendar runs until 2022.
According to ABIMO, an organization representing medical equipment manufacturers, the production capacity of Brazilian plants ranges from 1.2 to 1.5 billion syringes per year.
Since August last year ABIMO has been alerting to the need for joint planning between governments and manufacturers for the production of syringes and needles to vaccinate against Covid-19, in order to prevent shortages and dispute over supplies.
Last Thursday, January 7th, the federal government announced the administrative purchase of 30 million needle and syringe kits from three Brazilian manufacturers, alleging “imminent public danger”.
On the same day, President Jair Bolsonaro announced that new purchases of these supplies would be suspended until prices returned “to normal”.
In addition to SR, Becton Dickinson Indústrias Cirúrgicas, with plants in Curitiba (PR) and Juiz de Fora (MG), and Injex, in Ourinhos (SP), have until January 30th to deliver the stock to the Ministry of Health, which will pay an indemnity.
The measure, which intends to centralize the purchase of supplies and may compromise the delivery of purchases already made by states, was adopted after a failed call for tender by the Ministry of Health, which only managed to purchase 7.9 million of the 331 million syringes and needles intended by the federal government.
The price charged by companies, higher than expected by the government, was the main obstacle.
The companies allege that prices were raised due to increased demand and the dollar’s hike which increased the cost of polypropylene, a type of plastic that is the main raw material in the manufacture of syringes, by up to 50%.
The federal government has also restricted exports of syringes and needles and zeroed the import duties of these supplies, “creating unfair competition” and a “dangerous situation” for Brazilian companies, alerts SR’s Tomé da Silva.
According to Minister of Health Eduardo Pazuello, Brazil has secured 60 million needle and syringe kits for vaccination against Covid-19 and 354 million doses of the vaccine.
Another 40 million syringes and needles should be acquired through the PAHO – WHO’s arm for the Americas – by March.
Still according to the Ministry, the inventory held by states and municipalities to begin the immunization campaign against Covid-19 is “satisfactory” and new tender procedures should be opened to meet the growing demand.
Last Thursday, January 7th, the Federal Supreme Court (STF) ordered the Ministry to report, within five days, the stock of syringes and needles for vaccination.
A Folha survey found that state Secretariats have approximately 116 million syringes and needles in stock to begin vaccination.
The National Mayors Front, in turn, has already alerted that states stocks are also intended for other vaccination campaigns, such as against measles, as well as healthcare units. Unless this stock is replenished at the speed of the current demand, there may be a shortage of supplies along the vaccination campaign.