David Swann is the Reader in Design at the University of Huddersfield and is the creator behind ABCs: A Behaviour Changing Syringe. The product is designed to deter the reuse of used syringes in India. Once the syringe has been used, the syringe barrel automatically changes to the colour red. The thinking behind this is to deter future use of the syringe while keeping the costs of the syringe down to a minimum. Accounting for 83% of all the world's injections, India is the largest consumer of syringes in the world. Regrettably 63% of these injections are deemed unsafe and 32% transmit a disease in one form or another.
We have a chat to David Swann to learn more about the project, issues during development, user testing on the streets of Mumbai and how designers have to find their "respondability".
NJPC: How did the project originate?
David: The origins of the project coincides with being a finalist in the 2011 INDEX: Design to Improve Awards. Searching through a WHO patient safety database I discovered that their research priority number five was preventing unsafe injection practices.
NJPC: Which avenues did you explore when you started your research on the syringe?
David: An intensive literature review provided background knowledge on the academic research relating to this stubborn challenge. This brought me into contact with Marc Koska OBE, creator of the K1 auto-disable syringe and founder of the Safepoint Trust.
NJPC: How does the syringe technically work?
David: The premise of our innovation is not to deliver a costly innovation that provides 100% patient safety. History has shown that AD (auto-disposable) syringes now account for 95% of all immunizations but globally only 5% of curative injections use AD syringes. This is largely due to their prohibitive cost. Therefore I aimed to create a superior disposable syringe for the same cost - 2.5p.
NJPC: Did you have any failings during the design process and if so, what did you learn from them?
David: Originally we perceived the solution would be a new syringe design, but we discovered that introducing any new design, no matter how small the step, would cost millions to meet/gain FDA compliance approval. This changed our thinking and our innovation strategy. Adopting an intelligent label approach would save years and costs, with the added benefit of making any injectable safer: disposable, ADs and pre-filled.
NJPC: Where did the inspiration for using atmosphere packing technologies come from?
David: I wanted to engage and empower the patient to become a gatekeeper of their own personal safety- rather than the present default acceptance. The difficulty for patients is that it is impossible to determine a visual difference between a used/washed syringe and a sterile syringe removed from its packaging. Instigating a colour change would explicitly exposes the risk and could indicate without doubt prior use. Intelligent inks that activate to heat, light and Co2 would deliver this transformational performance. But a Co2 activated ink would need to remain deactivated while in the pack- hence the use of a nitrogen atmosphere as used by the food industry.
NJPC: The syringe only costs a fraction more than the syringes being used in India currently. What were the design decisions that you had to make to ensure that the costs were kept low?
David: Frugal thinking drives frugal solutions. Ask yourself how you can add real value without any additional cost. It's a real challenge that demands the acceptance of satisfice solutions- those simple ideas that are just good enough.
NJPC: You tested the idea of colour (red syringes being bad) on the streets of Mumbai with a 100% success rate. Were you surprised by this result as colour can be interpreted differently by different people?
David: Yes certain colours do have historic and cultural significance. But subliminally we are also exposed, accept, and interpret red visual warnings in everyday life; the TV standby; traffic lights, blood and car brake lights. In modern life we accept that red signifies stop.
NJPC: Are there any future qualitative or quantitative tests on behavior change that you will conduct for the product moving forward?
David: We plan to undertake further clinical, behavioral, chemical investigations to determine performance requirement and the impact of our innovation to present manufacturing processes.
NJPC: What are the next steps to bring the product into the Indian market?
David: We are in discussion/ seeking dialogues with commercial partners to realise our innovation and intellectual priority with both the visual indicator of prior use and as a package integrity monitor during the supply chain.
NJPC: This project is an excellent example of using design for social good. Do you have any advise for designers that wish to pursue a direction in social innovation but don't know how?
David: Designing behaviour change is the 21st century challenge for all designers. As Kigge Hvid, the CEO for INDEX: Design to Improve Life says, "find your respondability". If you have an opportunity to respond, you have the responsibility to do so.