NEW DELHI — Rajiv Nath’s factories were cranking out more than 7,600 syringes a minute when India decided to limit their export last month to shore up its own vaccination campaign.
The products were meant for clients around the world as nations scramble to inoculate their people and bring the pandemic to an end, but instead Mr. Nath’s warehouses were left with stocks of more than 45 million syringes that he had largely promised to UNICEF and the Pan American Health Organization.
And with India’s export restrictions on syringes in place through the end of this year, experts say the world could experience a shortfall of two billion to four billion needles through the end of next year. The shortages are expected to hit African countries the hardest.
“That will be truly disappointing,” said Prashant Yadav — a senior fellow at the Center for Global Development, a Washington research organization, and an expert on health care supply chains — “that after having waited for over a year to get a reasonable quantity of vaccines, when they do obtain the vaccines, they don’t have syringes to administer them.”
Although India is a small player in overall global exports, it is a major producer of the type of syringe that is being used globally for coronavirus vaccinations. The syringes break on second use to prevent the spreading of disease through reuse.
Covax, the vaccine-sharing initiative, is seeking the syringes from manufacturers around the world, and India was expected to meet at least 15 percent of the global demand for use with Covid vaccines and other inoculations.
The situation became so acute last month that the World Health Organization and PAHO asked India to allow Mr. Nath’s company, Hindustan Syringes and Medical Devices, one of the world’s largest syringe makers, to ship the orders it had agreed to before the restrictions were announced. Prime Minister Narendra Modi’s government subsequently increased the export quota for the health organizations but did not allow a blanket exemption.
The World Health Organization and UNICEF have warned that the syringe shortage could have “dire consequences” for the global vaccination effort.
In India, more than half of the 1.4 billion-strong population has received at least one shot of a Covid vaccine, but only 27 percent of people are fully vaccinated, according to a New York Times database. And new inoculations have slowed recently.
Unlike vaccine doses, syringes are bulky and are typically transported by sea. The shortage comes amid large disruptions in the global supply chain of shipped goods, and experts say that a Covax-like initiative is needed, with nations coming together to better supply syringes to poorer countries.
UNICEF, a major buyer of syringes for Covax, said in a statement on Wednesday that “syringe nationalism” could be addressed if big producers and wealthy countries “influence global markets in a way that unlocks access for other countries in the global south.”
The agency also said it was considering expanding use of another type of syringe approved by the W.H.O. that also prevents reuse.
Dozens of Indian syringe makers spent millions of dollars to scale up manufacturing last year, but buyers are increasingly relying on manufacturers in China.
ProcureNet, a Hong Kong-based supplier of pharmaceutical products, said this week that it would invest $20 million in Anhui Tiankang Medical, a Chinese manufacturer, to produce 750 million syringes for P.A.H.O. and other buyers.
“We continue to spend billions on the vaccine,” said Gurbaksh Chahal, ProcureNet’s chief executive, “but what good is the vaccine if we don’t have the tools to deliver the vaccine to the people?”