THE danger to public health posed by the unsafe practice of syringe reuse without proper sterilisation as well as the over-reliance on injections was acknowledged years ago. Because this was recognised as a primary cause of the spread of hepatitis B and C, particularly in the rural areas and in the lower income areas of cities, ways of tackling the problem of unsafe injection practices were looked into by our health authorities. But implementation of solutions to the problem has been found wanting. One solution which the health authorities decided upon was regulating the quality of syringes by having all manufacturers and importers register their syringe products under the Drugs Act, 1976. But according to the Rawalpindi/Islamabad chapter of the Pakistan Medical Association, the deadline given by the Ministry of Health for registration of syringe products has been postponed time and again since the expiry of the first deadline on Dec 31, 2007. The deadline was recently extended yet again by another three months, from Sept 30, 2009 to Dec 31.
No doubt ensuring safe injections is a daunting task here. Only a small percentage of injections use auto-disable syringes. Since the estimated number of injections administered annually is 1.5 billion, ensuring every injection is safe means we need to produce and/or import that many auto-disable syringes, which also cost more than ordinary syringes. On the other hand, approximately 94 per cent of the 1.5 billion injections are estimated to be unnecessary. Addressing this requires changing perceptions among the general population and doctors. Finally, proper medical waste disposal also needs to be ensured to prevent repackaging of syringes for resale. Only committed implementation of these measures will help stem the tide of unsafe injections that are fuelling diseases which are robbing families of their breadwinners.