by The Welthi Bureau | 07 FEB 2018
India needs urgent Healthcare System Strengthening (HSS) and introduction of Universal Infection Prevention (UIP) guidelines across the country
Every 1 $ investment in injection safety saves 14 $ in public healthcare
Even Countries like Uganda and Tanzania banned use of AD Syringes and it imports to fight HIV. Why it is not being done in India?
46 people getting infected with HIV due to reuse of a single syringe in Uttar Pradesh has caused concern among the health officials. Mr. Rajiv Nath, President, All India Syringes and Needles Manufacturers Association (AISNMA) states that this could be just a tip of an iceberg as the problem is spread across the country. If this menace is not stopped, India could be staring at an HIV / AIDS epidemic, Mr. Nath questioned National AIDS Control organization (NACO)’s lax attitude towards injection safety and preventable measures in its strategy to fight HIV.
Mr. Rajiv Nath said, ‘UP’s healthcare is fragile. It needs urgent HSS and introduction of UIP including urgent deployment of Auto Disable syringes and needle stick prevention IV Cannula to immediately limit epidemic from spreading.’
“Is injection safety in public healthcare a key element in NACO’s strategy to fight HIV as is done in Africa?”, Mr. Nath asked. The answer obviously is no as it thinks spread of infection via public healthcare is not an issue and therefore India has no funding or monitoring policy dedicated to public healthcare system strengthening . Further, there is no tracking of infections or registry via public healthcare from reuse of syringes/needles or needle stick injuries.
“NACO is myopic in limiting problem of Syringe reuse to only drug users”, Mr Nath said. Every time such tragedies like current one in Unnao or earlier in Modasa in Gujarat happens, it causes discussions and publication of a Guideline book and then forgotten. Bad habits can't be changed by education alone if culturally engrained and therefore reliance has to be on technology. As a car alarm forces you to belt up so does Auto Disable (AD) Syringes ensure- no possibility of Reuse.
Quoting WHO, Mr. Nath said that “Every $ 1 spent on injection safety saves $ 14 in public healthcare. A recent Health Technology Assessment study released by DHR finds Reuse Prevention AD Syringes cost effective at 1.90 Rs. Why use disposables that get misused and reused to become carrier of infection without universal precautions?” As in immunization, AD syringes can be used universally for all therapeutic injections.
In this context, it is important to ask, what is India’s Road Map to switch to Auto Disable Syringes as per WHO advisory to achieve this by 2020? Uganda and Tanzania banned imports and use of Std Disposable syringes to fight HIV and to disallow access to Quacks and Private sector to Disposable Syringes. Why it is not being done in India?, Mr Nath implored further.
The Ministers in various states of Health and Family Welfare and DGHS asks us to stop making Disposable Syringes and switch to AD syringes. We are ready to do so, but India should first stop buying disposable syringes in a predictable planned phased manner and switch to AD syringes and then CDSCO/ Regulators need to enforce a ban/ restricted access.
With more than 40 thousands Quacks in Delhi alone one can imagine how quickly and fiercely the HIV epidemic is spreading. Reusing syringes constitutes one of their main unsafe practices. Therefore 46 people infected with HIV in Unnao of Uttar Pradesh could as well be news of any part of Delhi and anywhere from rest of India.
“It is high time Govt. takes immediate cognizance of the serious issue and deploy Auto Disable Syringes to save India from Threat of HIV / AIDS epidemic. It is MUST for India to enforce Injection Safety on priority basis” concluded Mr Nath.
The DGHS at Global Hepatitis Conference held by WHO at Mumbai in 2016 announced India's commitment to follow WHO's 3rd Public Healthcare initiative of Injection Safety by Universal Deployment of SMART Auto Disabled Syringes by 2020. This was the 3rd global initiative after Polio eradication and Hand Washing.
In July 2016 and March 2017 DGHS and Add Secy. Health called 2 meetings with Indian manufacturers and gave the target date of July 2019 to switch over capacity to AD Syringes Manufacturing. Manufacturers sought a publicly announced Swach Injection Abhiyan and a phased Road Map that's not been announced thereafter. Manufacturers are unwilling to invest without guaranteed offtake.
Meanwhile Punjab is running a pilot project on Injection Safety as it has the highest incidence of Hepatitis C. Hepatitis C mainly spreads from exposure to blood typically in a healthcare setting.
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