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Auto-disable syringes are the best option to prevent reuse: HS Ratti, epidemiologist

Dr Colonel (retired)HS Ratti, anepidemiologistand project advisor to Safe Point — an NGO funded by HindustanSyringes& Medical Devices that is working towards safe injection practices — recommends auto-disable syringes for theCovidvaccination programme. Ratti tells ET Magazine in an interview that reuse of syringes is very common in India and the Covid vaccination programme should take that into account during rollout. Edited excerpts:

How safe are the syringes used for injections in India?
Reuse of syringes is very common in India, especially in smaller towns and villages. There have been instances reported where hospitals which flout biomedical waste disposal norms, and do not properly dispose used syringes properly. Sometimes, these syringes get recycled and then sold in the market. There have been several instances of blood-borne infection — and the main culprit has invariably been used and re-packed syringes. The only saving grace is the reinforced Biomedical Wastes Disposal Act, which lays down clear rules for the disposal of medical consumables. Many institutions are following these rules now.

What kind of infection could one contact through used syringes?
HIV, Hepatitis B and C, abscesses in the injected area… almost any blood-borne infection, especially if unsafe injection practices are followed.

What is the solution?
All state governments should mandate the use of auto-disable syringes now. Over 16 billion injections take place around the world every year. Of this, 6-8 billion happen in India. Nearly 15% of these injections are for immunisation purposes for children. These, as per WHO protocols, are delivered using auto-disable (AD) syringes. The remaining 85% are delivered using single-use disposable syringes, many of which are re-packaged and sold in the market fraudulently. Efforts to get other all state governments to mandate the use of auto-disable syringes now are actively under way

Do you recommend AD syringes for Covid vaccination programmes too?
Definitely! The scale of this programme is such that it will involve a lot of syringes. This can be an opportunity for unscrupulous elements to push used syringes back into the market. No public health expert will recommend single-use disposable syringes for a vaccination programme as critical as this one. Covid vaccination using single-use disposable syringes could pose a grave health risk.

But there are only 3-4 companies manufacturing AD syringes. And paramedics, nurses do not know how to use these syringes…
Companies making these syringes have large capacities. They should be able to supply the desired quantity. There are regular training programs conducted across states to train medical staff in areas of safe injection practices. Well-trained nurses and paramedics should be able to administer injections using AD syringes. The process is almost the same.

Are AD syringes foolproof?
Yes. Theoretically, 100%. But if someone wants to recycle and repack these too doing some jugaad, who can stop them.


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