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Towards Curative Auto- Disable Syringes . Dr Yvan Hutin Department of Blood Safety and Clinical Technology WHO, Geneva. Outline . What are the needs? What is available? How do we set standards? How do we open the way? How do we move forward?. The need.
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Towards Curative Auto- Disable Syringes Dr Yvan Hutin Department of Blood Safety and Clinical Technology WHO, Geneva
Outline • What are the needs? • What is available? • How do we set standards? • How do we open the way? • How do we move forward?
The need • AD syringes: a success in immunization services • There is a demand • There is an offer • The experience in the field is positive • Unmet needs in the curative services: • The number of injections is higher • Unsafe practices are highly prevalent • The informal private sector is difficult to reach • It is unclear whether sufficient quantities of single-use syringes would prevent reuse • WHO milestone for the exclusive use of single-use injection equipment by 2005
Syringes available • Mailed request to IASIT for available AD syringes of volumes exceeding 1 ml (March 2002). • Two syringes on the market: • One syringe with retractable needle and active inactivation • One syringe with breakable plunger and passive inactivation • Other manufacturers may have technologies up their sleeves
Setting standards • Can the same concept be kept? • Larger volume • Multiple injections of smaller volumes possible • Variable doses • Need of reconstitution • How do we proceed? • Agreement from ISO to proceed on with a standard • Potential intermediate use of a WHO procurement specification
A programme to open the way • The “stop TB” partnership • The Global TB Drug Facility (GDF) • Procurement of anti-TB drugs, including streptomycin • Recent progress • Decision of Stop TB to “bundle” injectable medications • Disposable syringes first with transition to AD ASAP • Use of the GDF need to formulate a WHO procurement specification that can work as an interim “standard” • Tender expected towards the end of 2002
The way forward • Support to GDF/ Stop TB to organize a first tender • Set up of the ISO committee for ISO standard 7886-4 • Promotion of the same “bundling” model for other donor or lender supported programmes • Community intervention needed to support future policy statements regarding the use of AD syringes in health services