The World Health Organization (WHO) wants to see universal adoption of syringes that can only be used once, to address the global problem of unsafe injections that are driving the spread of a number of infectious diseases.
It has released new policy guidelines on injection safety that recommend countries transition to the exclusive use of “smart” syringes by 2020, except in a few circumstances where a single use syringe would interfere with the procedure (such as when a patient is using an intravenous pump with a syringe).
The guidelines focus on the application of “good practices coupled with good technology” to make health safer, says Edward Kelley, director of the WHO service delivery and safety department.
WHO estimates that about 16.7 billion injections are given annually — around 90% are given into muscle or skin to administer medicines — and that many are unnecessary.
A 2014 study
estimated that in 2010 about 1.7 million people were infected with hepatitis B virus, 315,000 with hepatitis C virus and 33,800 with HIV through unsafe injection, WHO says.
Unsafe practices include reuse of injection equipment, overuse of injections where oral formulations of drugs are available and unsafe sharp waste management.
The “smart” syringes WHO recommends for intramuscular and subcutaneous injections have features that prevent re-use. Some include a weak spot in the plunger that causes it to break if the user pulls back on the plunger, while in others the needle retracts into the syringe barrel at the end of the injection.
Kelley says new syringes without safety features cost around US$0.03 to US$0.04, while the safety syringes cost at least twice as much.
 PÃ©pin J, Abou Chakra CN, PÃ©pin E et al. Evolution of the Global Burden of Viral Infections from Unsafe Medical Injections, 2000–2010. PLoS ONE 2014; 9(6): e99677. doi:10.1371/journal.pone.0099677.