This child is playing with a needle he found at the area dump!
Helping countries procure injection supplies
The last time you received an injection, you probably didn’t think much about it, other than how much it might hurt. But consider this: behind each injection are complex systems of procurement and logistics.
In the United States and other developed countries, the systems are firmly established and well resourced. Injections are given by trained personnel who always use a new, sterile syringe readily obtained from a nearby, reliably stocked supply room. Health workers dispose of used syringes in tamper-proof containers, preventing people from accidentally coming into contact with this hazardous medical waste.
In countries where budget resources are stretched thin, such systems are sometimes weak, and the very injections meant to prevent or treat disease can end up causing it instead.
PATH addresses the complex issues of safe injection from many angles. Some of our recent work has focused on the essential step of getting the right supplies in the right places—and at affordable prices.
How big is the problem?
About 16 billion injections are given in developing and transitional countries each year, according to the World Health Organization. At least 50 percent of injections in developing countries are estimated to be “unsafe.” In some countries, the rate may be as high as 70 percent.
Unsafe injections expose individuals to the risk of infection such as HIV or hepatitis B. This can happen when health workers reuse syringes or lack the training they need to give injections the best way.
An additional risk arises when systems for disposing of medical waste are weak. Used syringes may be gleaned from the garbage and resold. PATH staff have also observed children playing with used needles they’ve found in the area dump!
Getting the goods
For many years, PATH has been developing or researching technologies that make injections safer—including smart (autodisable) syringes, needle removers, and special containers for disposing of needles and other medical waste.
Now, as an integral partner of the Making Medical Injections Safer and the Guyana Safe Injection projects, PATH is helping ministries of health in several African countries and in Haiti and Guyana choose and procure these types of supplies—in whatever combination fits their health care environment.
Once the needs are identified, our procurement team, highly skilled in the specialized field of procuring goods internationally, identifies suppliers, initiates competitive bidding, and arranges for rapid shipment of an amazing array of products. To date, we have ordered and shipped 65,000,000 autodisable syringes, 25,000,000 retractable syringes, and 7,000,000 other disposable syringes. The advantage of the autodisable and retractable syringes is that they can’t be reused because they lock or the plunger automatically breaks after an injection is given. In addition, we’ve ordered safety boxes for disposing of used syringes properly and needle removers, which separate contaminated needles from syringes and contain them in a puncture-proof container.
Our involvement means that countries get the best price on high-quality products. We are able to keep prices reduced by pooling countries’ needs and purchasing in larger quantities. We ensure the quality of goods—often a problem in developing-country supply chains—using standard, professional procurement practices. Ready access to safer, more reliable supplies will spur developing-country health systems to adopt safe injection supplies as the norm.
Making it stick
To further stoke demand and make safe injection practices sustainable, we’re assisting individual countries in setting up or building on their own systems for procurement and medical waste disposal. We’re designing curricula and hosting workshops to help health officials build skills in forecasting the demand for supplies and in financing, purchasing, and managing them. Our medical waste experts are developing training materials for health workers and waste handlers.Our goal is a sustainable supply of the equipment that health workers need to make injections safe, knowledgeable health workers who use and dispose of syringes correctly, and secure waste management. In every country, injections meant to safeguard health really should do just that.
Photo: Robert Maletta.