Pakistan to ban conventional syringes in wake of HIV scandal

Pakistan will next week ban conventional syringes and switch to single-use versions to try to stop blood infections like an HIV outbreak that has infected hundreds of children.

The switch to auto-disable syringes that can only be used once will help curb the spread of blood-borne diseases from the reuse of needles, officials say.

Doctors welcomed the switch, which will take place at the end of November, but warned it must be strictly enforced to stop backstreet clinics and quacks flouting the rule.

Lax safeguards on giving injections and the reuse of needles are blamed as major factors in the country's high levels of diseases such as hepatitis and HIV. Pakistan has one of the world's highest levels of hepatitis and is estimated to have the fastest growing rate of HIV in Asia.

Health officials have pushed for the introduction of auto-disable syringes for years. Once an injection has been given, the syringe locks and cannot be used again.

The reuse of needles for injections or intravenous drips was blamed for a 2019 HIV outbreak that infected more than 800 children in the Sindh province town of Ratodero.

“If this would have been done before, I think such a type of outbreak might not happened,” said Dr Imran Arbani, the whistle blower doctor who first uncovered the Ratodero outbreak.

“If all health care providers use auto destructible syringes, I think blood infections like HIV, Hepatitis B and Hepatitis C, will not transmit any more.”

But he warned that supply shortages and lax enforcement would undermine the switch.

“The government has to make sure of 100 per cent availability of these syringes and concerned departments have to visit doctors and hospital to ensure their use.”

The ministry of national health services said manufacturers had been given exemptions on sales tax and customs duties to smooth the introduction.

“Conventional syringes will not be manufactured or sold in the market after November 30,” the ministry said.

“The Drug Regulatory Authority of Pakistan is already aware of a potential shortage that may be created once the ban is in effect, but it is working diligently to predict any supply and demand issues and will closely monitor any price hikes.”

Countries around the world are attempting to switch to safer syringes for the same reasons. Large national immunisation programmes have broadly switched already, but the use of syringes for treatments has lagged behind.

Pakistan's overstretched and badly funded public health system means its 220m residents rely heavily on small private health clinics which are poorly regulated and often run by unqualified staff.

There is also a culture of giving injections for minor ailments, with patients often demanding jabs because they believe they are better treatments than other medicines.

Zafar Mirza, a former special adviser on health to the prime minister, Imran Khan, said earlier this month: “Medical practitioners have inculcated the wrong belief among people that injections are needed for any minor ailment and that they are more effective.

“Hence the demand for injections is high. The statistics are mind-boggling. The highest number of injections in the world are administered in Pakistan – eight to 10 injections per person per year. Ninety-four per cent of these injections are not needed at all.”

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