1. Towards Curative Auto- Disable Syringes Dr Yvan Hutin Department of Blood Safety and Clinical Technology WHO, Geneva

2. Towards increased use of AD syringes in curative services Outline What are the needs? What is available? How do we set standards? How do we open the way? How do we move forward?

3. Towards increased use of AD syringes in curative services 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

4. Towards increased use of AD syringes in curative services 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

5. Towards increased use of AD syringes in curative services 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

6. Towards increased use of AD syringes in curative services 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

7. Towards increased use of AD syringes in curative services 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