Unsafe Practices & the Overuse of Injections, The 'ONE and ONLY' Problem


Written by Abhishek Anand

“Vaccines are the tugboats of preventive Health” – William Foege

The WHO says that unsafe practices and the overuse of injections across the globe can cause an estimated 33% of Hepatitis B virus, 42% of Hepatitis C virus and 2% of HIV infections every single year. Every year in Africa 20 Million people are administered with injections containing HIV infection.

Vaccination is the administration of antigen (a vaccine) to stimulate an individual’s immune system to develop adaptive immunity to a particular pathogen. Vaccines can prevent or ameliorate morbidity from infection. Vaccination is the most effective method for preventing infectious diseases; widespread immunity due to vaccination is largely responsible for the worldwide eradication of smallpox and the restriction of diseases such as polio, measles, and tetanus.


Injection is the most effective method of vaccinating a person. It is an infusion method of putting a fluid into a body usually with a syringe and a hollow needle which is pierced through the skin to a sufficient depth for the material to be administered into blood. With over 16 billion administrations all over the world in a year, injection has been the most commonly used medical procedure. It is used for both immunization and curative purposes. However among 16 billion administrations, curative purposes take the lion share to a tune of 90-95%.

Infection control breach
This important ammunition to counter many dreadful diseases turns out to be a paramount threat to the health care sector, if not administered properly. Syringes or single-dose medication vial is meant for a single patient and for one time use. But the infection control breach by the infirmary staff by reusing syringes/needles meant for one-time use has caused an irreparable damage, exposing patients to many blood borne diseases such as hepatitis and HIV, and to life-threatening bacterial and viral infections. Although safe injection practices represent very basic infection control measures, the Center for Disease Control and Prevention (CDC) routinely identifies and investigates outbreaks associated with deficient practices. According to a survey by CDC, in USA more than 150,000 patients have been impacted by unsafe injection practices since 2001. According to World Health Organization survey, up to 40 per cent of injections worldwide are given with syringes and needles reused without sterilization and in some countries this proportion is as high as 70 per cent.

In India, the story gets no better as expected. According to a survey by World Health Organization (WHO), 3 billion injection administrations are carried out annually in India. Of these, 2.49 billion are for curative purposes and among them 1.89 billion were unsafe. The private sectors were contributing to 2.1 billion injections to the total injections and among them 1.26 billion were found to be unsafe.

Boomerang effect
The deadly transformation of such widely practiced health care intervention which has benefited the people so extensively in the last century, into a health hazard and a threat to community health has made it the biggest irony. As a result, the non sterile injections may serve as a bridge for HIV and hepatitis transmission between high-risk groups and the general population. According to Dr. Santanu Chattopadhyay, Gastroenterologist, Founder and CEO, Nation Wide Primary Healthcare Services:

“Hepatitis B & C can both be contracted through the sharing of needles during drug use; via reuse of infected syringes; through blood transfusion, if the blood was not properly screened; and during tattoo making or piercing done with infected tools. In rare cases, an infected pregnant woman could spread the virus to her baby at birth. Even sharing of razors or tooth brushes with an infected person can spread the disease.”

According to a survey by IPEN group, Hepatitis B cases in India are approximately 1.1 million, with 240,000 annual deaths due to complications associated with it. Similarly for Hepatitis C, the figure for India is put at 400,000 cases, with about 96,000 deaths annually of causes related to the hepatitis C infection. A large percentage of these cases are due to unsafe injection practices.

Panacean Efforts
Prevention is better than cure. Instead of addressing the increasing Hepatitis victims, an efficient program which checks the possibility of an outbreak through infection control breach would be a smarter move. Working in that direction Marc Koska, a visionary entrepreneur has come up with a revolutionary design of syringes which breaks immediately after the first use. This design doesn’t give a chance for human exploitation through re-usage. His company Safepoint is distributing such syringes for 5 centsper piece all around the world.

One & Only Campaign
Another design of color changing syringes has come to the market. The color of the syringe automatically changes in its first use. The change of color could alert the patient that he/she is being administered by a used syringe.
Through targeted education and awareness efforts, the One & Only Campaign empowers patients and healthcare providers in America to insist on nothing less than safe injections – every time, for every patient. Since 2009, the campaign has developed tool kits and materials for providers and patients, including a clinician toolkit, a checklist, posters, a video, and a continuing education webinar. The Centers for Disease Control and Prevention (CDC) and Safe Injection Practices Coalition (SIPC) have also promoted awareness of safe injection practices at a wide variety of national and state meetings, conferences, and training activities.

Such new designs and awareness campaigns have to play a decisive role in this regard and have to act as an elixir to keep up world health and well-being,

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