After 30 years, @WHO finally begins pushing single-use syringes

Yesterday, the WHO officially updated its injection safety recommendations to call for the widespread adoption of single-use syringes, as well as a reduction in unnecessary injections (e.g., administering medications orally if they do not need to be injected):

A 2014 study sponsored by WHO, which focused on the most recent available data, estimated that in 2010, up to 1.7 million people were infected with hepatitis B virus, up to 315 000 with hepatitis C virus and as many as 33 800 with HIV through an unsafe injection. New WHO injection safety guidelines and policy released today provide detailed recommendations highlighting the value of safety features for syringes, including devices that protect health workers against accidental needle injury and consequent exposure to infection.

Transmission of infection through an unsafe injection occurs all over the world. For example, a 2007 hepatitis C outbreak in the state of Nevada, United States of America, was traced to the practices of a single physician who injected an anaesthetic to a patient who had hepatitis C. The doctor then used the same syringe to withdraw additional doses of the anaesthetic from the same vial – which had become contaminated with hepatitis C virus – and gave injections to a number of other patients. In Cambodia, a group of more than 200 children and adults living near the country’s second largest city, Battambang, tested positive for HIV in December 2014. The outbreak has been since been attributed to unsafe injection practices.

WHO is urging countries to transition, by 2020, to the exclusive use of the new “smart” syringes, except in a few circumstances in which a syringe that blocks after a single use would interfere with the procedure. One example is when a person is on an intravenous pump that uses a syringe.

Setting aside my horror that repeat use of non-sterile needles in still a thing in healthcare facilities here in the US, I saw this as a positive move on WHO’s part and assumed that the “smart” syringe referred to in the press release and several headlines was something only recently developed. After all, injection drug use has been the primary driver of HIV and hepatitis infections in Eastern Europe and Central Asia for years, and it is a significant component of the epidemics in southeast Asia and China’s Yunnan province as well.

Imagine my chagrin when I came across this piece from the Guardian‘s Global development professionals network. It tells the story of Marc Koska, the British inventor of the K1 single-use syringe, who has apparently been trying – unsuccessfully – to get the global health community to jump on this bandwagon…for 30 years.

Using existing technology Koska came up with a syringe that falls apart after one use, and sold his first one in 1997. Even though he’s sold more than 4 billion auto-disable syringes since, he has been repeatedly frustrated in his attempts to make the world aware of the problem caused by reusable syringes. “It’s been a very frustrating journey. Thirty years to get WHO turned around. Thirty years to get the manufacturers turned around. You’ve got too many parts to expect it to be a three year journey.”

“There is a very basic reason why it hasn’t happened and that is because the manufacturers haven’t had a market,” he argues. “If the manufacturers could sell a product and it was identified where they were going to sell it and who was going to pay for it, they would make it.

“Today, [WHO Director Margaret] Chan is a hero, but I think the next chapter might be just as challenging as the first bit,” he says.

“My gut feeling is that the ministries of health will be most resistant, because they’ve been saying for so long that they don’t have a problem of reuse in their countries. They’re never going to say that ‘we’ve got a terrible problem with hepatitis C because I can’t be bothered to buy enough syringes’. So now ministers have got to change their position and say, from Tuesday, we’re only going to buy auto-disable syringes.”

The frustrations of market forces blocking the development or widespread adoption of critically-needed global health resources is an old hat to most in the field, but this seems particularly egregious…WHO really should have caught on much sooner.


Note: This was cross-posted to my own professional blog.

Global Health Weekly News Round-Up

Politics and Policies:

  • The Food and Drug Administration has announced that it will begin exercising its authority given under a 2009 law, power to regulate cigarettes and other tobacco products that they believe pose public health risks.
  • In an effort intensify campaign to publicize new health insurance options and to persuade consumers, the White House is recruiting mayors, county commissioners and other local officials.

Programs:

  • A health check program has been launched in Accra, in order to reach out to the people of Ghana who are challenged with non-communicable diseases (NCDS), in an affordable and effective way.
  • The United Kingdom (UK) is starting a rotavirus vaccination program to protect the babies from infection which causes diarrhea, vomiting, abdominal pain, fever and dehydration.
  • Ben & Catherine Ivy foundation grants more that $9 million for brain cancer research.

Research:

  • To help avert 3 million AIDS deaths by 2025, the World Health Organization (WHO) through its guidelines is recommending the patients the start medicine at earlier stage of the deadly disease.
  • According to global Diabetes attitudes, wishes and needs 2 study one in five people with diabetes feel discriminated against them because of their condition. About 16% people suffering from this condition are at risk of depression.
  • According to the United Nations Program on HIV/AIDS (UNAIDS), Ghana cuts new HIV infections among children by 76% since 2009. It states that one three in ten children in need of treatment have access to it.
  • A report released by the United Nations state that Nigeria has highest number of children with HIV/AIDS virus in the world. It states that the incidence rate has not increased much but the increase in the prevalence rate has remained stagnant.
  • According to the scientists, new World Health Organization (WHO) test- based approach against malaria does not work everywhere. There must be a hard diagnosis before the disease is treated.
  • According to the research results published in the Journal of Infectious diseases, infant rotavirus vaccine is effective against this disease in Ghana. Results showed a significant response in parameters of efficacy, safety and immune impact of vaccine.
  • A study published in the journal’ Diabetologia’, ethnicity should be considered while making guidelines for physical activity. They state that south Asians need more exercise than white Europeans to reduce diabetes risk.
  • According to a research review published in BMJ, high consumption of fish reduces risk of breast cancer by 14%. It replenishes the body with all omega 3 essential fatty acids which can only be acquired from external sources as body cannot manufacture it.
  •  In a study published in Cell Transplantation journal, type 2 diabetes patients who receive self-donated bone marrow stem cells require less insulin. According to the scientist’s good glycemic control appeared as a critical factor in the transplanted and non-transplanted control group.
  • A study indicates that consuming more than 2-3 standard alcohol drinks per day is linked to deadly digestive tract cancers including mouth, throat, larynx and esophageal. They also warn of risk of bowel, breast and prostate cancers.
  • The scientists have found out that the patients of Crohn’s disease also have a virus – enterovirus in their intestines as compared to those who did not have this disease. It also said that the genes associated with the onset of this disease are vital for the immune response against this virus.
  • According to the researcher’s malaria parasite are full of iron which they cannot digest nor can excrete them. Their invention- hand-held battery operated malaria detector will use the power of magnets to detect them.

Diseases & Disasters:

  • Reports state that Lusaka (Zambia) records approximately 185 new HIV/ AIDS infections every day. It has high prevalence rate of 20.8 percent as compared to the other districts of Zambia.
  • The cholera epidemic in the Democratic Republic of the Congo claims lives of 257 people. Lack of proper sanitation and clear water are stated to be the main cause of the outbreak.
  • Polio outbreak in Somalia jeopardizes global eradication. Before this there was no case of this disease for more than five years. This outbreak is reported in its early stages and WHO experts see more cases coming in next few weeks.
  • A report released by Greenpeace suggests that a Chinese herbal medicine contains a variety of pesticides. It is increasingly accepted in the western countries for medicinal use.
  • Reports have shown a new trend of HIV infection among the youths of Manipur (India). Unsafe sex practice has been indicated to be the major mode of HIV transmission among them.
  • According to the UK’s Medicines and Healthcare Products Regulatory Agency (MHRA). Diclofenac, a common painkiller raises the risk of heart attack and stroke among the patients with serious underlying heart conditions.
  • Health officials are warning that tularemia cases are on rise in New Mexico. Four cases have been so far been reported.
  • Japan and Poland are facing epidemic of rubella. Travel warnings have been issued by the Centers for Disease Control and Prevention for the pregnant females visiting these countries.

IH News Global Health Weekly News Round-Up

  • May 31 was observed as World anti-tobacco day by the World Health Organization.
  • The Fitness Industry Council Canada has announced June 1 as National Health and Fitness Day.

Politics and Policies:

  • The Republic of Congo has passed a law that prohibits the purchase, consumption and possession of tobacco for minors, pregnant women and mentally ill. The advising and any kind of promotion of tobacco are also prohibited in the country. Smoking is prohibited in public places.
  • According to the World Health Organization On June 10th Ethiopia is launching an emergency mass-vaccination campaign against yellow fever.
  • According to the Ghana’s Minister of Health, the country is committed to ban all forms of tobacco advertisements and promotions.
  • Smoking in presence of children equaled to physical violence in Latvia.
  • Russia’s smoking ban came into effect on Saturday. It involves no smoking in public places and curbing cigarette advertising and sales.

Programs:

  • The World Health Organization (WHO) in Gambia is launching polio campaign to vaccinate 400,000 children under five years.
  • The Ministry of Finance of Lesotho has signed two agreements totaling $17 million with the Global Fund to fight against HIV/AIDS, tuberculosis and malaria.
  • Professionals for Humanity International (PROFOH) have announced its third free medical screening in this year in Nigeria.
  • After the discovery of polio this week, United Nations emergency team rushes to vaccinate 424,000 people living in a refugee camp in Kenya.
  • Zimbabwe is going to conduct its first national tuberculosis prevalence survey with an objective to determine the national prevalence of bacteriologically-confirmed pulmonary TB among people aged 15 and over.
  • Rotary India extends its help to Pakistan in its polio vaccination drive.
  • The World Health Organization is calling on the countries to ban advertising about the tobacco products.

 Research:

  • Improvement of maternal health and reduction in child mortality in some countries was highlighted in a recently released report ‘Accountability for Maternal, newborn and Child Survival ‘.
  • According to the director of the National Institute of Combat of HIV (INLS), the prevalence of HIV in Angola has not changed since 1997.
  • According to the researchers patients who have developed oral cancer due to HPV can have sex with their spouses or long term partners.
  • According to a study done by the researchers at the Institute for Clinical Evaluative Sciences, rates of diabetes have jumped 15 fold within a decade for the Chinese Canadians.
  • A systemic review confirms that the licensed medicines for smoking cessation are successful in assisting people to quit smoking.
  • Scientists are using new optics-based single virus detecting methods for determining the exact viral load of a sample by counting individual virus sample.
  • New malaria vaccine developed by the team Japanese researchers has cut the infection rates by 72%.
  • A study conducted in over 13 hospitals in Indonesia, Singapore, Thailand and Vietnam shows that doubling Tamiflu vaccine dose does not help in severe flu.
  • Results of a study warn development of resistance to drug used in treatment of H7N9 virus.
  • A group of scientists discover how a single gene mutation helps brain cancer cells to survive and drive tumor growth.
  • According to the United Nations scientists, Fukushima No.1 nuclear plant has very low radiation doses and there is no increased risk of cancer on local residents.
  • According to the experts nearly one-sixth of young adults in Sri Lanka are overweight. Lack of nutrition education and food culture of the country are reasons for this problem.
  • A study states that particular combination of bacteria in the human digestive system can identify patients who have or are likely to develop Type 2 diabetes.
  • A study shows that the Coenzyme Q10 cuts the mortality rate by half in heart failure patients.
  • Report released by EU says that several new health risks are emerging from new chemicals, products and changing lifestyle patterns. It is important to address these issues all together.
  • According to a study fizzy drinks do harm to the teeth as drugs.
  • New vaccine for lung cancer has been developed by the scientists of Argentina and Cuba. It activates the body’s immune system to promote its destruction.

Diseases & Disasters:

  • Tornadoes hit Oklahoma again on 1st June. Death toll rises to 9.
  • A report issued by the Chinese Ministry of Land and Resources state that the ground water of China is poisoned. It did not address the severity and scope of this problem.
  • Death toll from bird flu has risen to 38 in China.
  • According to the reports of the United Nations, there is a suspected outbreak of Ebola fever in the north of the Democratic Republic of Congo.
  • According to the reports by Ghana Health Service, cholera outbreak hits greater Accra region.
  • The World Health Organization is concerned about the new strain of Coronavirus which has killed 55 of the confirmed cases.
  • A Starbucks in Hong Kong used water from the public restroom to brew coffee.
  • Pakistan is facing a severe measles epidemic. Since the start of 2013 about 239 deaths have been reported.
  • According to the Ministry of Health, Philippines, new cases of HIV infections recorded in the month of April were 388. It was 67 percent higher than those recorded in April 2012.
  • According to the reports Singapore is facing Dengue epidemic. More than 7,700 people are reported to be infected as of May 25.
  • Frozen berry and pomegranate mix has been reported to be linked to hepatitis A outbreak in five states in U.S.

IH News Global Health Weekly News Round-Up

  • First UN International Day of fistula marked in Ghana to ensure that victims were treated and re-integrated into society in Ghana.

Politics and Policies:

  • The government of Mauritius is preparing to enforce new laws for more graphic warnings on cigarette packs.
  • Voters in Portland have defeated measures to add fluoride to water supply.
  • The Texas House passed a measure that would prevent the state from expanding its Medicaid program.
  • Abortion Law (procedure at the 12th week of pregnancy) in Arkansas is temporarily blocked by a federal judge.

Programs:

  • The World Bank has announced $1 billion in a proposed new funding to help countries in the Africa’s Great Lakes Region to provide better health and education services besides targeting energy, roads, agriculture, cross-border trade and jobs.
  • United Nations Family Planning Innovation to launch two new initiatives that will increase access to family planning and improve maternal health in the world’s most marginalized areas.
  • The Business of a Better World (BSR) has launched an online platform to create culturally accurate training materials on women’s health in developing countries.
  • GlaxoSmithKline (GSK) has announced its contribution of $750,000 to the One Million Community Health Workers Campaign in sub-Sahara Africa.
  • Power to childcare centers ban unvaccinated children in Queensland.
  • An independent organization, Save the Children has received a contribution of $500,000 to support its ongoing flood relief efforts in Mozambique.
  • An emergency preparedness ad response center is being launched by the experts from the United Nations International Atomic Energy Agency (IAEA) in Fukushima, Japan.
  • United Nations refugee agency is working to help to contain cholera epidemic in Niger by implementing emergency sanitation and prevention measures.
  • UNICEF is working to prevent further spread of measles in the Central African Republic.
  • Mass vaccination campaign contained the spread of meningitis in South Sudan. The meningitis outbreak was declared by the ministry of health on April 30.

 Research:

  • According to the reports the World Health Organization has applauded Eritrea on its accomplishments in combating malaria.
  • Most EU beaches get clean bill of health, by the European Environment Agency. It says vast majority are clean and safe.
  • According to a new study relaxation of marijuana laws in Colorado has caused significant spike in number of young children treated for accidentally eating marijuana-laced cookies, candies, brownies and beverages.
  • A report by Substance Abuse and Mental Health Services Administration (SAMHSA) says that one in ten parents did not talk to their teen children about dangers of consuming drugs, alcohol etc.
  • In the 66th World Health Assembly, the WHO has praised Thailand for the world’s best governance for medicine.
  • According to the United Nations Report, the number of people in Africa receiving antiretroviral treatment has increased from less than 1 million to 7.1 million over the seven years.
  • According to a report released by the United Nations Japan must continue efforts to deactivate Fukushima nuclear plant.
  • In a report released by the United Nations greater efforts and more resources are needed to improve health of Palestinian refugees.
  • A study shows that potatoes and beans provide most nutrients per penny.
  • According to a study conducted by Dr. Bassiouny at Kornberg School of Dentistry, diet soda might be as bad for teeth health as taking methamphetamines or crack cocaine.
  • According to a study published in The Journal of Alzheimer’s Disease, two compounds found in cinnamon can play a role in delaying the onset of Alzheimer’s disease.
  • A research presented at the Heart Failure Congress 2013, heart failure accelerates the aging process and brings on early andropausal syndrome (AS).
  • The scientists at the Massachusetts Institute of Technology (MIT) have developed an injectable nanogel that can monitor blood-sugar levels and secrete insulin when treated.
  • A study revealed that the people who were interviewed while eating at fast food restaurants typically underestimate the calorie count of the meal in front of them by a large margin.

Diseases & Disasters:

  • A category EF-5 storm killed 24 people, injured many and damaged and estimated 12,000 homes in Moore, Oklahoma on May 20.
  • A parliamentary committee has revealed that since last year in Zimbabwe, more than 45,000 people have died due to HIV-related ailments and around 1.2 million people are living with this virus.
  • Disease kills children, causes miscarriages in camps near Nyala, South Darfur.
  • According to Tunisia Ministry of Health, SARS- like virus is being reported spreading among the people of country.

Global Health Weekly News Round-Up

Politics and Policies:

  • A partnership between the Government of Benin and the U.S. government was launched to help Benin achieve its objective of eliminating neglected tropical diseases by 2020.
  • U.S. Supreme Court weighs dispute over AIDS funding.
  • HHS announces new digital and mobile health application to help people to stay healthy.

Programs:

  • Nigeria may soon relax the criteria for placing people living with HIV on antiretroviral (ARV) treatment in order to increase number of people being treated.
  • Imbuto project has announced its plans to set up a model facility in Bugesera district, Eastern project. It will integrate elimination of mother to child transmission of HIV/AIDS services through its family package project.
  • The Embassy of the Republic of China (Taiwan) and the Ministry of Health and Social Welfare of the Gambia have signed an agreement on maternal health improvement program.
  • The Word Bank has approved a $7 million line of credit to improve the delivery of healthcare services in Djibouti.
  • Smile Train and Operation Smile in collaboration with the Government of the Republic of Rwanda have announced the launch of Rwanda Smiles to create the first-ever country in Africa.
  • A national strategic plan for HIV, tuberculosis and sexually transmitted infections has been adopted during South African National AIDS Council meeting in Secunda, Mpumalanga.
  • A two year maternal health project aimed at promoting community involvement in the assessment of the performance of selected health facilities and providers in the delivery of maternal health services was launched in Koforidua.
  • The UN refugee agency has appealed for millions of dollars to help to meet the needs of Malian refugees including healthcare, water and sanitation.
  • Canada funds IOM humanitarian projects involving emergency health, water and sanitation projects in Zimbabwe.
  • A partnership between Samaritan’s Purse Canada, University of Calgary, Canadian International Development Agency is running a healthcare project that is helping people of South Sudan.
  • To save upto 2 million children every year from deaths caused by pneumonia and diarrhea, the World Health Organization and UNICEF has launched a new Global Action Plan.
  • Cuba’s second round of anti-polio vaccination campaign starts on Friday through April 25 to keep this island free of this debilitating disease.

Research:

  • According to the reports from the municipal public health supervisor over 20 HIV/AIDS positive cases have been reported during the first quarter of this year.
  • According to the reports Kogli (Nigeria) has cases of HIV/AIDS rising since last 2 years. This rise has been attributed to lack of availability of funds for the state action committee on HIV/AIDS.
  • Global fund has increased funding (additional $25 million to 12 states and the Federal Capital Territory) for HIV/AIDS in Nigeria.
  • According to the Kwara State Ministry of Health Coordinator (Nigeria) for HIV/AIDS about 1.8 million children have been orphaned by HIV/AIDS related death in Nigeria.
  • A study states that breast feeding for more than four months lowers mother-to-infant HIV risk through their milk.
  • According to a qualitative research marriages in Malawi are a risk factor for HIV infection in females.
  • Results of a study involving people of Uganda states that food access and diet quality are associated with health-related quality of life.
  • Scientists from the University of Kansas made a discovery that aspirin directly and indirectly suppressed the proliferation of two different breast cancer strains.
  • Statistics from Chinese Center for Disease Control and Prevention states that China now has nearly 120,000 new cases of multi-drug-resistant tuberculosis.
  • According to the scientists DPP-4 inhibitors have cardio-protective effects on type 2 diabetes mellitus.
  • A study finds a relation between endometrial cancer at young age and risk for endometrial cancer.
  • A study reports that highly active retroviral therapy (HAART) may help to protect hearts of young patients.
  • Scientists from Indiana School of Medicine links beer with increased levels of dopamine in the brain.
  • The new U-M National Poll on Children’s health about 40% parents give young children cough/cold medicine that they shouldn’t.
  • According to a research letter published in the journal Emerging Infectious Diseases, some visible signs of Lyme disease are easily missed or mistaken.
  • A study indicates that high salt diet and ulcer bacteria together combine to increase the risk of cancer.
  • According to a study lung cancer mortality rates linked to primary care provider density.

Diseases and Disasters:

  • Plaque draws scientist’s attention as potential terrorism weapon.
  • Death count due to bird flu reaches 20 in China.
  • An earthquake of magnitude 7.0 struck China on Saturday. It is discouraging volunteers in the earthquake zone.
  • Vietnam has announced that special measures have been adopted to prevent the H7N9 avian flu from entering the city.
  • The Department of Health of Minnesota has alerted the doctors to a new strain of influenza  for the patients who have travelled to Asian nation and have flu-like symptoms.
  • According to the scientists, new strain of bird flu virus that has killed 17 people in China has acquired a significant genetic diversity.
  • Honduras reports two deaths from hemorrhagic dengue fever. In addition about 3,000 cases of classic dengue cases have been registered this year.
  • Reports have indicated a presence of a bird flu virus in Norfolk, UK.