Gujarat is yet to conform with the Centre's recommendation of to use auto-disable (AD) syringes at government hospitals to reduce the risk of infection.
Government of India had issued an advisory notice in December 2008 to all state governments recommending the use of AD syringes at government hospitals. It had already mandated a phase-wise introduction of AD syringes at Central government hospitals and suggested the same for the rest of the country. As health is a state subject, the onus was on the states to implement the same.
As per WHO definition, AD Syringes are those that are automatically rendered unusable after having delivered the prescribed dose of vaccination. These cost around 50 paise more compared to regular syringes.
"While states like Karnataka have achieved almost 100 per cent usage of these syringes at government hospitals, others like Kerala, Madhya Pradesh, Delhi and also local self government bodies like the Brihanmumbai Municipal Corporation (BMC) are fast catching up, in Gujarat there is zero procurement", claimed Rajiv Nath, joint managing director of Hindustan Syringes & Medical Devices Limited (HMD), one of the largest producers of single use syringes in India.
Interestingly, after the Modasa tragedy in April 2009 where a mass outbreak of hepatitis occurred from infected needles, the state government had planned promote safe injections through the use of AD syringes. State health minister Jay Narayan Vyas was unavailable for comment. He had earlier ruled out making the use of AD syringes mandatory questioning its availability.
Nath said, "The state government has brushed aside the importance of using auto-disable syringes to check infection, shifting the reason behind the Modasa outbreak to spurious manufacturing and negligence on the part of doctors."
Talking of availability, HMD, the major producer of AD syringes in the country with an over 85 per cent market share, has converted 30 per cent of its net capacity of 3 billion needles and 1.5 billion syringes per annum to manufacture only AD syringes, that comes to around 900 million units. Nearly, 70 per cent of these AD syringes are exported by HMD to more than 40 countries including Uganda, Nigeria, Ethiopia, Kenya and Tanzania. The demand in India is pegged to be around 200 to 300 million AD syringes per annum.
Nath further added that, "At the Moscow Safe Injection Global Network (SIGN) meeting of WHO, it was proposed to extend this policy for curative injections in a phased manner, as the problem was more evident for curative or therapeutic injections. These account for over 90 per cent of the injections in the developing world including India".
According to WHO data, currently 60 per cent of all injections in India are unsafe and as International Clinical Epidemiology Network (INCLEN) has pointed out around one-third of injections are re-used.