ISLAMABAD: The Ministry of National Health Services (NHS) has announced that the conventional disposable syringes have completely been banned and replaced with auto-disable syringes across the country.

The decision was made after the HIV outbreak in Larkana in 2019. Currently, 13 companies are manufacturing auto-disable syringes and three others have been allowed to import them.

In May 2019, a sudden outbreak of HIV was observed in Larkana (Ratodero). As over a thousand persons, including children, were found positive, the government of Pakistan requested the World Health Organisation (WHO) to investigate the matter.

A WHO-led team reached Pakistan to ascertain the source of the outbreak and how to control it, provide technical expertise, particularly in the areas of HIV testing, paediatric HIV treatment and family counselling and ensure adequate supplies of rapid diagnostic tests and antiretroviral medicines for adults as well as children along with the single-use needles and syringes.

13 firms manufacturing auto-disable syringes, three others allowed to import them, says official

Later, former special assistant to prime minister on health Dr Zafar Mirza said 95 per cent injections in Pakistan were administered unnecessarily.

“A decision has been made to take a number of other steps to ensure that the disease would not spread. From next year, auto-destructible syringes will be used across the country due to which that issue would be addressed. Safe blood transfusion is being ensured. We will also introduce infection prevention programme in hospitals,” he had announced.

Ministry of NHS spokesperson Sajid Shah told Dawn that President Dr Arif Alvi had issued an ordinance to allow the import of raw material for manufacturing auto-disable syringes without any sales tax and customs duty.

He said a task force on injection safety was also established which launched the National Action Plan for injection safety in December 2019. The provinces recommended placing a ban on conventional plastic syringes to control the spread of blood-borne diseases such as AIDS, HIV and hepatitis C.

“Now, conventional syringes cannot be manufactured or sold in the market. The importers and local manufacturers were given timelines to phase out this switch. To incentivise local manufacturers to switch to auto-disable syringes, they were given exemptions on customs duties and sales tax,” he said.

Mr Shah said the ban on plastic syringes was adopted to prevent the reuse of syringes, impose proper disposal and promote oral medication. He said drug addicts reuse syringes to inject drugs due to which both HIV and hepatitis C were spreading in the group.

“Auto-destruct syringes cannot be used after a single use. Once the syringe has been used the plunger gets locked. Any attempt to unlock the plunger destroys the syringe, preventing its reuse.

Unfortunately, when contaminated plastic syringes aren’t disposed of and reused on another patient, they can transmit blood-borne diseases and lead to outbreaks like the AIDS outbreak in Larkana in 2019,” he said.

Drug Regulatory Authority of Pakistan (Drap) Chief Executive Officer Dr Asim Rauf told Dawn that the federal Expanded Programme of Immunisation (EPI) had already switched to using auto-disabled syringes. In 2020, the EPI launched a media campaign on injection safety.

“As many as 13 companies have been allowed to manufacture auto-disable syringes and three companies have been allowed to import syringes so that there would be no shortage of syringes in Pakistan. Unfortunately, disposable syringes were becoming a reason for the spread of HIV, hepatitis C and other diseases,” he said.

Published in Dawn, January 12th, 2022