SAFE POINT INDIA, India's leading voluntary organization working towards enhanced patient and health worker's safety and to bring down overall healthcare cost through safe injection practices, has urged Prime Minister Narendra Modi to launch a nationwide "Rashtriya Swachh Injections Abhiyan" to end the continued practice of unsafe injections which result in avoidable loss of life, serious health risks and increased healthcare burden.

"We wish to draw the attention of Prime Minister Shri Narendra Modi Ji towards the menace of unsafe injection practices and sincerely urge him to use his good office to launch 'Rashtriya Swachh Injections Abhiyan', said Mr Rajiv Nath, Project Director & Trustee, and Safe Point India.

Explaining the urgent need for such a nationwide programme, Mr Nath pointed out that "Injections should be life giver, not life taker but unsafe injection practices, mostly in the form of reuse of safety injections from dirty contaminated needles, continues to be a serious threat to life of patients and health workers, casting shadows over public healthcare and immunization programme while raising individual and national healthcare cost burden."

Mr Nath added that such a campaign would be relatively lower cost but concomitant benefits in terms of health, safety and hidden savings in saving lives or loss from income due to extra days on a hospital bed or taxpayers money in treatment costs, would be humungous.

Studies and common medical observations have found that unsafe injections can result in the transmission of blood-borne pathogens from patient to patient (through reuse of syringes); patient to healthcare worker (through needle-stick injuries) and at times from health worker to patient. The community at large is also at risk when used injection equipment is not safely disposed of. Unsafe injection practices have also been the cause of outbreaks of viral hepatitis B and C and HIV in healthcare settings including in high income countries.

The threat resulting from unsafe injection practices in India is real and widespread due to inadequate laws, lax regulation as well as low awareness among countryside.

The Safe Injection campaign would be all the more relevant as recently the WHO Director General, Dr Margaret Chan called out for WHO's 3rd Public Healthcare initiative viz. Injection Safety through deployment of Smart Auto Disable Syringes in all developing countries by 2020 and the need for partnership between all stakeholders in public and private sector to achieve this. (The first two initiatives were eradication of Polio & Hand Washing).

India has been chosen to be one of the three 'Pilot Countries' along with Egypt and Uganda to launch the WHO's Injection Safety Initiative. All donors had been urged to fund procurement of only safety engineered injection devices which prevent reuse and don't lead to accidental needle stick injuries among healthcare workers and provide funding for ancillary needs including appropriate quantities of single dose diluents and safety boxes, sharps waste management and health worker training.

According to a WHO study, for every 1$ invested in injection safety, savings are to the tune of over 14 $ in hidden cost of public healthcare spending for treatment of ailments. This is substantial and to correlate one can compare with another WHO study - every 1$ invested in immunisation has been resulting in 16$ savings to a Nation. Prevention is far less cost than Cure.

Mr Nath believes Andhra Pradesh as a pilot state would be ideal to start this Clean Injection- Swach Injection campaign as they received encouraging response from AP CM Shri Chandra Babu Naidu and his Health Dept. on this.

According to WHO, every year over 16 billion injections are administered worldwide in developing world. India alone has over 4 billion injections currently per annum. The vast majority - around 90 percent - are given in curative care. Immunization accounts for around 5 to 10 percent of all injections where AD syringes are already deployed while the remaining indications include transfusion of blood and blood products, intravenous and intramuscular administration of drugs and fluids and administration of injectable contraceptives.

Backgrounder on Safe Injection Practices in India (Laws, regulations & practices): Injection Safety was universally introduced into the Immunization Campaign in India in 2006 nearly a decade ago when in 2005 an India Clen Report financed by World Bank highlighted nearly 2/3rd of injections as unsafe and risk of infections from re-use.

In December 2008, Dr Ramadoss then Union Minister of Health sent an advisory to all CGHS hospitals to start using AD Syringes for curative injections (which are nearly 80 percent of the injections), by April 2009 and requested all State Health Ministers to similarly follow. But the impetus died after he left.

Thereafter, in August 2014 the Health Secretary Shri Luv Verma released an Injection Safety Handbook. In December 2014, the National Health Systems Resource Centre released a HTA (Health Technology Assessment) on AD Syringes and recommended its usage to address infections from injections.