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The Times of India OnLine
Saturday
7 April 2001

Unsafe injections lead to global disease burden
NEW DELHI: Billions of injections-a vast majority of them unsafe
and unnecessary-are being administered to patients globally, leading to
serious disease and millions of deaths annually, a government scientist warned
here at the International Conference on Harm Reduction this week.

”Roughly 12 billion injections are given each year globally,” said Dr. Keith
M. Sabin, an epidemiologist with the division of HIV/AIDS prevention of the
Centres for Disease Control and Prevention. “We estimate that 75 percent of
these 12 billion injections are not necessary,” he added, quoting the
World Health Organisation (WHO) figures.

”So, 9 billion unnecessary injections are being administered globally at
a rough cost of 50 cents a shot,” Sabin said. “Some $4.5 billion is
being wasted annually on these unnecessary injections.”

From reported surveys it is known that in Eastern Europe, for instance, an
average individual receives as many as 15 injections a year, Sabin noted. In
Southeast Asia, the ratio is five injections per year per individual. “These
are largely not needed,” he said.

In many parts of the world, these injections are very unsafe. “Equipment is
being reused without particularly being sterilised,” Sabin pointed out. “In
Southeast Asia, nearly 80 per cent of injections that are given are with
nonsterilised equipment. The next highest rate is found in Africa, which is a
shade under 80 per cent and then Eastern Europe with nearly 70 per cent
injections with unsafe equipment,” he said.
”(As a result), we see extraordinary high numbers in Africa and Asia
infected with all three major blood-borne pathogens such as HIV, hepatitis
B(HBV) and hepatitis C virus (HCV),” Sabin stated. “Asia is extraordinarily
high for HBV and HCV,” he added.
According to WHO, in Africa, chronic infections for HIV, HCV and HBV were22.7
million, 22.5 million and 59.3 million in 1998. Comparable figures for Asia
were 7.3 million, 107.5 million and 286.8 million.

”One is certainly fuelling the other,” Sabin said. “Unsafe injections are
fuelling high prevalence rates of disease and high prevalence of disease
is making it more likely that you are going to get a bad needle-stick.”

According to data published in the Bulletin of WHO in October 1999,unsafe
injections cause somewhere between 8-16 million HBV cases, 2-5 million HCV
infections, and 80,000-160,000 HIV infections annually worldwide.

”The cost of these is about 1.3 million early deaths resulting from chronic
liver infections from HBV or HCV, and HIV developing into AIDS and leading to
death ultimately, and a loss of 26 million years of life with direct medical
costs of well over $500 million annually,” Sabin concluded.

”This is a problem of tremendous importance and it needs to be addressed on
a national level with as many stakeholders as possible participating in the
development of a national strategy in the affected regions,” Sabin said.
(Reuters)

 

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