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SIGN in 2002
Update regarding the Delhi action points
Yvan Hutin
Annual SIGN Meeting
Phnom Penh - October 2002
Outline
• Poor injection practices: the challenge remains
• SIGN: Who we are and where we are
• Perspectives for this SIGN meeting
Outline
• Poor injection practices: the challenge remains
• SIGN: Who we are and where we are
• Perspectives for this SIGN meeting
Injections are overused
Number of injections per person
and per year, by region,
year 2000
Global burden of disease study, 2000
South America
Central Europe
West Africa
China and Pacific
South East Asia
East and Southern Africa
Eastern Europe and
Central Asia
South Asia
Middle East Crescent
0
2
4
6
8
10
Number of injections per person and per year
12
Injections are unsafe
Proportion of injections given
with reused equipment, by region,
year 2000
Global burden of disease study, 2000
South America
Central Europe
West Africa
China and Pacific
Injections given with
equipment reused in the
absence of sterilization
Injections given with sterile
equipment
South East Asia
East and Southern Africa
Eastern Europe and
Central Asia
South Asia
Middle East Crescent
0
2
4
6
8
10
Number of injections per person and per year
12
Global burden of disease study, 2000
Injections are a dangerous
engine of disease
• Hepatitis B
– Highly infectious virus
– Highest number of infections (> 20 million annually)
– More than 30% of new HBV infections
• Hepatitis C
– More than 2 million infections each year
– More than 40% of new HCV infections
• HIV
– More than 250 000 infections each year
– Approximately 5% of new HIV infections
– Substantial cause of HIV infection in South Asia
Injection practices
can be improved
Interventions
Average effectiveness of intervention studies
in a literature review
Reduction of
unsafe use
5 studies
Reduction of
overuse
19 studies
0%
20%
40%
60%
Effectiveness (%)
80%
100%
EUR B
AMR B
EMR D
SEAR D
Regions
WHO CHOICE, World Health Report, 2000
Safe and appropriate use of
injections is cost-effective
SEAR B
EUR C
WPR B
Cost per DALY averted with interventions
for the safe and appropriate use of injections
expressed as a proportion of the annual GDP per capita
AMR D
AFR D
AFR E
0%
5%
10%
15%
20%
Cost effectiveness ratio / GDP per capita
25%
30%
35%
Outline
• Poor injection practices: the challenge remains
• SIGN: Who we are and where we are
• Perspectives for this SIGN meeting
SIGN: Participants and secretariat
NGO
Associations
UN
WHO
SIGN Secretariat
Industry
Governments
www.injectionsafety.org
Action points formulated at the
New Delhi meeting: Status
•
•
•
•
•
•
Practical “Injection safety planning aid”
Policy statements by professional associations
Improved mechanism for setting standards
Policy for better access to injection equipment
Assistance to AD syringes introduction
Better WHO waste management option database
Achieved
Achieved
Action points formulated at the
New Delhi Meeting: Status
•
•
•
•
•
•
•
Advocacy kit
National SIGN coalitions
Working group for health care workers protection
SIGN working groups in WHO regional offices
Better communication with IASIT
Synergies with other programme areas
Progress towards plastic recycling
Partially
achieved
Partially achieved
Action points formulated at the
New Delhi Meeting: Status
•
•
•
•
•
•
•
•
•
Joint resource mobilization efforts
Pilot projects on AD syringes introduction
Quantification of the importance of illegal recycling
National Regulatory Authority assessment tool
Option paper on waste management
Local production of sharps containers
Environment-friendly syringes
Engagement of environmental stakeholders
Centralized waste management
Not achieved
Not achieved
Outline
• Poor injection practices: the challenge
• SIGN: Who we are and where we are
• Perspectives for this SIGN meeting
SIGN Meeting 2002: Menu
• Priority given to presentations from countries
• Four sections on:
–
–
–
–
Assessment
Planning
Implementation
Evaluation
• Presentation and discussion of the draft injection
safety policy planner
• Special day for technologies, including field visit
The essential
drug village
The challenge ahead...
The EPI
village
There are BRIDGES
between our programmes
Future perspectives
• Safe and appropriate use of injections has gained
visibility internationally
• SIGN participants have moved the agenda forward
with country-level achievements
• Future work for the SIGN alliance could be better
guided through a more focussed list of action points
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