By 2008, 56 out of 58 countries continued using auto-disable syringes after GAVI's three-year support ended

Uganda INS 2009 AD syringes box

The vaccination toolkit - vaccination vials, cotton buds and auto-disable syringes - ready for use in a health clinic in rural Uganda. Source: UNICEF/2009/Anne Lydia Sekandi

September 2009 - It would be a cruel irony if an injection to prevent one disease merely inflicted another.

Yet, without safe injection practices, expanding vaccine coverage in the age of highly transmissible diseases like  HIV/AIDS, runs a very real risk of spreading infection.

Accelerated adoption

Alert to the risk from its foundation in 2000, GAVI immediately allocated US$ 110 million to buying an estimated 2.5 billion auto-disable (AD) syringes for countries successfully applying for injection safety support (INS).

According to a GAVI evaluation published in 2009, the programme accelerated the adoption of new standards for safe injections in developing countries. Increasing the use of AD syringes, which lock and cannot be re-used, and disposal boxes lies at the core of INS.

Long-term benefit

The study also pointed to another long-term benefit of INS.

When GAVI introduced INS in 2000, support was limited to three years to prompt developing countries to find sustainable sources of funding. Of the 58 countries which had received the support by 2008, 56 continued using AD syringes and safety boxes after GAVI's help ended.

Safe injection policies

Countries have also indicated that GAVI support was influential in introducing safe injection policies and practices to the broader health sector.

Developing countries' growing emphasis on injection safety is spreading beyond basic immunisation to other medical services and programmes, such as curative care, HIV/AIDS programmes and family planning.

More than 90 percent of the countries consulted for the GAVI study stated that INS was instrumental in their decision to widen injection safety practices.

Waste management

The use of disposable technology contributed to heightened awareness of the need for better healthcare waste management and several countries used GAVI's cash support for injection safety to fund the construction and maintenance of incinerators.

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