S-2002-01-2002_OVE

Initiated: October 2001 MEC/SafeInjectf0ct2oo2
THE WMA STATEMENT ON SAFE INJECTIONS IN HEALTH CARE
Adopted by the WMA General Assembly, Washington 2002
PREAMBLE
1. According to the World Health Organization, an estimated 12 billion injections are
administered worldwide each year. Of these injections, many millions are unsafe,
especially those that areadministered with a re-used syringe and/or needle.
2. The most common diseases acquired from unsafe injections are hepatitis B, hepatitis C
and AIDS. Each year, unsafe injections account, on a worldwide basis, for an
estimated:
• 8 to 16 million new hepatitis B virusinfections
• 2.3 to 4.7 million new hepatitis C virusinfections
• 80,000 to 160,000 new human immunodeficiency virus infections
3. In many countries disposable equipment is always used in health care settings, and the
major problem is the safe use and disposal ofsharps.
major problem is the safe use and disposal or snarps,
4. In the majority of cases, physicians are involved in the prescription and/or
administration of injections. Therefore they are in a prime position to bring about
changes in behaviour, which could lead to the appropriate and safe use ofinjections.
5. Safe and appropriate use of injections is a necessary component of Hlv, prevention.
Safe practices to prevent HIV infection also yield substantial spin-off benefits outside
the mvprevention area, such as for other infections like hepatitis B and C.
BASIC CONSIDERATIONS
6. Unsafe injections result from the overuse oftherapeutic injections and unsafe injection
practices. These practices include the use of unsterilized or inadequately sterilized
needles, the re-use of syririges and the inappropriate and unsafe disposal of syringes
and needles.
7. Safe injection practices prevent harm to the recipient, the provider and the community.
Unsafe injections cause widespread harm by spreading pathogens on a large scale.
The WMA Statement on Safe Injections in Health Care (Document MEC/SafelnjectfOct2002) is an official
policy document ofthe World Medical Association, the global representative body for physicians. It was first
adopted by the WMA General Assembly, Washington 2002.
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8. Physician attitudes and inappropriate practice standards may be important
determinants in the overuse of”therapeutic” injections in certain countries. These are a
result of the assumption that some patients only feel satisfied with a treatment if it
includes an injection. Scientific evidence has shown that this assumption is incorrect.
Patients prefer good communication with physicians to receiving injections.
Furthermore the payment schemes in some health care systems may be structured in a
way that they provide perverse incentives for unnecessary use ofinjections.
9. Most non-injectable medications are equivalent in action and efficacy to those which
are injectable.
10. Unsafe injections are a waste of precious healthcare resources and can easily be
prevented through integrated interventions. For an effective national, regional or local
strategy to promote safe injections, the following primary elements are necessary:
10.1 The use of injection should be limited to suitably trained health care
professionals and trained lay persons;
10.2 Behaviour change among patients and health care professionals to decrease tit
injection overuse and achieve injection safety;
10.3 The availability of necessary equipment and supplies, where possible
disposable;
10.4 The appropriate management ofsharps waste.
11. Increased availability of appropriate injection equipment and supplies, where possible
m~~a.91e”,”. in_~~_~~s _!h~c;_at:ety of !njectio~ ~thout necessarily increasing the
disposable, increases the safety of injections without necessarily increasing the
number ofunnecessary injections.
RECOMMENDATIONS
12. That National Medical Associations cooperate with their national governments or …
other appropriate authorities to develop effective policies on the safe and appropriate •
use of injections. These policies would demand appropriate financing and include the
assessment of current injection practices and the development of an integrated plan.
Such a plan should support the provision of adequate supplies of injection equipment,
measures to enforce proper standards of sterilisation where needed, the management of
sharps waste and training programs to deter the overuse of injections and promote safe
injection practices.
The WMA Statement on Safe Injections in Health Care (Document MEC/SafeInject/0et2002) is an official
policy document ofthe World Medical Association, the global representative body for physicians. It wasfirst
adopted by the WMA General Assembly, Washington 2002.
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13. That physicians worldwide are urged to:
MECfSafeInjectl0ct2002
13.1 Prescribe non-injectable medication rather than injectable medication
whenever possible and promote the use of non-injectable medication with
patients and their colleagues;
13.2 Use injectable medications only if safe and appropriate and administer
injections in a way that does not harm the recipient, the provider and the
community;
13.3 Ensure that only waste disposal containers for sharp objects be used to .safely
dispose ofused surgical material (e.g. needles, blades, etc.), and that the covers
of sharp instruments not be re-utilised.
13.4 Raise awareness regarding the risks involved with unsafe injections and help
bring about behaviour changes in patients and health professionals to promote
safe and appropriate injections. Training in this area should emphasise that
needles should not be re-sheathed.
25.11.2002
25.11.2002
The WMA Statement on Safe Injections in Health Care (Document MEC/SafelnjectlOct2002) is an official
, policy document ofthe World Medical Association, the global representative body for physicians. It wasfirst
adopted by the WMA General Assembly, Washington 2002.
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