Marc Koska’s SafePoint Trust got some well deserved coverage in the English Guardian last Friday. Having spent years researching and building up the skills necessary, he developed a syringe that cannot be reused. Despite UNAIDS’ and WHO’s constant denials, reuse of injecting equipment is very common in poor countries, where there is a high prevalence of blood borne viruses such as HIV, hepatitis and many bacterial infections. Such reuse is also extremely dangerous; in the case of HIV, risk of infection from reused injecting equipment is many times higher than unprotected heterosexual sex.
Exclusive use of this technology for preventive and curative injections will be pioneered in Tanzania. Koska used some secret filming of injecting equipment reuse to persuade the Minister of Health and Social Welfare of the need for such a change in injecting practices. She was convinced. The WHO does, to a limited extent, accept that there is a problem. They say 1.3 million people die from injecting equipment reuse every year. They just don’t bother making it clear to people in high HIV prevalence countries how common these practices are, or how people can avoid being infected.
SafePoint also adds some of the estimated figures for people infected with serious and life-threatening diseases from syringe reuse: an estimated 7 billion of the 17 billion injections administered every year are unsafe; 21 million transmissions of hepatitis B and 2 million of hepatitis C; 20 million medical injections in Africa alone contaminated with HIV; more than half of HIV positive transmissions in children in Europe were a result of contaminated equipment reuse in Romania, alone.
Asking people here in East Africa who work in healthcare about injecting equipment reuse, including those specializing in HIV, generally elicits denial, even hostility. Many people are vaguely aware that HIV can be transmitted through non-sexual routes; they just happen to swallow the HIV industry’s reassurances that almost all transmission is through heterosexual sex. Because they don’t see non-sexual routes as a threat to their health or the health of their families, they pay little or no attention to avoiding the risk.
Koska tries to hammer the point home by citing figures for the difference between the number of injections administered and the number of syringes imported. He finds that “Tanzania has 45 million people and they are importing 40m syringes. With an average of five injections each a year, they need 220m”. As he reminds us, immunization only accounts for about 10% of injections, the other 90% being accounted for by treatment.
Self-destruct or ‘autodisable’ syringes, such as the ones Koska’s company manufactures, are as cheap to produce as non-autodisable syringes. However, it is slow to change practices where commercial interests are involved. Given UNAIDS’ and WHO’s lack of interest in non-sexual transmission of HIV and other diseases, indeed, their active opposition to warning Africans against such threats, it is not surprising that manufacturers of these unsafe syringes see no reason to make changes.
Let’s hope Koska’s SafePoint Trust program in Tanzania reveals something of the true extent of the problem so that other medium and high HIV prevalence countries can follow suit so that infection rates can be cut, perhaps substantially.