Injection Safety Helps Protect Everyone

Of the 16 billion injections given annually worldwide according to WHO estimates, too many are unnecessary and unsafe. Unsterilized needles are reused, mishandling of dirty needles endangers both patients and health care workers, and inadequate sharps waste disposal contaminates the community, exposing the wider public to health risks. These unsafe and unnecessary injections spread HIV and hepatitis B and C in communities already burdened by poverty and disease.

In 2004, as part of the President’s Emergency Plan for AIDS Relief (PEPFAR) focusing on countries with high HIV prevalence, John Snow, Inc. (JSI) and its subcontractors, Program for Appropriate Technology in Health (PATH), Academy for Educational Development (AED), and the Manoff Group, were awarded funds through the Centers for Disease Control and Prevention (CDC) and the US Agency for International Development (USAID) to implement “Rapid Interventions to Decrease Unsafe Injections” in 11 countries. The project is commonly known as Making Medical Injections Safer (MMIS).

By the end of the five-year project (2009) and with national counterparts, MMIS will establish an environment where patients, health care workers, and the community are better protected from the medical transmission of HIV and other bloodborne pathogens.

MMIS works in 11 countries in Africa and the Caribbean to promote a world in which:

• In every health facility, trained health care workers administer only necessary injections safely, using appropriate safe injection devices.
• Health care waste is efficiently managed using methods that are safe for the community and the environment.

• Technical Approaches - An overview of MMIS support for sustainable approaches in injection safety
• Program Highlights - Read about recent MMIS program successes and activities
• Resources - Usable materials in injection safety, including references, norms & standards, training manuals, survey tools, and more from MMIS and partners
• Contact Information - MMIS headquarters and country program offices in Africa and the Caribbean
• Links - External sites for more resources and information on injection safety

To support the strategic vision and objectives of the project, MMIS works with global, regional, and in-country partners to systematize approaches, build capacity, and sustain injection safety programs. Collaboration with host nations is central to MMIS efforts. Lasting success depends on leadership by government and private sectors and, ultimately, on local capacities for injection safety and health care waste management. MMIS works with countries to achieve sustainability through:

• Supporting governments in the development of national plans and policies
• Working through national injection safety task forces
• Promoting South-to-South exchanges of experience
• Building partnerships at international and regional levels to foster collaboration

These task forces and partnerships provide the foundation for making improved injection safety a reality.

MMIS provides support for sustainable approaches for injection safety, including:

• Training, support, and capacity building — To ensure only safe and necessary injections become a professional and social norm within health systems and among ancillary services personnel
• Safe injection commodity management — To improve the availability of safe injection equipment (syringes with re-use prevention and/or needlestick prevention features and safety boxes)
• Advocacy and behavior change — To establish high quality services and reduce the risk of needle stick injury among health personnel and to reduce the provision of unnecessary injections.
• Sharps waste management — To establish the most effective, practical, and safe means of waste disposal in health care settings.
• Monitoring and evaluation — To address key constraints and opportunities along the path toward the overall goal of preventing new infections of HIV and hepatitis B and C.