Islamabad: With more than 2,100 children diagnosed with HIV over the past 15 months and unsafe injections emerging as a major source of transmission, federal health authorities have ordered a nationwide crackdown on banned conventional syringes while initiating a review of ‘10 ml disposable’ syringes due to their high potential for reuse.
The decisions were taken at a high level meeting chaired by Director General Health Dr Abdul Wali Khan at the Drug Regulatory Authority of Pakistan (DRAP), attended by DRAP CEO Dr Obaidullah, senior health ministry officials, WHO’s deputy head in Pakistan, representatives of Unicef, executive directors of PIMS Dr. Rana Imran Sikandar and Polyclinic Prof. Shahzad Munir, officials from the National Institute of Health (NIH) Islamabad including its ED Dr. Salman and Dr. Mumtaz Ali Khan, IHRA and infectious disease experts.
Officials said the meeting reviewed the rising number of HIV infections in both children and the general population, with particular concern over unsafe injection practices, reuse of syringes and poor infection prevention and control measures.
According to official data, at least 2,108 paediatric HIV cases have been reported nationwide in the last 15 months, although experts believe the actual number is higher as recent data from Punjab is still being compiled.
Health experts say a large proportion of these infections are linked to reuse of syringes and unsafe blood transfusions.
A key focus of the meeting was the widespread use of 10 ml disposable syringes, which experts described as a double edged issue. While these syringes are medically required for certain procedures, they are also frequently reused in clinical and informal healthcare settings, increasing the risk of transmission of HIV, hepatitis B and hepatitis C.
In view of this, the federal health ministry decided to constitute a sub-committee of experts to assess whether the continued use of 10 ml syringes should be restricted or replaced with auto disable or auto destruct syringes that cannot be reused.
Officials said the committee would evaluate the role of these syringes in disease transmission and submit recommendations after examining clinical needs, safety concerns and international practices. Any decision to disallow or restrict 10 ml syringes would require approval from the federal cabinet.
Alongside the policy review, DRAP has ordered strict enforcement of an existing ban on conventional disposable syringes through a nationwide market survey.
In a directive issued on April 22, DRAP’s Division of Quality Assurance and Laboratory Testing directed the National Task Force for eradication of spurious and substandard products to conduct a countrywide survey to ensure compliance with the ban and identify any illegal products still being sold in the market.
The letter reiterated that DRAP had imposed a complete ban on the import and manufacture of conventional disposable syringes with effect from July 31, 2021, and cancelled all registrations of such products. However, concerns remain that these syringes continue to circulate, particularly in unregulated segments.
Provincial drug control authorities have been instructed to take strict regulatory action in cases of non compliance, while a comprehensive report on findings and enforcement actions has been sought by April 27.
Officials said the crackdown aims to remove unsafe syringes from circulation and address one of the key drivers of blood borne infections in the country.
Health experts have long warned that Pakistan remains among the highest users of therapeutic injections globally, with millions administered daily, many of them unnecessary and often delivered using unsafe practices.
Participants at the meeting stressed the need for stronger infection prevention and control systems, better monitoring of healthcare providers and increased public awareness to discourage unnecessary injections.
Officials also highlighted the importance of ensuring availability of safer alternatives, including auto disable syringes, particularly in public sector programmes.
Experts say the outcome of the sub committee’s review on 10 ml syringes could have significant implications for injection safety policies, as authorities attempt to balance clinical requirements with the need to prevent avoidable infections.
With HIV cases continuing to rise and evidence pointing to preventable transmission routes, the government’s combined approach of regulatory enforcement and policy review signals a more focused effort to curb unsafe injection practices in Pakistan.
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