Until a few decades ago, children were vaccinated using reusable syringes on syringe machine, which exposed them to the risk of transmission of bloodborne diseases like Hepatitis B and HIV. “Sometimes, these used syringes were resold and reused, and we have encountered instances of children using them as toys”, tells Robin Nandy, UNICEF Chief of Immunization.

According to a study sponsored by WHO in 2015, up to 1.7 million people contracted hepatitis B, up to 315 000 with hepatitis C, and 33,800 with HIV through unsafe injections.

A trained vaccinator administers a measles injection to two-year old Fatima during the nationwide campaign in Bhojha village in Kasur disitrict, Punjab, Pakistan.
UNICEF/UN0300751/Zaidi
A trained vaccinator administers a measles injection to two-year old Fatima during the nationwide campaign in Bhojha village in Kasur disitrict, Punjab, Pakistan.
The situation started to improve in 1999, when UNICEF, the World Health Organization and the United Nations Population Fund (UNFPA) jointly called for the improvement in injection safety standards. In a statement, the organizations noted that AD syringes were already available and affordable and declared that they should be the device of choice for administering vaccines in both routine services and during mass campaigns.

Since then, several initiatives have driven progress in injection safety for immunization. An example of collective advocacy was taken by the Measles and Rubella Initiative (M&RI), launched in 2001 and led by the American Red Cross, the United Nations Foundation, the U.S. Centers for Disease Control and Prevention, UNICEF and the World Health Organization. The partnership required that safe injection equipment, including AD syringes, were used as part of the support they provided countries to carry out vaccination campaigns.

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