WMA Statement on Safe Injections in Health Care

Adopted by the 53^rd WMA General Assembly, Washington, DC, USA, October 2002
revised with minor revisions by the 192^nd WMA Council, Bangkok, Thailand, October 2012
and reaffirmed with minor revisions by the 221^st WMA Council Session, Berlin, Germany, October 2022

PREAMBLE

According to the World Health Organization, billions of injections are administered worldwide each year in health care and many of them are unsafe.

The most common diseases acquired from unsafe injections are hepatitis B, hepatitis C and HIV.

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 of injections.

The WMA recognizes that unsafe injections result from inadequate education, the overuse of therapeutic injections and unsafe injection practices, including the use of unsterilized or inadequately sterilized needles, the re-use of syringes, the misuse equipment and supplies or inappropriate disposal of sharps waste.

Unsafe injections are a waste of precious healthcare resources and can easily be prevented through integrated interventions, developing effective local, national and regional promotion strategies.

Physician attitudes and inappropriate practice standards may be important determinants in the overuse of “therapeutic” injections incorrectly assuming that patients’ satisfaction depends on injection prescription or accepting incentives for unnecessary use of them.

Behavior change among patients and health professionals needs to be developed to decrease injection overuse and achieve injection safety.

Safe injection practices prevent harm to the recipient, the provider and the community, while avoiding the widespread of different pathogens that can result from unsafe injections such as hepatitis B and C and HIV. In this sense, it is a necessary component of prevention for these infections.

RECOMMENDATIONS

Taking into consideration that reducing unsafe injections in healthcare involves different parties, the WMA calls:

Constituent Members to

1. Cooperate with their national governments or other appropriate authorities to develop effective policies on the safe and suitable use of injections, including appropriate financing, the assessment of current injection practices and the development of an integrated plan;
2. Develop a plan that supports the provision of adequate supplies of injection equipment, measures to enforce proper standards of sterilization where needed, the management of sharps waste, and education programs to deter the overuse of injections as well as promote safe injection practices;

Physicians worldwide to

3. Educate patients on equivalent action and efficacy of non-injectable medications;
4. Prescribe non-injectable medication whenever possible and promote the use of non-injectable medication that are viable alternatives;
5. 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;
6. Ensure that only waste disposal containers for sharp objects be used to safely dispose of used surgical material (e.g. needles, blades, etc.), that the covers of sharp instruments not be re-utilised, and, if possible, use auto-disable syringes
7. 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. Education in this area should emphasise that needles should not be re-sheathed.