2. Beirut April 2011

8. Harm Reduction Coalition Policy Statement on Auto-Disable Syringes Dr Sharon Stancliff, Medical Director - New York Office

9. Auto-disable syringes WHO-UNICEF-UNFPA joint statement (1999) –By the end of 2003, all countries should use only auto- disable syringes for administering all immunizations UNICEF (2001) – No longer enter into procurement contracts for standard disposable syringes WHO guidelines for single use syringes (2007) –Reuse prevention syringes prequalify for procurement

10. WHO: Safe syringes for injection safety 1. Reuse Prevention Feature a)Auto-disable b) Breaking plunger 2. Reuse and Needle Stick Prevention Features a)Needle Stick Prevention b) Retractable syringes

11. Issues Several countries moving towards exclusive import of auto-disable syringes Syringe procurement strategies that don’t take the needs of PWID into account Difficulty of “being heard” in countries where PWID don’t have a voice

12. Unintended consequences  Reduced availability of standard disposable syringes  Auto-disable syringes generally not suited to drug preparation and injection  Modification of auto-disable syringes  Difficult to effectively clean  Circumvent auto-disable feature by sharing before plunger fully depressed

17. Syringes Used by IDUs Vary in Size and Design Low dead High dead space space

18. Vietnam – HDSS 3ml detachable needle (Front loading)