1. Countries Experiences on Access to Injection Equipment Sophie Logez WHO/BCT/DCT Phnom Penh, 24-26 October 2002

2. Strategy for the Safe and Appropriate Use of Injections Behaviour change among patients and health-care workers Access to safe injection equipment and infection control supplies Appropriate management of sharps waste

3. Access to Injection Equipment Increased access to safe injection equipment improved injection practices:  1999, Immunization: WHO/UNICEF/UNFPA/ joint statement on the use of auto-disable syringes in immunization services  2002, Curative services: recommendations of the 12 th Expert Committee for the selection of essential medicines ACCESS

4. Countries experiences on access to injection equipment (1) Experiences in selected AFR and WPR countries –Burkina Faso –Guinea –Mongolia –Cambodia Interviews of the participants from 12 countries of the WPR national drug policy meeting, October 2002

5. Countries experiences in access to injection equipment (2) Burkina FasoMongoliaCambodiaGuinea Single-use equipment included in the national essential drug list Yes No Use of national drug procurement system for injection equipment YesNoYesNo Forecasting methodsConsumptionNoConsumptionNo Independent procurementYes NoN/A Joint distribution of essential drugs and injection equipment YesNoYesNo Local productionNoYesNo Sterilizable injection equipment usedNo Phased outYes Reported shortagesNoYes Unsterile injections-+/- ++

6. Situations in 12 Countries the WPRO Region ACCESS WPRO NDP participants survey Single-use equipment included in the national essential drug list 7/12 Use of national drug procurement system for injection equipment 11/ 12 Forecasting methodsConsumption: 11/12 Joint distribution of essential drugs and injection equipment 11/ 12 Local production 4/ 12

7. Conclusions A number of parameters will influence access to injection equipment and ultimately injection practices –inclusion in the essential drug list –use of the national drug procurement –joint distribution of medicines and injection equipment –local production Access and ultimately injection practices will depend upon the number of favourable parameters In WP region, some essential drug programmes may want to examine their procurement situation to: –identify unfavourable parameters –evaluate if shortages of equipment do not lead to unsafe practices

8. Draft WHO procurement guide for injection Equipment  Objective of the guide: Strengthen good quality purchase of injection equipment at affordable price (quality standards)  Audience: procurement officers, programme managers  Proposing practical tools: product selection, forecasting, method of procurement and selection of suppliers ACCESS