Pubdate: Sun, 20 May 2001
Source: Jakarta Post (Indonesia)
Copyright: The Jakarta Post
Contact:  http://www.thejakartapost.com
Details: http://www.mapinc.org/media/645

NEEDLE-SHARING AND HIV/AIDS

NEW DELHI, India (JP): The dangerous practice of needle-sharing among 
Intravenous Drug Users (IDUs), which has intensified the spread of the 
HIV/AIDS epidemic in many countries, has been a major concern among 
non-governmental organizations (NGOs) all over the world.

Many NGOs in Third World countries have been trying to eradicate this risky 
practice as much as their limited manpower and funds allow.

Some have won support both from their government and community to implement 
full-scale Needle and Syringe Exchange Programs (NSEPs), while there are 
also NGOs that succeed in dispensing substitute drugs which can be taken 
orally.

Meanwhile, NGOs in countries culturally and religiously opposed to those 
remedies opt for low-profile solutions, such as raising the IDUs' awareness 
of the grave dangers of the practice through leaflet distribution and other 
educational efforts.

The good news is that several companies specializing in manufacturing 
medical and medical-related products have also paid a lot of attention to 
this issue. The results have been the emergence of several products 
specifically designed to reduce the use of contaminated syringes and needles.

One of those products is the Vanishpoint syringe, which was exhibited 
during the 12th International Conference on the Reduction of Drug Related 
Harm, held here last April.

Manufactured by Texas-based Retractable Technologies Inc., the needle on a 
Vanishpoint syringe is automatically retracted after injection, rendering 
both the syringe and needle virtually useless after just one injection.

Automatic retraction is activated by fully depressing the plunger while the 
needle remains in the recipient's vein. The company has also manufactured a 
blood collection tube with the same mechanism.

"Vanishpoint syringes require: less disposal space than a standard syringe, 
preventing disposal-related injuries; minimal training; and can be 
activated by just one hand," the company's Executive Vice President Lillian 
E Salerno said.

In a country, in this case the US, where 40 percent of new HIV infections 
are directly or indirectly caused by contaminated needles, and where 
needlestick injuries result in 50 to 60 HIV infections each year, the 
Vanishpoint syringe seems to be the solution that, for years, everybody has 
been waiting for.

"We received a very warm response both from the medical community and the 
general public. Last year we sold around 30 million syringes, a soaring 20 
million units more than we sold in 1999. We have estimated that in 2001 we 
will sell around 70 million units of this syringe," Salerno said.

The street price for this syringe in the U.S. is around 40 U.S. cents, 
definitely more expensive than a standard syringe, which only costs around 
6 cents. Unfortunately, the price would probably be doubled, even tripled, 
in Third World countries, especially the ones that have been crippled by 
the Asian economic crisis, such as Indonesia. This is a major obstacle to 
popularizing the syringe among IDUs.

"We are in the process of looking for local manufacturers in Asia. If we 
can find them we will be able to reduce several costs and eventually lower 
the price of the product," Salerno said.

Vanishpoint's design has one flaw though, as pointed out by a drug user 
attending the conference. The Vanishpoint syringe and needle can be re-used 
if, in the first injection, the drug user does not fully depress the 
plunger, thus preventing needle retraction.

"Let's say, hypothetically of course, we use a 3 cc Vanishpoint syringe. 
After injecting one cc, and the needle hasn't been retracted yet, I pass 
the syringe to another user so he can inject another one cc. Then he can 
pass the syringe to a third user who will inject the last one cc of the 
drug. So, only after 3 cc of drug, and, unfortunately, 3 users, the plunger 
is finally fully-depressed and the needle retracted," he said.

Another expert at the conference also pointed out the need to conduct a 
thorough and extensive report before this new type of syringe could be 
judged fairly as an effective new tool in fighting the widespread HIV/AIDS 
epidemic.

Another medical product at the exhibition was the Sharpsafe Exchange 
plastic container for used syringe and needle disposal. The container 
features unsurpassed leakage resistance, a reinforced base for puncture 
resistance and a non-return feature ensuring that, once inserted, syringes 
and needles cannot be retrieved. Manufactured by Australian-based company 
Frontier the street-price of Sharpsafe Exchange is around $1. Some 50,000 
containers are sold each month in Australia alone.

Ultimately, the awareness and commitment of IDUs in protecting themselves 
from HIV/AIDS is still a crucial factor in this battle. The best technology 
and appliances will prove useless if IDUs ignore them. 
- ---
MAP posted-by: Jay Bergstrom