The purpose of writing this article is only to discuss the possible factors responsible for the reuse of auto-disable syringes. This article is not intended to confront any government policy. The assessment of risk factors associated with AD syringe reuse should be carried out for the betterment of people and society. Otherwise, expensive AD (auto-disable) syringes might fail to reduce the risk of transmission of blood-borne infections. Let’s discuss.
CONVENTIONAL SYRINGES
Conventional syringes, or hypodermic syringes, are medical devices designed to inject fluid or medicine into the body or to withdraw fluid from it. They consist of a barrel with a bold scale and a plunger with a fixed or detachable needle. Conventional syringes can be made of glass, metal, or plastic. Syringes made of plastic are commonly called disposable syringes because they are intended for single use and should be discarded after one-time use.
HOW CONVENTIONAL SYRINGES ARE INVOLVED IN SPREADING BLOOD BORNE INFECTIONS
Reuse and resale of unsterile syringes after one-time use have become the primary causes of spreading blood-borne infections such as HIV (Human Immunodeficiency Virus), AIDS (acquired immunodeficiency syndrome), and Hepatitis B and C in Pakistan and other developing countries, especially in private healthcare facilities.
According to The News International (2023), experts estimate that between 15–20% of syringes and needles are reused annually in Pakistan, with about 1.5 billion injections administered every year. Reuse of unsterile syringes and contaminated blood transfusions remain major causes of HIV and hepatitis transmission.
Similarly, Dawn (2019) reported that investigations into the Ratodero HIV outbreak in Larkana revealed that unsafe and repeated syringe use was the main cause of infection spread among hundreds of children and adults.
Although disposable syringes are cost-effective and convenient to use, the contributing factors for the reuse of conventional syringes are as follows:
1. To save money
2. Due to unauthorized practitioners
3. Poor waste disposal
4. Poor market regulation
5. Weak implementation of laws
WHY HAS THE GOVERNMENT OF PAKISTAN IMPOSED A BAN ON CONVENTIONAL SYRINGES?
The HIV outbreak in Larkana exposed the dangerous consequences of syringe reuse.
The Express Tribune (2019) reported that the Sindh Healthcare Commission (SHCC) sealed over 350 clinics operated by quacks after finding that the reuse of syringes and IV drips played a key role in spreading HIV among children.
In January 2022, the Government of Pakistan officially banned conventional disposable syringes nationwide and mandated the use of auto-disable (AD) syringes for both immunization and therapeutic purposes (Dawn, 2022).
This policy shift aimed to ensure that no syringe could be reused and to restore public confidence in safe injection practices.
WHAT IS AN AUTO-DISABLE SYRINGE?
Due to its internal safety mechanism, an AD syringe locks automatically after a single use, ensuring it cannot be used again. It is specifically designed to prevent reuse and thereby stop the transmission of infections through contaminated needles.
WHY ARE AD SYRINGES USED IN IMMUNIZATION PROGRAMS?
Conventional syringes can be resold and reused, creating a serious risk of transmitting blood-borne infections such as Hepatitis B and C. For this reason, AD syringes are now recommended in all national immunization programs, where millions receive vaccine shots safely without exposure to infection.
A campaign launched by the Ministry of National Health Services in 2021 (Dawn) emphasized discouraging unnecessary injections and promoting auto-disable syringes to reduce blood-borne disease transmission.
HOW IS TRACKING OF USED AD SYRINGES DURING IMMUNIZATION EASIER?
AD syringes increase the volume of medical waste during immunization. Despite this, tracking used AD syringes is easier because records clearly indicate how many people were immunized and how many syringes were consumed. After administering an injection, medical staff immediately cut the needle and lock the plastic body, making it practically useless and minimizing the chances of reuse.
Proper disposal of medical waste will ultimately help achieve the goal of minimizing blood borne infections caused by contaminated syringes.
WILL THE ABOVE-MENTIONED DECISION OF THE GOVERNMENT OF PAKISTAN EVENTUALLY MAKE US THE LEAST BLOOD-BORNE INFECTION-EXPOSED STATE?
Yes, this decision is a significant step toward minimizing the risk of spreading blood-borne infections. However, the risk will always exist because Pakistan faces challenges in law enforcement and healthcare waste management (HCWM).
Several studies and media reports indicate that HCWM practices in both public and private hospitals remain below WHO and Pakistan Biosafety Rules 2005 standards. Segregation, handling, storage, and disposal of medical waste are often neglected. The News (2023) and Dawn editorials have repeatedly warned that weak monitoring and poor implementation undermine the effectiveness of otherwise sound policies.
If this is the state of large hospitals, the situation in private clinics is even more concerning. Every street corner hosts multiple unregistered clinics, many run by unqualified practitioners. There is no consistent government mechanism to ensure they follow HCWM protocols or properly dispose of syringes. If used needles are not cut or destroyed after injections, they can easily be collected and resold by profiteers, reintroducing the same risks the AD syringe policy aimed to eliminate.
NOW THE MILLION-DOLLAR QUESTION: CAN SOMEONE DEFEAT THE DISABLE MECHANISM OF AD SYRINGES?
Yes, it is possible that someone could intentionally defeat the disable mechanism of AD syringes. With little effort, it can be done forcibly, especially if low-quality materials are used. If someone intentionally avoids depressing the plunger fully (under-dosing), the disable mechanism will not activate. Therefore, the possibility of AD syringe reuse and resale cannot be ruled out.
According to health experts cited in Dawn’s 2021 article “The Great Syringe Switch”, even with auto-disable syringes, misuse or tampering remains a concern if monitoring and quality checks are weak. This underscores that technological solutions alone cannot replace strong regulatory oversight.
CONCLUSION
The Government of Pakistan should maintain strict oversight on all these issues and adopt a focused approach toward medical waste management and market surveillance. Otherwise, achieving minimal exposure to blood-borne infections will remain a dream.
All hospitals and private clinics must be properly monitored by relevant government agencies. Without effective waste management and strong enforcement, it will be nearly impossible to achieve a reduction in blood-borne infections even with AD syringes that are three times more expensive than conventional ones
FREQUENTLY ASKED QUESTIONS (FAQs)
1. What makes an auto-disable syringe safer than a conventional one?
An AD syringe locks automatically after one use, preventing reuse and ensuring that the same syringe cannot transmit infections from one person to another.
2. Can low-quality AD syringes still be reused?
Yes. If made from substandard materials or tampered with intentionally, the locking mechanism may fail or be bypassed, increasing the risk of reuse.
3. How does syringe reuse spread HIV and Hepatitis in Pakistan?
When a syringe contaminated with infected blood is reused, viruses such as HIV and Hepatitis B or C can enter another person’s bloodstream, spreading the disease.
4. What steps has Pakistan taken to prevent unsafe injections?
The government has banned conventional disposable syringes and introduced AD syringes nationwide. Public awareness campaigns and stricter health facility monitoring are also ongoing.
5. What can healthcare workers do to reduce infection risks?
They should always use sterile, single-use AD syringes and follow safe disposal protocols as per WHO and Pakistan Biosafety Rules 2005.
DISCLAIMER
This article is intended for educational and public health awareness purposes only. It does not replace professional medical advice, diagnosis, or treatment. The author holds no affiliation with any government body or manufacturer and aims solely to promote evidence-based understanding of injection safety and infection control practices.
CALL TO ACTION
Unsafe injection practices can cost lives. Support the use of auto-disable syringes and demand strict medical waste management in your local healthcare facilities.
Share this article to spread awareness together, we can move Pakistan toward safer healthcare practices and a future free from preventable infections.
REFERENCES
1. Dawn News. “Reused syringes spread HIV in Larkana, says PM’s adviser.” December 2019.
2. The Express Tribune. “‘SHCC’s inaction against quacks led to HIV outbreak.’” June 2019.
3. The News International. “Reuse of syringes, contaminated blood transfusion major causes of hepatitis C, HIV spread in Pakistan.” 2023.
4. Dawn News. “Conventional disposable syringes banned across country.” January 2022.
5. Dawn News. “The Great Syringe Switch.” November 2021. 6. Dawn News. “Drive launched against unsafe injection use.” January 2021.