ISLAMABAD: Senior paediatricians, pharmacists and administrators of leading tertiary-care hospitals have urged the Drug Regulatory Authority of Pakistan (Drap) to immediately review its decision to ban conventional 10cc syringes, warning that the move could seriously disrupt neonatal and paediatric care without addressing the actual causes of Pakistan’s growing HIV outbreak among children.
Medical experts from Pakistan Institute of Medical Sciences (PIMS), Shifa International Hospital, Jinnah Postgraduate Medical Centre (JPMC) and other major public and private hospitals, along with professional pharmacy bodies, are calling for an evidence-based review of the decision. They maintain that while preventing syringe reuse is essential, a blanket restriction on conventional 10cc syringes is neither supported by scientific evidence nor recommended by the national HIV Taskforce constituted by the prime minister following the recent paediatric HIV outbreaks.
In a letter to Drap Chief Executive Officer, Prof Dr Muhammad Khalid Shafi, chairperson of the National Immunization Technical Advisory Group (NITAG) and senior leader of the Pakistan Paediatric Association (PPA), said the objective of eliminating syringe reuse was commendable but cautioned that banning conventional 10cc syringes could have “severe unintended risks” for neonatal and paediatric care across Pakistan. He said the 10cc syringe was an indispensable clinical tool used daily in neonatal intensive care units (NICUs), paediatric wards and emergency departments. It is routinely required for reconstituting and diluting intravenous medicines, preparing accurate paediatric drug doses, administering medicines through nasogastric (NG) and orogastric (OG) tubes to premature and critically ill newborns, and safely giving oral liquid medicines and oral rehydration solution to infants who cannot swallow medicines conventionally.
Prof Khalid warned that removing the syringe from routine clinical use could create serious operational difficulties in NICUs and children’s hospitals, potentially affecting the care of thousands of newborns and critically ill children everyday. He urged the Drap to exempt conventional 10cc syringes from the restriction or immediately review the decision through consultation with paediatricians, infectious disease specialists and infection-control experts.
Other experts from PIMS, JPMC, Shifa International and other healthcare facilities argued that the misuse of syringes could be prevented through stricter enforcement rather than an outright ban. They proposed restricting the sale of conventional 10cc syringes to registered hospitals and healthcare facilities, ensuring procurement through licensed pharmacies, strengthening hospital infection-control systems, and taking strict action against syringe reuse in both public and private healthcare settings.
They noted that Pakistan’s HIV outbreaks have repeatedly been linked to unsafe injection practices, reuse of disposable syringes, poor infection-control measures and unsafe medical procedures rather than the size of syringes themselves. They pointed out that the national HIV Taskforce, constituted to recommend measures after the surge in paediatric HIV cases, did not recommend banning conventional 10cc syringes.
The experts called for wider availability of reuse prevention syringes for routine injections while allowing conventional 10cc syringes to remain available for specialised hospital procedures where they are considered essential. They said patient safety could best be ensured through evidence-based regulation that balances infection prevention with uninterrupted clinical care.
