(WHO) is preparing new technical guidelines on preventing infection from injections. These guidelines will be discussed in advance of the Cairo meeting. Soon after the Cairo meeting, it will be possible to consult them in the form of a provisional document open for comments from the public on the SIGN Internet site.

At the Cairo meeting, the participants will review the results of the actions and activities undertaken since last year, exchange information, compare experiences and coordinate their advocacy and public awareness activities.

"In the last year, some progress has been made in the field of injection safety. Egypt, which is demonstrating its desire for progress by hosting the meeting, has recently set up a national coalition called "Developing Infection Control in Egypt" (DICE). This new coalition is very active in its work to ensure injection safety in the country. Some interesting initiatives are also taking place in other countries. Pakistan has set up a national "SIGN" group, Tanzania has launched an education campaign for the population and health workers, and Burkina Faso has made spectacular progress with injection safety between 1995 and 2000. I believe this represents a real growth of awareness, but there is still a lot to be done," said Dr Yvan Hutin, of the Department of Blood Safety and Clinical Technology at WHO and head of the SIGN secretariat. "The Cairo meeting will help us to better coordinate our actions in light of what has already been achieved," he added.

The members of the Global Network (SIGN) are collaborating in three strategic fields:

• Creating and maintaining a common strategic framework;
• Promoting exchange of ideas and information to encourage research on innovative solutions and cost-effectiveness;
• Coordinating advocacy, communication and awareness strategies.

WHO recommends a threefold strategy for injection safety:

• Promoting change in the behaviour of health workers and the general public in order to reduce abusive recourse to injections;
• Ensuring sufficient supplies of products such as syringes and needles in order to avoid reuse of the same materials;
• Appropriate arrangements to dispose of used cutting materials and sharps.

WHO, UNICEF, the United Nations Population Fund (UNFPA) and the International Federation of Red Cross and Red Crescent Societies (IFRC) have recommended in a joint declaration that autodestruct and single-use disposable syringes should be used for vaccination by 2003. The price of these syringes has come down considerably and there is now little difference in price as compared with ordinary disposable syringes.

Injections are one of the most common acts of preventive and curative medicine. Every year, 12 billion injections are given throughout the world, 90% of them for therapeutic purposes and the rest for prevention (essentially for vaccination). In many countries, deeply rooted beliefs about the supposedly superior efficiency of injections are current among the public as well as health workers.

Many injections given for therapeutic purposes are useless and may pose risks if all the rules of hygiene and safety are not respected. Every year, risky injections cause 8 to 16 million cases of infection with the hepatitis B virus, 2.3 to 4.7 million cases of infection with the hepatitis C virus and 75 000 to 150 000 cases of infection with HIV/AIDS.