SIGN meeting 1999, 4-5 October, Geneva WHO headquarters, Switzerland
An increasing body of evidence suggests that unsafe injection practices and overuse of therapeutic injections combine to account for large-scale bloodborne pathogen transmission worldwide. As a response to this emerging concern, stakeholders sharing a common interest in safe and appropriate use of injections worldwide joined their forces in a Safe Injection Global Network (SIGN).
The objectives of the SIGN alliance
The SIGN associates met for the first time on October 4th and 5th, 1999. The objectives of this meeting were to review the available evidence in term of injections and their adverse effects, to define terms of association for SIGN, and to obtain consensus on a common strategic framework. Throughout the world, injections are overused to administer medications and unsafe injection practices, particularly re-use of syringes and needles without sterilization, are common. As a result, in many developing and transitional countries where hepatitis B virus and hepatitis C virus infections are highly endemic and where studies have been conducted, unsafe injection practices account for a large proportion of new infections. In addition, a mathematical model suggests that unsafe injections may cause 8-16 million cases of hepatitis B virus infection, 2.3-4.5 million cases of hepatitis C virus infection, and 80,000-160,000 cases of HIV infection annually world-wide.
The proposed structure of SIGN
The SIGN associates wish to constitute a free association of stakeholders sharing a common interest for safe and appropriate use of injections. A secretariat, based at the World Health Organization headquarters should facilitate the activities of the network. SIGN associates agree to exchange information, coordinate their communication and advocacy strategies, and to define a common strategic framework.
The SIGN strategy
The SIGN strategic framework has two broad objectives. Under the first one, "Innovation in approaches", the SIGN associates want to conduct pilot interventions to test the feasibility of approaches to safe and appropriate use of injections and to achieve large-scale introductions of newer technologies supporting safer use of injections. Under the second one, "Achieving safe and appropriate use of injections", SIGN wants to obtain the implementation of national policies and plans for safe and appropriate use of injections in all countries world-wide and to promote injection safety in donor or lender-funded services making use of injections.
Future directions
SIGN provides a multidisciplinary response to a complex and important public health problem. SIGN associates need to define how their organizations will contribute to the strategic framework and need to think broadly in planing strategies and interventions.
