Rajiv Nath, HMD, India, is the Forum Coordinator of AiMeD – Association of the Indian Medical Device Industry

A Discussion with Rajiv Nath, Joint Managing Director, Hindustan Syringes & Medical Devices Ltd, India

What is the role of healthcare systems as “amplifiers” of AMR?

Rajiv Nath: Antimicrobial resistance (AMR) control in most countries like India is just being understood and is limited to AMR steming from unrestricted access to antibiotics. It has not been realized that Infection Prevention and Control (IPC) strategies are required to fight this war with bugs. The biggest cesspool breeding these bugs are so-called healthcare facilities: patients get admitted to hospitals to seek treatment and be cured, not realizing that they may be exposing themselves to unwanted life-threatening infections in these same hospitals, especially in the developing world. Dirty hospitals act as amplifiers to AMR infections.

Such as transmitting infections with the unsafe use of sharps?

Rajiv Nath: You have unsafe injection practices ranging from inadvertently double dipping a syringe used on an operated patient into a multi-dose vial (only changing the needle) and then transferring the infection into another patient (since the vial is now contaminated), even if a new syringe is used for this other patient, or the bad practice of blatant reuse of syringes on multiple patients and other single-use devices, to other malpractices of unsafe reuse such as IV sets on changing an IV catheter and reuse of stainless instruments, e.g., vaginal speculum, dental forceps, without proper steam sterilization etc. All these unsafe practices are common.

Less than a cent to prevent a case of AMR?

Rajiv Nath: 6-8 billion injections annually are unsafe. Daily over 20 million patients are being injected not just with antibiotics or medicines but with a cocktail of bugs!

The implementation of WHO DG’s advice to all developing countries to switch to SMART Syringes that are Auto Disabling is urgent, yet we keep on delaying this vital change by conducting further validation studies and waiting for price to come down to save a quarter of a cent!

Excerpts of interview from AMR-Times.