I
107TH CONGRESS
1ST SESSION
H. R. 2453
To amend the Foreign Assistance Act of 1961 to improve injection safety
in immunization and other disease control programs administered under
that Act.
IN THE HOUSE OF REPRESENTATIVES
JULY 10, 2001
Mr. UPTON (for himself, Mr. MORAN of Virginia, Mr. GREENWOOD, Mr. ROE-
MER, Mr. BROWN of Ohio, Mrs. ROUKEMA, and Mr. ROHRABACHER) in-
troduced the following bill; which was referred to the Committee on Inter-
national Relations
A BILL
To amend the Foreign Assistance Act of 1961 to improve
injection safety in immunization and other disease con-
trol programs administered under that Act.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Improving Global
Health Through Safe Injections Act’’.
SEC. 2. FINDINGS.
The Congress finds that—
(1) injections are among the most frequently
used medical procedures, with an estimated 12 bil-
lion injections administered each year world-wide;
(2) while injections have been used effectively
for many years for preventive and curative health
care, unsafe injections pose a serious risk to public
health in many parts of the world, particularly in de-
veloping countries where up to 50 percent of injec-
tions are administered with used syringes and nee-
dles;
(3) unsafe injection practices have been linked
to the transmission of many pathogens between pa-
tients, including the hepatitis viruses, HIV, the
Ebola virus, dengue fever virus, and the malaria
parasite;
(4) officials with the World Health Organiza-
tion and the Centers for Disease Control and Pre-
vention have estimated that of the 12 billion injec-
tions given globally each year, 9 billion are not nec-
essary;
(5) studies estimate that in Southeast Asia and
in Africa nearly 80 percent of injections are given
with nonsterilized equipment, and in Eastern Europe
nearly 70 percent are given with nonsterilized equip-
ment;
(6) data from the Safe Injection Global Net-
work, an organization affiliated with the World
Health Organization, indicate that unsafe injection
practices in developing countries cause 8 to 16 mil-
lion hepatitis B infections, 2.2 to 4.5 million hepa-
titis C infections, and 75,000 to 150,000 HIV infec-
tions annually;
(7) unsafe injection practices are particularly
associated with the transmission of hepatitis B, the
fifth leading cause of death from infectious diseases
in the world, and hepatitis C, which, taken together,
account for 75 percent of all cases of chronic liver
disease world-wide;
(8) the enormous hepatitis C epidemic now
sweeping across Egypt has been traced to the reuse
of syringes in that nation’s schistosomiasis cam-
paign;
(9) the original 1976 Ebola epidemic in
Yambuku, Zaire, was traced to the reuse of three sy-
ringes on some 300 to 500 patients visiting a hos-
pital there; and
(10) studies have documented that the spread
of HIV infection in Russian infants and their moth-
ers in the 1980s was due to the reuse of syringes
in pediatric wards.
SEC. 3. AMENDMENT.
Section 104(c) of the Foreign Assistance Act of 1961
(22 U.S.C. 2151b(c)) is amended by inserting after para-
graph (7) the following new paragraph:
‘‘(8) In carrying out immunization programs and
other programs for the prevention, treatment, and control
of infectious diseases, including tuberculosis, HIV and
AIDS, polio, and malaria, the Administrator of the United
States Agency for International Development, in coordina-
tion with the Centers for Disease Control and Prevention,
the National Institutes of Health, national and local gov-
ernments, and other organizations, such as the World
Health Organization and the United Nations Children’s
Fund, shall develop and implement effective strategies to
improve injection safety, including eliminating unneces-
sary injections, promoting the availability and use of sin-
gle-use auto-disable needles and syringes and other safe
injection technologies, strengthening the procedures for
proper needle and syringe disposal, and improving the
education and information provided to the public and to
health professionals.’’.
SEC. 4. REPORTING REQUIREMENT.
The Administrator of the United States Agency for
International Development shall transmit 2 reports to the
Congress on the implementation of paragraph (8) of sec-
tion 104(c) of the Foreign Assistance Act of 1961 (22
U.S.C. 5151b(c)), as added by section 3 of this Act. The
first such report shall be transmitted not later than March
31, 2002, and the final report shall be transmitted not
later than March 31, 2003.
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