KARACHI: Highlighting critical clinical factors, the Pakistan Paediatric Association (PPA) in a letter has urged the Drug Regulatory Authority of Pakistan (Drap) to grant an exemption or targeted exclusion for 10cc conventional syringes to safeguard neonatal and paediatric operations.
Following surge of HIV cases associated with unsafe medical practices particularly the alleged reuse of contaminated syringes, Drap has imposed a complete ban on conventional 1cc (non-insulin) disposable syringes with effect from Dec 31, 2026. It also imposed a ban on retail/ market sale of conventional 10cc disposal syringes from Jan 1, 2027.
In the letter, PPA’s Dr Muhammad Khalid Shafi asked Drap’s chief executive officer that the healthcare system “confronts an unprecedented and alarming surge in paediatric HIV cases across Pakistan, it is paramount that all public health regulatory measures prioritise this crisis as a top-tier national emergency. However, to effectively curb transmission without compromising patient outcomes, regulatory decisions must remain rigorously evidence-based, targeted, and aligned with clinical realities”.
Dr Shafi, also the chairperson of the National Immunisation Technical Advisory Group, points out that while Drap’s objective to eliminate syringe reuse through regulatory enforcement is commendable in intent, the recent blanket policy banning conventional/manual syringes — specifically the 10cc size — presents severe unintended risks to paediatric and neonatal care across the country.
“I urge the authority to carefully reconsider the scope of this prohibition based on the following critical clinical factors: The 10cc syringe is an irreplaceable clinical instrument required for the accurate reconstitution, dilution, and precise volumetric administration of essential intravenous paediatric medications.
“In neonatal intensive care units and paediatric wards, 10cc syringes are standard, nonnegotiable tools used for enteral feeding via nasogastric and orogastric tubes in premature and critically ill infants.
“Paediatricians routinely utilise needleless 10cc syringes to accurately measure and safely deliver oral liquid formulations and rehydration solutions to infants who cannot otherwise swallow standard dosage forms,” the letter says.
Dr Shafi argues that a broad, blanket prohibition on 10cc syringes creates an immediate clinical bottleneck that jeopardises daily, life-saving interventions in paediatric and neonatal wards and that regulatory actions to curb blood-borne pathogens must be driven by data and designed with clear, measurable clinical outcomes in mind, ensuring that infection control measures do not inadvertently disrupt essential medical care.
On behalf of the PPA, he urged the Drap to grant an immediate exemption or targeted exclusion for 10cc conventional syringes to safeguard neonatal and paediatric clinical operations while safer, standardised alternatives are fully evaluated and integrated.
“Convene a dedicated advisory panel comprising clinical experts, paediatric infectious disease specialists, and PPA representatives to review infection control strategies and establish evidence-based guidelines that target the true drivers of syringe reuse”, the letter says.
Published in Dawn, July 19th, 2026
