8.4 EPI Revolving Fund of the Pan-American Health Organization (PAHO) The EPI Revolving Fund is a pool of money maintained by PAHO that enables countries to pay in advance for vaccine and syringe purchases. Within a given period, countries must reimburse the fund for the cost of each purchase. The main purpose of the fund is to ensure a uniformed and continuous supply of vaccines and supplies for country immunization programs.
8.5 Safe Injection Practices An injection is a traumatic procedure that consists of puncturing the skin with a syringe and needle in order to introduce a substance to heal or prevent disease. Approximately 12 to 16 billion injections are administered each year worldwide; one out of 20 (5%) injections is administered for vaccination purposes. • Injections can be administered by intravenous, intramuscular, intradermal or subcutaneous routes. Vaccinations do not use the intravenous route. • Hazardous injection practices may lead to transmission of blood-borne pathogens (HIV, Hepatitis C virus and Hepatitis B virus) from one patient to another, from patient to health care worker, and rarely from health care worker to patient. The community at large can also be exposed to serious infectious risks when injection equipment is not adequately discarded. • Many epidemiologic studies in industrialized countries have documented spread of Hepatitis B due to accidental needle pricks or the shared use of syringes and needles. • A safe injection does not endanger the recipient’s life, expose the health care worker to any avoidable risk, or produce any waste that may be harmful to other people. Characteristics of a safe injection Safe for the injection recipient Safe for the health worker Safe for the community and the environment
8.6 Safety of the Injection Recipient Five interrelated aspects are fundamental in guaranteeing the safety of vaccinees:
167