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Injections are one of the most frequently used medical procedures. The World Health Organization (WHO) estimates that 12 billion injections are given annually, 5% of which are administered for immunization and 95% for curative purposes. Unsafe injection practices (especially needle and syringe re-use) are commonplace in low-income country health settings, and place both staff and patients at risk of infection with blood-borne viruses (BBVs). It is estimated that up to 160 000 human immunodeficiency virus (HIV), 4.7 million hepatitis C and 16 million hepatitis B infections each year are attributable to these practices. The problem is complex and fuelled by a mixture of socio-cultural, economic and structural factors. An appropriate response on the part of international organizations, governments, health administrators, community organizations and health workers, including those who work in the area of HIV …