The Indonesian government is starting a nationwide program to vaccinate infants against deadly hepatitis B. Working with a U.S. group, the government is training midwives to use a new type of syringe that makes vaccinations simpler to do and more cost effective. Doctors say the hepatitis B virus can be spread from person to person almost 100 times more effectively than HIV - the virus that causes AIDS.

An adult is likely to survive a hepatitis B infection. But almost a quarter of the children who carry the virus will die as a result because of developing deadly complications. Worldwide, hepatitis B claims 500,000 lives every year. A vaccine to prevent hepatitis B has existed for years. But in Indonesia, the problem has been reaching infants born in rural areas to vaccinate them within days of birth. Dr. Anton Wijaya is with the Jakarta office of the private group PATH, the Program for Appropriate Technology in Health. "In Indonesia you know that 80 percent of the births still happen in homes, not in clinics, so that's one of the constraints met by the government in the past, because there's no facility for sterilizing or carrying the vaccine down to the baby's home without risking infection and without risking high wastage of the vaccine," he says.

In the past, doctors carried several doses of the vaccine to a rural area in a single container. But once opened, most the vaccine would be wasted if there was just one child to vaccinate in an area. That made efforts to combat the disease expensive and time-consuming.

That may soon change. After running a pilot program in three provinces, the Indonesian government in collaboration with PATH is starting a nationwide campaign to vaccinate children with a new device - called a "Uniject." "PATH introduced Uniject - which is a single dose, already sterile, pre-filled device and ready for use as a single dose, that will prevent the wastage and secure the sterility of the injection itself. With that device, the midwives can directly give the injection," he says.

With Uniject, the hepatitis B vaccine is carried in a sealed plastic bulb attached to a very small needle. The Uniject device can be used only once, so there is no risk of spreading other diseases through contaminated needles.

Dr. Wijaya also says that if the nationwide hepatitis B program succeeds, the Uniject device may be used in the future to help prevent several other diseases.