WHO NEWS

Developing countries face safe blood shortage

Stricter quality checks for blood transfusions and more blood donors are needed in developing countries, said experts from WHO on World Blood Donor Day on 14 June. Whilst celebrations took place in many cities around the world to mark the contributions made by voluntary blood donors everywhere, the overwhelming majority of the world's population — 82% — does not have access to safe blood. Most of these live in regions with the heaviest burdens of disease where an adequate, safe supply of blood is in constant need.

"A sufficient, safe blood supply is a key part of an effective health care system and essential for disease prevention," said WHO Director-General, Dr LEE Jong-wook. "In our work to increase access to treatment for people living with AIDS around the world, safe blood is a crucial part of our prevention and care strategy."

Many developing countries still rely on blood from family replacement or paid donors and in these countries, the seroprevalence in donors for transfusion-transmissible infections such as HIV, hepatitis B and C, and syphilis, is much higher than in countries with voluntary, unpaid donation.

An adequate supply of safe blood requires a pool of healthy, regular, voluntary donors who give blood without financial or other reward. According to WHO, research has shown that donors who give blood voluntarily are the safest donors. However, a recent WHO survey shows that only 39 of 178 countries have 100% voluntary, unpaid blood donation. The survey also showed that 20 countries in the world do not have 100% screening for HIV and 24 do not have 100% screening for hepatitis B, 37 for hepatitis C and 24 for syphilis. A number of countries do not screen at all for these infections.

In spite of the poor figures, there are strategies in place to address the problem of blood safety in some countries such as South Africa and Zimbabwe. Zimbabwe's Pledge 25 encourages school leavers to pledge to give blood 25 times before they are 25, while also committing to leading healthy lives in order to keep their blood safe. The initiative saw HIV infection rates among blood donors drop from 4.45% in 1989 to 0.61% in 2001.

The shortage of safe blood is compounded by the shortage of donors in developing countries — where that blood is needed most. Of the estimated 81 million units of blood donated every year around the world, only 39% comes from developing countries, contributing to a global blood shortfall of around 40 million units a year. Despite efforts to rectify this imbalance, the average number of blood donations has not improved significantly in developing countries — it remains around 12 times higher in industrialized countries than in developed countries, according to WHO.

Most countries still lack a nationally coordinated blood transfusion service and rely on voluntary blood donor organizations which have been set up in over 50 countries. According to Daniela Bagozzi from WHO's department of Health Technology and Pharmaceuticals, these organizations play a key role in blood donor recruitment and retention through peer education and promotion.