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Geneva, Switzerland, UNAIDS, 1997 Oct. 7 p. (UNAIDS Point of View; UNAIDS Best Practice Collection)Eighty percent of the world's population live in developing countries, but developing countries use only 20% of the world's blood supply for transfusions. The human immunodeficiency virus (HIV) which causes AIDS is easily transmitted through blood transfusions. In fact, the chances that someone who has received a transfusion with HIV-infected blood will himself or herself become infected are estimated at over 90%. While millions of lives are saved each year through blood transfusions, in countries where a safe blood supply is not guaranteed, recipients of blood run an increased risk of infection with HIV. Other diseases -- such as hepatitis B, hepatitis C, syphilis, Chagas disease and malaria -- can also easily be transmitted through blood transfusions. Worldwide, up to 4 million blood donations a year are not tested for either HIV or hepatitis B. Very few donations are tested for hepatitis C. (excerpt)
In: Health and disease in developing countries, edited by Kari S. Lankinen, Staffan Bergstrom, P. Helena Makela, Miikka Peltomaa. London, England, Macmillan Press, 1994. 503-11.Blood transfusion is a routine hospital function. Whole blood and red cell concentrates are needed for managing anemia and hemorrhage, while plasma, coagulation factors, white cell and platelet concentrates are used for the management of burns, hemophilia, and hematological disorders. The blood transfusion services (BTS) should be part of the national health plan. Transfusion medicine consists of donor recruitment and retention, collection, testing, processing, storage of blood, and training of physicians in appropriate use of blood. Estimation of the need of blood and blood components is usually difficult to make. An annual collection of 5 units of blood per hospital and in acute care is sufficient. Formulation of a national blood policy is necessary for every country. The policy should define: 1) the responsible organization for implementation of the blood program, 2) the method of funding the BTS, 3) the concept of blood donation, and 4) the regulations of blood donation and transfusion. Already 61% of developing and 32% of the least developed countries have adopted such a policy. Responsibility for the organization of transfusion services lies with the ministries of health, which may delegated it to a governmental or nongovernmental organization. The Red Cross is most often associated with BTS. Provision of funding is effected by an annual allocation or on a cost recovery basis. Processing and storage requires refrigeration. Costing of blood transfusion services must include the capital and overhead costs. Other topics included in this report are: national blood transfusion service; recruitment and selection of blood donors (voluntary unpaid blood donation and donor recruitment utilizes the importance of this service to society); collection and processing of blood (testing ABO and Rh groups, HIV, hepatitis B and C, syphilis, Chagas disease, and malaria); blood transfusion service in a small hospital; recruitment and training of personnel; and international organizations dealing with blood transfusion.