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VOX SANGUINIS. 1994; 67(4):377-81.As part of an effort to monitor the safety of global blood transfusion services, the World Health Organization circulates a questionnaire for use in a database on blood safety. In 1992, 67% of countries responding to the survey (100% of developed, 66% of developing, and 46% of less developed countries) were screening all blood donations for HIV antibodies and 87% of these countries (100% of developed, 92% of developing, and 63% of less developed countries) carried out supplementary testing to confirm positive results. All developed countries, 72% of developing, and 35% of less developed countries screen blood for hepatitis B surface antigen and 94%, 71%, and 48%, respectively, screen for syphilis. The primary reasons for inadequate blood testing are the cost of test kits and reagents and the unreliability of supplies. The proportion of safe donors is highest in systems where all donors are voluntary and nonremunerated--conditions that exist in 85% of developed countries but only 15% of developing and 7% of less developed countries. Blood safety would also be improved by more appropriate use of transfusions and the provision of alternatives such as saline and colloids. Other problems include insufficient blood supply (e.g., none of the less developed and only 9% of developing countries collect 30 units or more per 1000 population per year) and inadequate quality assurance in all aspects of preparatory testing.
NEW YORK TIMES. 1992 Jun 4; A1, B10.The international AIDS Center at the Harvard School of Public Health led a coalition of AIDS research from around the world in an analysis of more than 100 AIDS programs and discovered that the HIV/AIDS pandemic is more serious than WHO claims. Its findings are in the book called AIDS in the World 1992. AIDS programs do not implement efforts that are known to prevent the spread of HIV. For example, clinicians in developing countries continue to transfuse unscreened blood to many patients, even though HIV serodiagnostic test have existed since 1985. Further, programs do not evaluate what works in other programs. As long as people debate whether or not to distribute condoms, exchange needles, or offer sex education and whether people with AIDS deserve care, the fight against HIV/AIDS is hindered. The report recommends that leader come up with a new strategy to address the AIDS pandemic. WHO claims to have done just that at its May 1992 meeting. An obstacle for WHO is political pressure from member nations. On the other hand, the private Swiss foundation, Association Francois-Xavier Bagnoud, finances the Harvard-based AIDS program, allowing members more freedom to speak out. The head of the Harvard program believes the major impact of AIDS has not yet arrived. Contributing to the continual spread of HIV is the considerable difference of funding for AIDS prevention and control activities between developed and developing countries (e.g., $2.70 per person in the US and $1.18 in Europe vs. $.07 in sub-Saharan Africa and $.03 in Latin America). Even though developed countries provide about $780 million for AIDS prevention and care in developing countries, they do not enter in bilateral agreements with developing countries. 57 countries limit travel and immigration of people with HIV/AIDS. Further, efforts to drop these laws have stopped. Densely populated nations impose travel constraints to prevent an explosive spread of HIV.