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    Safe blood: the WHO sets out its principles.

    Koistinen J

    AIDS ANALYSIS AFRICA. 1992 Nov-Dec; 2(6):4, 6.

    Developing countries face considerable obstacles to ensuring a safe blood supply and safe blood transfusions. There is a tendency for developing countries to not have enough available blood so they depend on family blood donors. Blood donors receive money for their donation. Testing is unreliable as is recording of results. Many clinicians do not have the experience to adequately determine when a transfusion is needed, e.g., physicians ordered a blood transfusion for a 5-year old African girl with pneumonia who had anemia (hemoglobin level of 52 m) after the 1st HIV test was negative. Yet this anemia case did not require a blood transfusion. A repeat of the test revealed the donated blood was indeed HIV positive. 2 other children also received that blood. The basic principles of blood safety are enough safe blood donors, a responsible blood transfusion service which can ensure appropriate and safe processing and testing of blood, and appropriate use of blood. A safe blood donor is healthy and has no risk factors for HIV and other infections. 40-60% of donated blood in developing countries goes to pregnant women often during delivery and children. The leading source of blood in the least developed and developing countries is replacement donors (88% and 81% respectively) who tend to be family members or friends. Yet often relatives of the patient pay someone they do not know to donate their blood. Blood banks also pay for donations and more than 56% of them are uncoordinated banks in hospitals. So organized blood donation services which can safely test and process blood would reduce the risk of transmitting HIV and other infections. WHO has set up a blood safety policy that encourages member countries to establish their own national blood transfusion policy. It supports countries along these lines via its global Programme on AIDS an the Global Blood Safety Initiative. Any blood safety activities can only succeeded with political commitment.
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