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MMWR. Morbidity and Mortality Weekly Report. 2016 Feb 12; 65(5):115-9.Blood transfusion is a life-saving medical intervention; however, challenges to the recruitment of voluntary, unpaid or otherwise nonremunerated whole blood donors and insufficient funding of national blood services and programs have created obstacles to collecting adequate supplies of safe blood in developing countries (1). Since 2004, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has provided approximately $437 million in bilateral financial support to strengthen national blood transfusion services in 14 countries in sub-Saharan Africa and the Caribbean* that have high prevalence rates of human immunodeficiency virus (HIV) infections. CDC analyzed routinely collected surveillance data on annual blood collections and HIV prevalence among donated blood units for 2011-2014. This report updates previous CDC reports (2,3) on progress made by these 14 PEPFAR-supported countries in blood safety, summarizes challenges facing countries as they strive to meet World Health Organization (WHO) targets, and documents progress toward achieving the WHO target of 100% voluntary, nonremunerated blood donors by 2020 (4). During 2011-2014, overall blood collections among the 14 countries increased by 19%; countries with 100% voluntary, nonremunerated blood donations remained stable at eight, and, despite high national HIV prevalence rates, 12 of 14 countries reported an overall decrease in donated blood units that tested positive for HIV. Achieving safe and adequate national blood supplies remains a public health priority for WHO and countries worldwide. Continued success in improving blood safety and achieving WHO targets for blood quality and adequacy will depend on national government commitments to national blood transfusion services or blood programs through increased public financing and diversified funding mechanisms for transfusion-related activities.
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.