[EQ] Blood Services in Central Asian Health Systems - Clear and Present Danger of Spreading HIV/AIDS and Other Infectious Diseases

Blood Services in Central Asian Health Systems:

A Clear and Present Danger of Spreading HIV/AIDS and Other Infectious Diseases

 

Patricio V. Marquez, Lead Health Specialist
Europe and Central Asia Region Human Development Unit and Central Asia Country Management Unit

The World Bank in collaboration with U.S. CDC/CAR, USAID and WHO-EURO

Global HIV/AIDS Program, World Bank – May 2008

 

Available online as PDF file [67p.] at:
http://siteresources.worldbank.org/INTECAREGTOPHEANUT/Resources/cabloodbankstudy.pdf

 

“…Understanding how communicable diseases spread is key to controlling them. Blood transfusions are a small contributor to communicable disease transmission compared to other well-reported modes, but ensuring the safety of the blood supply in a health system is largely within the purview of national governments…”

 

“…The report discusses inter-related parts of blood transfusions systems, and presents an overview of the parts that need to be strengthened in Central Asia. Numerous parts are in serious need of organizational restructuring, new investment and increased budgetary support for operation and maintenance.

 

This report sets them out such that each can be addressed in turn – and some simultaneously. The report also discusses the health threat posed by alarmingly low levels of blood supplies, fostered by a culture that places little value on donating blood, public fear of being infected by giving blood, and the near absence of donor promotion campaigns.

 

Evaluating communicable diseases rates in blood donors is essential for monitoring the safety of the blood supply and donor screening effectiveness. This assessment found that the current screening for blood borne pathogens of donated blood in Central Asia may be providing a false sense of security -- the risk of receiving an infected blood unit and acquiring a transfusion transmitted infection in the countries of the region is real. More ominous is the fact that some health facilities in Central Asia do not test blood donations at all. This means that the transmission risks indicated in this study may be conservative estimates, as they are based on a sample that excludes the blood that never reaches the existing screening system….”

 

 

Content:

EXECUTIVE SUMMARY

PREFACE

CHAPTER I: THE BURDEN OF COMMUNICABLE DISEASES

CHAPTER II: WHY ARE BLOOD TRANSFUSION SERVICES IMPORTANT IN A HEALTH SYSTEM?

A. Clinical use of blood and its products

B. Availability of blood supplies

C. Testing for blood borne infections

D. HIV infection through blood transfusions

E. Recommended strategy for strengthening blood transfusion services

F. The challenge in Central Asia

 

CHAPTER III: STATE OF BLOOD TRANSFUSION SERVICES AND SAFETY OF THE BLOOD SUPPLY IN CENTRAL ASIA

A. Methodology

B. Main Findings of the Overall Assessment

1. Status of blood transfusion services in Central Asia

2. How safe is the blood supply in Central Asia?

3. Level of infection among blood donors

4. How have governments responded to the findings of this assessment?

5. Ongoing support from international agencies

 

CHAPTER IV: RECOMMENDATIONS TO IMPROVE BLOOD SERVICES IN CENTRAL ASIAN HEALTH SYSTEMS

A. Develop national blood program and improve its stewardship

B. Address chronic under-financing of blood transfusion services

C. Improve the quality of transfusion services and related medical practice

D. Strengthen preventive public health and primary health care programs to reduce the supply-demand gap for blood transfusion.

E. Foster regional communication and collaboration arrangements among the Central Asian countries

F. Are these interventions cost-effective?

THE WAY FORWARD

Annex 1: Status of Health-related MDGs in Central Asia

Annex 2: Methodology for Assessing Accuracy of Blood Screening in Central Asia

Annex 3: Questionnaire: Blood Donor Information

References

 

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