BLOOD SAFETY -- AT WHAT COST?
February 16, 2006
The provision of safe and adequate blood supply is an important component of national health. It requires government commitment and support to ensure that blood is safe, accessible and adequate to meet transfusion requirements, say Linda Bekker and Robin Wood writing in the Journal of the American Medical Association.
However, there are large inequalities in the distribution of safe blood:
- Some 80 percent of the world's population has access to only 20 percent of the world's safe blood supply.
- A lack of safe blood results in considerable mortality; it is estimated that up to 150,000 pregnancy-related deaths could be avoided each year with greater access to safe blood.
- Presently, fewer than 30 percent of countries have nationwide blood transfusion services and approximately 50 percent of donations are from family or paid donors -- recognized sources of unsafe blood.
South Africa has instituted policy changes to safeguard its blood supply, say Bekker and Wood:
- In 1999, the country closed donor clinics where HIV seroprevalence was high, providing educational materials to encourage self-exclusion of those with high-risk behaviors and triaging donated blood by population profiling based on ethnicity, sex and donation frequency.
- The crisis in South Africa highlights several ethical issues such as the medical stigmatization of population groups by excluding them from the blood donor pool, the use of race in medical decision-making and the relationship between public health medicine and society.
- A further aspect is the tendency of public health medicine to ignore societal roots in favor of medical interventions, which operate further downstream; it is easier to use more sophisticated screening technologies than address the underlying social inequalities.
Source: Linda-Gail Bekker and Robin Wood, "Blood Safety -- At What Cost?" Journal of the American Medical Association, February 1, 2006.
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