Goal 3: Advance Translational Research

Implementation Research to Improve Global Availability of Safe Blood Transfusions

What well-developed principles and lessons learned can be employed to improve the safety and availability of blood transfusions in developing countries?

 

The WHO Global Status Report 2013, many research reports, and a recent assessment of burdens of transfusion transmissible infections with HIV, HBV and HCV identified several critical challenges: 1) Significant proportions of blood collections in a large number of countries are being conducted without oversight by national health authorities, for which little is known about their donor safety profile, donation screening practice and overall quality schemes; 2)Lack of adequate supply of blood for transfusion in many countries makes it difficult to eliminate paid blood donations even though it is well known that such donations are not safe; 3) One of the major reasons is the lack of voluntary non-remunerated blood donors and donations (VNRBD); 4) International efforts, including those by the US, have helped many countries establish quality blood supply systems to improve blood safety and availability but the challenge is to sustain such systems without continual external financial support, that is, the challenge is to establish and maintain quality blood supply systems cost-effectively to make them sustainable.

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Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Significant progress has been made globally in providing adequate supply of safe blood for clinical transfusion thanks to efforts by many, including the US PEPFAR and research supported by NIH such as the REDS programs. Nevertheless, there remains a lack of blood for transfusion and paid blood donations are still collected in many countries. A total of 25 countries were not able to screen all donated blood for one or more of infections with human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis in 2011. As many as 24% of blood donations in low-income countries were not screened following basic quality procedures which include documented standard operating procedures and participation in an external quality assurance scheme. (WHO: Global Status Report 2013). Implementation research to identify cost-effective and sustainable ways to improve blood supplies in the developing world can help reduce blood shortage while enhancing safety by eliminating transfusion transmission of HIV, HBV and HCV.

Feasibility and challenges of addressing this CQ or CC :

Research, including studies supported by the NHLBI REDS, REDS-II, and REDS-III programs, has identified major gaps in global blood supply and reasons for such gaps. International programs, especially PEPFAR, have gained valuable experience implementing quality systems. The time has come to conduct research to optimize the implementation, that is, to find out how to improve global supply of safe blood for transfusion more efficiently in local settings and in a more sustainable manner.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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Idea No. 95