The chance of receiving a safe transfusion varies from one country to another. This depends on whether there is a good, safe blood donor program in place.

According to the World Health Organization (WHO), some 60% of the global blood supply goes to 18% of the world’s population.

There is a serious disparity between countries when it comes to both the availability and safety of blood. People in developing countries continue to face the greatest risks from unsafe blood and blood products.

In general, countries with higher per capita incomes have higher donation rates. Partially, this results from a more efficient blood collection systems.

In wealthy countries, one out of every ten people entering a hospital needs blood. That person may be a trauma victim. Also, they may need heart surgery or an organ transplant. Or they may be receiving treatment with blood products for leukemia, cancer or other diseases, such as sickle cell anemia.

Aging Population

With an ageing population, the demand for blood continues to increase in wealthy countries. In low income countries, women and children are the groups with the greatest need for blood.

According to the WHO, more than half a million women die every year from pregnancy complications worldwide; 99% of them in developing countries. Hemorrhage, accounting for 25% of complications, is the most common cause of maternal death.

Safety Issues

The WHO recorded that during the early 1990s, unsafe transfusions were responsible for 10% of HIV infections; many of them in high income countries.

In many countries, biologists try to make blood safe. But the majority of developing nations still don’t carry out even the most basic mandatory tests for diseases such as HIV or Hepatitis B and C.

Most countries still lack a nationally coordinated Blood Transfusion Service. Despite some improvements in this important area, fewer than 30% of countries have a well-organized service in place according to the WHO.

Too many countries still rely on family replacement (a member of the patient’s family donating his/her blood) or paid donors. Family replacement donors may feel under pressure to donate and may therefore hide aspects of their health and lifestyle, which could mean that their blood is more likely to contain infection.

In the case of paid donors, governments may think that the financial incentive will motivate more donations and boost supplies. However, needy paid donors avoid mentioning important details about their health status.

Many blood transfusions are unnecessary. Patients around the world risk infection during blood transfusions when alternatives—such as intravenous replacement fluids—would be equally effective.

Right Blood to Right Patient at Right Time

At the heart of global efforts to ensure universal access to safe blood is the move to a system of regular voluntary, unpaid blood donors.

Deemed the safest, such donors have a sense of responsibility towards their community and keep themselves healthy so as to be able to keep giving safe blood.

It is clear that quality checking is also vital to a safe blood supply. A reliable system needs to be in place to ensure proper screening and proper matching of blood. The error of giving the wrong blood can be fatal to a patient.

Centralized blood collection systems coordinated nationally have several advantages over small blood banks—better trained personnel, better equipment, for instance—and those benefits contribute substantially to blood safety.

These centers can also provide better attention to donors, which is important for increasing voluntary donations, and are better to break blood down into its component parts.

In many cases, doctors don’t require full blood transfusions as the patient may only need one component of the blood for his or her condition. Overuse or misuse of whole-blood transfusions isn’t only less cost-effective; it also increases the risk of transmitting infections.

Progress

While 100% voluntary blood donation is in high income countries of the Americas, both low-income countries, represent the exceptions as they have introduced 100% voluntary donation since they created their national blood transfusion service.

Voluntary blood donor organizations have been set up in over 50 countries. These organizations, which are managed by blood donors themselves, play an important role in blood donor recruitment and retention through peer education and promotion.

Data collected from the WHO’s 178 member states showed that the number of tests not being performed for the four main markers of infection, HIV, HBV (hep B virus), HCV (hep C virus) and syphilis, decreased from 13 million in 1998- 99 to just six million in 2000 – 01.

Our Precious Blood

Blood is a rich product which can be broken down into many parts. Its main components are red cells, platelets and plasma, and the plasma itself contains a variety of proteins.

All of these substances have different uses and patients will need different components depending on their own blood type and on their condition.

For instance, an anemic person will only require red cells, while a hemophiliac needs clotting factors from plasma.

Red cells last only 35 days and platelets only 5 days, so a regular supply of fresh blood is vital. Just one half liter of donated blood can help save as many as three people’s lives.

There are four main blood types: A, B, AB and O. AB is the universal recipient and O negative is the universal donor. Blood centers often run short of type O and B blood.

While a given individual may be unable to donate, he or she may be able to recruit a suitable donor. Blood banks are always in need of volunteers to assist at blood draws or to organize blood drives. Much of today’s medical care depends on a steady supply of blood from healthy donors.

This article is from Science’s archive and we’ve originally published it on an earlier date.