Safe blood for all: A component of achieving universal health coverage

June 15, 2019 - 21:45

TEHRAN – The theme of this year’s campaign of World Blood Donor Day, which is annually celebrated on June 14, is blood donation and universal access to safe blood transfusion, as a component of achieving universal health coverage.

The World Health Organization (WHO) has developed the slogan “Safe blood for all” to raise awareness of the universal need for safe blood in the delivery of health care and the crucial roles that voluntary donations play in achieving the goal of universal health coverage. 

The theme strongly encourages more people all over the world to become blood donors and donate blood regularly – actions which are key to building a strong foundation of sustainable national blood supplies that are sufficient to meeting the needs of all patients requiring transfusion.

The day and the theme is also a call to action to all governments, national health authorities and national blood services to provide adequate resources and put in place systems and infrastructures to increase collection of blood from voluntary, regular unpaid blood donors; to provide quality donor care; to promote and implement appropriate clinical use of blood, and to set up systems for the oversight and surveillance on the whole chain of blood transfusion.

The campaign aims to celebrate and thank individuals who donate blood and to encourage those who have not yet donated blood to start donating, to highlight the need for committed, year-round blood donation, to maintain adequate supplies and achieve universal and timely access to safe blood transfusion, to focus attention on donor health and the quality of donor care as critical factors in building donor commitment and a willingness to donate regularly, to demonstrate the need for universal access to safe blood transfusion and provide advocacy on its role in the provision of effective health care and in achieving the goal of universal health coverage and to mobilize support at national, regional and global levels among governments and development partners to invest in, strengthen and sustain national blood programs.

Iran and blood donation

According to the 2016 global status report on blood safety and availability, 64 countries (Europe 21, Americas 22, Africa four, Western Pacific four, and Eastern Mediterranean three) reported a total of 101,994 autologous donations in 2013.  Italy reported the largest absolute number of autologous donations.

Iran pioneers in donor deferral rate in countries by the WHO region, following by Egypt and Morocco.

In units of fresh frozen plasma transfused per 1000 population in countries by WHO region in East Mediterranean countries, Iran ranks fourths after Jordan, Saudi Arabia and Bahrain.

According to the report, the whole blood donations collected (excluding autologous donation) in 2013, the number of voluntary non remunerated donors (VNRD) are  2,001,791, out of which 450,100 are first time donor and 6,9100 repeat donor.

Iran and Tunisia are the only countries in the region producing plasma-derived medicinal products (PDMP), Hajibeigi noted.

In February 2018, admiring the attempts of Iran in blood supply, the official site of WHO has mentioned to the “success story” of the country. Part of this report comments that “The Iranian Blood Transfusion Organization has reduced the risk of transfusion-transmitted infections drastically in recent decades thanks to improved donor selection, better tests and new methods of screening. All donated blood is tested for HIV, hepatitis B and C and Human T-lymphotropic virus."

Some facts on blood safety and availability

According to WHO, of the 117.4 million blood donations collected globally, 42% of these are collected in high-income countries, home to 16% of the world’s population.

In low-income countries, up to 52% of blood transfusions are given to children under 5 years of age; whereas in high-income countries, the most frequently transfused patient group is over 65 years of age, accounting for up to 75% of all transfusions.

An increase of 11.6 million blood donations from voluntary unpaid donors has been reported from 2008 to 2015. In total, 78 countries collect over 90% of their blood supply from voluntary unpaid blood donors; however, 58 countries collect more than 50% of their blood supply from family/replacement or paid donors.

Only 50 of 173 reporting countries produce plasma-derived medicinal products (PDMP) through the fractionation of plasma collected in the reporting country. A total of 83 countries reported that all PDMP are imported, 24 countries reported that no PDMP were used during the reporting period, and 16 countries did not respond to the question.

National blood policy and organization

Blood transfusion saves lives and improves health, but many patients requiring transfusion do not have timely access to safe blood. Providing safe and adequate blood should be an integral part of every country’s national health care policy and infrastructure.

WHO recommends that all activities related to blood collection, testing, processing, storage and distribution be coordinated at the national level through effective organization and integrated blood supply networks. The national blood system should be governed by national blood policy and legislative framework to promote uniform implementation of standards and consistency in the quality and safety of blood and blood products.

Blood supply

About 117.4 million blood donations are collected worldwide. 42% of these are collected in high-income countries, home to 16 % of the world’s population.

About 12,700 blood centers in 170 countries report collecting a total of 100 million donations. Collections at blood centers vary according to income group. The median annual donations per blood center is 1,300 in the low-income countries, 4 100 in lower-middle-income countries and 8,500 in upper-middle-income countries, as compared to 23,000 in the high-income countries.

There is a marked difference in the level of access to blood between low- and high-income countries. The whole blood donation rate is an indicator for the general availability of blood in a country. The median blood donation rate in high-income countries is 32.6 donations per 1000 people.

This compares with 15.1 donations per 1000 people in upper-middle-income countries, 8.1 donations per 1000 people in lower-middle-income countries, and 4.4 donations per 1000 people in low-income countries.

According to World Health Organization, the safest blood donors are voluntary, non-remunerated blood donors from low-risk populations. The World Health Organization’s goal is for all countries to obtain all their blood supplies through voluntary unpaid donors, in accordance with World Health Assembly resolution 28.72, which was adopted back in 1975.