Final Evaluation of the Regional Initiative and Plan of Action for Transfusion Safety 2006-2010

Delegates to the 51st Directing Council were briefed this afternoon on the results of a final evaluation of the Regional Initiative and Plan of Action for Transfusion Safety 2006-2010. The report analyzes data from 35 countries and territories, excluding Canada, the United States, Puerto Rico and the French Territories. It also incorporates the findings of an External Evaluation Team appointed by PAHO’s Director to assess problems and progress in this area in Member States.

The evaluation found that only four countries in the Caribbean follow a legal framework for blood services, while all but three Latin American countries have such a framework. Even in the countries with legal frameworks, however, insufficient human and financial resources are allocated for transfusion safety at the national level. The multiplicity of operational actors, coupled with limited oversight by health authorities, represents a major obstacle to the appropriate use of resources.

Data from the countries show an inverse relationship between blood availability and maternal mortality rates, and between the mean number of blood units processed annually by center and total blood availability at the country level. This suggests that creating more blood banks does not result in improvements in blood availability or timely access.

The data also support the premise that the only way to achieve sufficiency of blood and equitable access is by collecting blood exclusively from voluntary, non-remunerated donors. The practice of hospitals requiring patients to provide blood replacements continues to be the major obstacle to universal voluntary blood donation.

The evaluation found improvements in screening for infectious markers. Countries with more than 50% voluntary blood donation show lower prevalence of infectious markers in donated blood.

The report also noted that the inefficiency of blood systems throughout Latin America and the Caribbean have serious financial implications. In 2009, units that were discarded because of positive markers for infectious diseases represented an estimated wastage of almost US$20 million. The cost of expired red blood cells in 2009 was estimated at almost US$55 million. Multiplicity of blood processing centers and lack of standardized processes contribute to this financial situation in PAHO Member States, the report said.

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