|Safe Blood in Developing Countries - The Lessons from Uganda (EC, 1995, 151 p.)|
|Section One - Introduction and summary|
|Chapter One - Safe blood and HIV/AIDS: The Uganda achievement|
The EC, then in the process of launching its new HIV/AIDS programme, was asked to give support to Uganda. Dr Lieve Fransen, who already had extensive experience of public health planning in Africa, was hired as a consultant in April 1987 to identify where the EC could best provide support. She had just defended her PhD in Public Health at the University of Antwerp and was specialised in tropical medicine, epidemiology and genito-urinary medicine. She felt highly motivated to play a part in the mobilisation then taking place around HIV in developing countries, and especially in Uganda where the epidemic was spreading fast.
During a short visit to Uganda in that month she was able to discuss with all parties involved both the epidemic and the response to it. She received great support from the newly appointed EC Delegate to Uganda, Karl Harbo. She recognised that the epidemic was already of serious proportions, and that its consequences would be devastating. The opportunities to do something about it had to be both well chosen and quickly organised. She recommended that EC support to Uganda could best be used for a safe blood initiative, because:
1. the blood supply was totally unsafe and was used mainly for pregnant women and for children, whom she saw as the window of hope for the future. She also stressed the importance of the responsibility falling upon the government and the public health service to protect the population against unsafe blood, both for its own sake and for prevention of HIV
2. both for the EC and for the Uganda government, this initiative meant starting from nothing and needed technical assistance. But it also needed a long-term commitment and a comprehensive approach with high initial investment costs that other aid donors were not willing or able to undertake at that time
3. the presence of a consultant from another aid donor who was also interested in promoting safer blood through the Red Cross, meant that there was an EC member state which might also be involved, raising the possibility of a joint European Union effort.
During her mission to Uganda she studied the feasibility of such a project, despite the lack of data on blood or its safety. She proposed to start with a first phase to provide safe blood for the Kampala/Entebbe area, and then expand in the spirit of 'doing while learning' because there were no previous models of how to do this kind of work and this kind of foreign aid. To implement the project, the EC at first sought a European agency or European technical assistance to help Uganda's Ministry of Health to put into a place a detailed policy, strategy and plan. But after much deliberation the Commission decided to hire a technical assistant, in the person of Dr John Watson-Williams, as its manager-on-the-spot. An international tender was organised to provide equipment and supplies.
This was the beginning of the story that lead the EC to develop a comprehensive policy and strategy for safe blood in developing countries, in the context of the larger EC HIV/AIDS programme which had just started.