|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|
Today, less than a decade after being resurrected from the wreckage left by 15 years of alternating civil war and neglect, the Uganda Blood Transfusion Service (UBTS) is supplying almost all the hospitals in Uganda - over 90 of them - with almost all the supplies they need of safe, screened blood that is free of the HIV virus and of hepatitis. The exceptions are mainly where and when continuing security problems in the north of the country make direct supplies too dangerous to deliver. Even then, there are fall-back local arrangements for blood screening.
In so doing, the UBTS has saved countless lives, not only among those who have been taken to hospital and need a blood transfusion, but also among those who, as potential blood donors, have received AIDS education, and among those who have sought a blood test so as to know their HIV status and avoid passing on the infection to others, for example, when about to marry and have children.
The UBTS and its central laboratory at the Nakasero Blood Bank in Kampala and its four regional blood banks in Gulu, Mbale, Mbarara and Fort Portal, have therefore become an object lesson to other developing countries, many of whom do not have a comprehensive safe blood policy or programme, about what can be achieved and how it can be achieved.
The UBTS has also become an object lesson to funding agencies about how a social sector aid project can be carried out - and a potential test case for their commitment to better health in the world. The European Commission in Brussels was the first and remains the main technical and financial supporter of the Uganda safe blood project (American, French and Canadian donors then added contributions), and has committed over ECU 7 million to it. In return, the project played a pivotal role in the development of the EC's own worldwide commitment to the global programme on HIV/AIDS. In the context of Uganda's own HIV/AIDS campaign, the safe blood programme has a significance far wider than the simple narrow-focus screening of blood for hospitals, vital though that is. The diverse collection of activities that go to make up a fully-fledged safe blood programme in an African context make it one of the most efficient, measurable, and cost-effective mass interventions yet devised against the HIV epidemic.
There are signs, tentative but hopeful, that at long last the HIV epidemic in Uganda may be stabilising or even declining. A recent evaluation of the UBTS suggests that the blood transfusion service may have been preventing 5,400 new HIV infections a year, as against 18,800 prevented by other means e.g. changes in sexual behaviour. Whether or not this is exact, the UBTS has played a part in Uganda's campaign against HIV/AIDS that is far more significant and demanding than would be the case these days in, say, a European country.
Thanks to its rehabilitation, the UBTS and its 100 or more staff are now supplying nearly 40,000 units of blood a year to Ugandan hospitals, enough for today's needs. Given that even in cold storage blood only lasts for about 35 days, it has to keep up a continuous (but not excessive) supply of new blood. In the future, its level of activity will respond to the evolution of Uganda's medical services. The UBTS is also contributing to medical research on AIDS transmission.