At a Glance

Millions of lives are saved each year through blood transfusions. Nevertheless, people have an increased risk of becoming infected with HIV and other infections, such as hepatitis B and hepatitis C, through transfusions of blood and blood products that have not been collected and tested correctly.

It is estimated that between 5% and 10% of all HIV infections worldwide have been acquired through transfusion of contaminated blood and blood products.

HIV and other transfusion-transmissible infections (TTIs) can be eliminated or substantially reduced through a blood safety programme which ensures:

· the establishment of a national blood transfusion service (NBTS), accountable to the government or to a government-appointed non-profit organization, having its own budget and trained staff;

· recruitment and selection for blood donations from unpaid, voluntary, low-risk donors;

· the screening of all donated blood for HIV and other TTIs;

· the appropriate and rational use of blood.

Donor selection is of the utmost importance. Family replacement and paid or professional donors are more likely to carry TTIs and should be excluded from giving blood.

Any information obtained during the recruitment and selection of donors - or through screening blood - is strictly confidential. It must never be used as a basis for stigmatization or discrimination in the community.

It is important to minimize the number of inappropriate blood transfusions so as to reduce the risk of TTIs and other possible adverse reactions from transfusions. People who prescribe and use blood should be trained to avoid unnecessary or inappropriate transfusions.

The use of blood substitutes, such as crystalloids and colloids, for volume replacement should be encouraged as appropriate. Such substitutes will not transmit infections and are much cheaper than whole blood.

Preventing the causes of anaemia and blood loss is important. Children, for instance, are often given transfusions for chronic anaemia, a condition that can be caused by malnutrition or malaria. By improving nutritional and health standards, and controlling malaria, the incidence of chronic anaemia - and the consequent number of blood transfusions - can be reduced.