|Blood Safety and AIDS: UNAIDS Point of View (UNAIDS, 1997, 8 p.)|
· Eighty percent of the world's population live in developing countries, but developing countries use only 20% of the world's blood supply for transfusions.
· The human immunodeficiency virus (HIV) which causes AIDS is easily transmitted through blood transfusions. In fact, the chances that someone who has received a transfusion with HIV-infected blood will himself or herself become infected are estimated at over 90%.
· While millions of lives are saved each year through blood transfusions, in countries where a safe blood supply is not guaranteed, recipients of blood run an increased risk of infection with HIV.
· Other diseases - such as hepatitis B, hepatitis C, syphilis, Chagas disease and malaria - can also easily be transmitted through blood transfusions.
· Worldwide, up to 4 million blood donations a year are not tested for either HIV or hepatitis B. Very few donations are tested for hepatitis C.
· Blood transfusions will always carry certain risks, but HIV transmission through blood transfusions can virtually always be prevented. One can do this by setting up and maintaining a safe blood supply, and by using the blood appropriately.
· The difficulties hindering a safe blood supply include:
a lack of a national blood policy and plan, lack of an organized blood transfusion service, lack of safe donors, or the presence of unsafe donors; lack of blood screening; and the unnecessary or inappropriate use of blood. Blood screening means testing donated blood for the presence of disease-causing viruses, bacteria or other micro-organisms, or for the presence of antibodies produced against these agents. Shortages of funds, test kits and trained staff also hamper efforts to ensure a safe blood supply.
· A safe blood supply can be only achieved if three essential elements are in place:
- There must be a national blood transfusion service run on non-profit lines which is answerable to the ministry of health.
- There must be a policy of excluding all paid or professional donors, but at the same time encouraging voluntary (non-paid) donors to come back regularly. People are suitable as donors only if they are considered to have a low risk of infection.
- All donated blood must be screened for HIV, as well as for hepatitis B and syphilis (and hepatitis C, where possible). In addition, both doctors and patients must be aware that blood should be used only for necessary transfusions.
· In many countries, regulations on blood donations, screening and transfusions exist but are not adhered to. It is important that regulations are established and rigorously enforced.