Global “Truisms” on Providing a Safe and Adequate Blood Supply

1. Global “Truisms” on Providing a Safe and Adequate Blood Supply Chris Gresens Jim MacPherson 12 March 2013

2. Countries should have a safe and adequate blood supply that matches and supports the needs of its healthcare system; such a supply allows a country to provide its citizens with critical medical and surgical therapies • Priority for establishment of a safe and adequate national blood system, to ensure no patient dies for lack of blood within a country’s health system, should be set through a “national blood policy” written and published by its ministry of health in conjunction with hospitals and blood providers; this includes ensuring systems are in place to meet blood needs during disasters and epidemics • Working groups of experts and stakeholders, in the form of local hospital transfusion committees as well as national/regional policy-driven groups, should be formed to address issues as they arise and to drive the health system to an optimal blood use

3. A volunteer non-remunerated blood donor system may be labor intensive, but is an inexpensive way to help ensure the safest blood is available for transfusions to patients; when necessary, governments should promote the “civic duty” of its citizens to give blood whenever possible • A quality infrastructure (such as based on CoE, FDA, ISO requirements) is a low cost way to ensure the safety of blood components along the supply chain from the donor to the patient and to help to ensure “right patient, right blood” principles; this includes developing standards, documentation, training and a program for continuous quality improvements • Such a quality infrastructure includes feedback mechanisms (so-called hemovigilance) on adverse outcomes from those who provide a transfusion to those who process and provide the blood, thereby ensuring continuous quality improvements based on patient outcomes

4. Good and inexpensive infectious disease-marker testing systems are available to all economies and should be used; the level of technology applied should be proportional to the disease-transmission risk • Local and regional blood collectors need to cooperate on donor recruitment and blood inventory management activities so as to ensure an adequate blood supply is available and that those donor gifts are not wasted • Hospitals should ensure a safe inventory level to meet foreseeable patient needs • Physicians prescribing transfusions should have continuous education on appropriate and optimal blood use

5. International guidelines, workbooks, manuals, etc., exist to address all the above issues and should be adapted within a country to match its needs • Governments and bloodbanking experts in developed economies should share their successful tools for ensuring a safe and adequate supply through ongoing education and sharing of best practices at technological levels sustainable for developing economies • Regional alliances, such as America’s Blood Centers, the European Blood Alliance, the Asia Pacific Blood Network (and the emerging Alianza Latinoamericana de Sangre), are proven vehicles where more developed blood programs can easily and inexpensively address educational needs of developing programs through networking ListServs, webinars, regional training, twining, etc.