Bill & Melinda Gates Foundation Grants $4.9 Million to Pan American Health Organization to Improve Safety of Blood for Transfusion in the Americas

WASHINGTON -- The safety of blood used for transfusion in the Americas is set to improve as a result of a three-year grant for $4.9 million by the Bill & Melinda Gates Foundation that will enable the Pan American Health Organization (PAHO) to set up a regional initiative to strengthen country-level blood safety programs.

At present, only 18 countries -- eight in the English-speaking Caribbean, eight in Latin America, and two in North America -- report screening 100 percent of donated blood for the viruses that cause AIDS, Hepatitis B, and Hepatitis C. Dr. José Ramiro Cruz, PAHO's regional advisor in laboratory and blood services, says, "This means that annually, around 50,000 units of blood are transfused without being screened for HIV and Hepatitis B Virus, and around 1.5 million units of blood are not tested for Hepatitis C Virus."

The grant will help the Pan American Health Organization and the countries of the region move toward the screening of all blood units for HIV, Hepatitis B and C, and syphilis, with additional screening for Chagas' Disease in Latin America by the end of 2003.

The funds will be used to improve the efficiency of the laboratories that act as screening centers for blood, develop national quality assurance programs, set up external evaluation programs for blood banks, and promote voluntary, non-remunerated blood donation through educational programs.

Dr. George Alleyne, Director of PAHO, said, "We are extremely grateful to the Bill & Melinda Gates Foundation for this grant to help us improve the safety of blood for transfusion in the region of the Americas. The availability and safety of blood is essential to saving lives and improving the safety of the blood supply is one of the main priorities of the Pan American Health Organization."

"Safe blood supply is a critical component in improving health standards in this region and in addressing the spread of infectious diseases," said Dr. Gordon Perkin, Director of the Global Health Program at the Bill & Melinda Gates Foundation. "We are pleased to support the work of PAHO in building the screening infrastructure to make safe blood the rule rather than the exception throughout the hemisphere."

"Blood for transfusion is scarce in all countries of the Americas," Dr. Cruz said. "Most countries collect less than 40 percent of the blood units needed to respond to the medical needs of their populations." Only five countries get all their blood from voluntary, unpaid donors -- the safest group. One goal of the new project, according to Dr. Cruz, is that 50 percent of blood donors in each country of the Americas will be voluntary, altruistic, and non-remunerated donors within three years.

Experts are already working to design educational programs, based on local beliefs, attitudes and practices, to foster blood donation by altruistic donors, using integrated approaches that include community participation. Another key activity will be to improve blood donation centers to make them more accessible and friendly to donors, and to develop regional guidelines for recruitment and selection of potential donors.

Blood is essential in hospitals and health facilities to prevent death or major complications in seriously ill patients who require transfusion as a result of accidents, violence, major surgery, clotting disorders or complications of pregnancy and childbirth. Blood used for transfusion must be free of pathogens that might cause illness in the person getting the blood, and the best way to assure this safe blood is to have it come from voluntary donors who have been interviewed and selected to weed out any who have engaged in risky behaviors or been infected by microorganisms that can be transmitted through blood. The second screen is laboratory-based and encompasses the testing for infectious markers in donated blood.

Lack of resources has been cited as the main constraint to the universal serological screening of blood, and this has led to the use of pooled samples for testing blood, which may affect the sensitivity of the tests. Often, the lack of quality assurance programs in laboratories leads to false negative results, which can permit blood that is infected to be transfused. Under the grant, PAHO will work to get 100 percent coverage of blood screening in the Americas, to ensure full participation of national reference blood banks in performance evaluation programs, and to identify and monitor groups at high risk for transfusion-transmitted infections for Hepatitis C infections.

A principal thrust of the blood safety program will be to improve the efficiency of the laboratory screening process, setting up national systems under the leadership of the Ministries of Health with active participation of other institutions involved in transfusion medicine. It is expected that the number of centers that screen for infectious markers will be reduced and the quality of the blood products will be improved.

Founded in 1902, the Pan American Health Organization works to improve health and raise living standards in all the countries of the Americas. It also serves as the Regional Office for the Americas of the World Health Organization.  For more information about the Pan American Health Organization, visit the website.