Blood supplies unsafe in two-thirds of nations

Organizations unite on World Health Day in global safety effort

April 07, 2000|By NEW YORK TIMES NEWS SERVICE

UNITED NATIONS -- More than two-thirds of the world's nations are failing to supply safe blood to their populations, the World Health Organization says, adding significantly to the spread of the virus that causes AIDS, potentially deadly forms of hepatitis and other diseases.

The countries where people are most at risk are the poorest and often those where diseases are spreading fastest, the World Health Organization says. These countries contain 80 percent of the world's population, or about 4.8 billion people.

The World Health Organization, with the International Federation of Red Cross and Red Crescent Societies, is beginning today -- World Health Day -- a yearlong campaign to improve the safety of blood around the world.

Poor countries face cost problems in making blood supplies safe. But experts say poor social policies with a low priority on public health programs contribute to the problem, as does inadequate testing. Hospital equipment may be contaminated or reused, and blood may be stored improperly.

Most important may be the common Third World practice of buying blood, experts say.

"Paid donors, it has been demonstrated many, many times, are at much higher risk of being infected," said Dr. David Brandling-Bennett, deputy director of the Pan American Health Organization in Washington.

Brandling-Bennett said business travelers who visit developing countries usually do not need to fear blood contamination if they avoid risky behavior and use only hospitals approved by U.S. embassies or consulates.

In the United States, immigrants should be told the importance of full disclosure when giving blood, he said.

The Western Hemisphere, said Dr. Jose Ramiro Cruz, the Pan American Health Organization's adviser on laboratory and blood safety, is the world's safest in the handling of blood.

South Asia, particularly India, and Africa are special concerns. The World Health Organization estimates that tens of thousands contract the virus that causes AIDS and millions are infected annually with hepatitis B and C, which can lead to liver failure or liver cancer.

Dr. Kevin Cahill, an expert on tropical diseases in New York, and president of the Center for International Health and Cooperation, said economics and attitudes play a part. "When you deal with many countries where the total health expenditure per capita is in the range of $15 a year, as in some African countries, the thought that you can spend that amount typing and cross-matching blood -- it's a fantasy," he said.

"Not just blood-banking is a low priority; health is a low priority in most developing countries," he said. "Health and humanitarian issues should be central in foreign policies, not peripheral issues."

Women of childbearing age are among the most vulnerable in the developing world, experts say. Corinne Whitaker, senior program officer for Africa at the International Women's Health Coalition in New York, said this is especially true in societies where women bear children young and often. They are frequently anemic and their small size makes them prone to injuries in childbirth.

"Getting access to any blood is a challenge in much of Africa," Whitaker said. "That's complicated by the issue of screening for safe blood." She said that women go to hospitals with "walking blood banks" in the form of relatives to guarantee the availability of safe blood.

Problems with the blood supply are not been limited to developing nations. Over the past decade, court cases have demonstrated the extent to which early warnings about the virus that causes AIDS were ignored in the United States, France, Germany, Switzerland and other countries, with the result that thousands of hemophiliacs and others in need of blood may have been infected.

Brandling-Bennett and Cruz say the problem now is a decrease in donors.

"Countries should be targeting to have about 5 percent of their populations regularly donating blood," Brandling-Bennett said. "The U.S. is at about 4 1/2 percent; Canada is a little over 3 percent."

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