Safe blood for millions of sick and injured patients in Africa is becoming increasingly available — but still denied to millions — on the subcontinent, according to Rep. Chris Smith (R-NJ) who chaired a hearing this week that probed this often ignored and crucial issue. 

    “Despite some initial progress,” Smith said, “much more needs to be done to ensure that no woman, man or child in Africa dies or gets sicker because a blood transfusion was unavailable or because the blood itself was riddled with infection.”

    Smith, who chairs the Africa, Global Human Rights, and International Operations Subcommittee said, “this is basic and comes down to addressing two challenges: blood shortages and tainted blood. If we provide leadership and resources the impact on saving lives will be breathtakingly dramatic,” he added.

    Rep. Chaka Fattah (D-PA) testified that of all the “transfusions performed each year in sub-Saharan Africa, as many as half are improperly or untested for infectious diseases.” He added that, “the transmission of infectious diseases such as HIV due to an unsafe blood supply is completely preventable.” 

    At Smith’s hearing on Tuesday, Dr. Nellam Dhingra, Coordinator of Blood Transfusion Safety at the Geneva-based World Health Organization (WHO) said, “the most common cause of maternal death is severe bleeding …in Africa, severe bleeding during delivery or after childbirth contributes up to 44% of maternal deaths. Many of these deaths could be prevented through access to safe blood.”

    Noting that globally AIDS has been responsible for more than 25 million deaths since 1981, Dr. Dhingra said that today “an estimated 40.3 million people are living with HIV with a disproportionate number of 60% -- or more than 25 million as of 2005 --living in Africa.”

    “The risk of HIV infection through unsafe blood and blood products is extraordinarily high -- 95% to 100% -- compared to other common routes of HIV exposure,” Dr. Dhingra said. 

    “Bad blood” Smith said, “is lethal not just due to the transmission of AIDS but other horrific diseases such as hepatitis B and C.”

    Dr. Dhingra however, noted some progress and said, “It can be cautiously estimated that nearly 500,000 HIV infections through blood transfusion are already being averted each year in sub-Saharan Africa through the adoption of simple blood safety measures in voluntary blood donation, blood donor selection and quality-assured testing of donated blood.”

    Several witnesses, Smith said, “underscored the need for more voluntary, unremunerated—unpaid—donors to give clean blood for transfusion.”

    On the scarcity of clean blood in Africa, Dr. Jerry Holmberg, Senior Advisor for Blood Policy and Executive Secretary of the Advisory Committee on Blood Safety and Availability, at the U.S. Department of Heath and Human Services testified that “Africa needs an estimated 14 million units of blood but has only 3.6 million units.”

    In addition to lack of supply, Dr. Holmberg said, “in many Sub-Saharan African countries, blood services are either non-existent or significantly under resourced or lacking the infrastructure and capacity to ensure sustainable operations.” He noted however that President Bush’s Emergency AIDS program “supports the development of integrated strategies for blood safety,” in 14 countries.

    According to Smith, since 2004 Bush’s AIDS plan has obligated more than $106 million in those 14 countries alone.

    Karen Shoos Lipton, Chief Executive Officer of Advancing Transfusion and Cellular Therapies Worldwide (AABB) an organization that has set voluntary standards for accredited blood centers for 50 years testified that “in order to fully benefit African patients, attention must be given to improving transfusion medicine ‘vein to vein’-- from the collection of blood from volunteer donors, to the safe testing and processing of blood components, to the act of transfusing these products into patients.” She noted that technical experts are “limited” in the field and called for “incrementally expanding funding to technical assistant providers.”

    Dr. Caroline Ryan from the U.S. Office of Global AIDS said, “There are significant challenges to developing and maintaining an adequate and sustainable supply of safe blood” and noted the “lack of basic infrastructure which includes such things as consistent electricity, refrigeration, physical structures, and laboratory equipment.” In addition, she cited the “inadequate administrative procedures in place to allow for the purchase and management of blood-related commodities.” She explained that these challenges are further aggravated by the “lack of or inadequate policy around blood safety and the clinical use of blood as well as the lack of “strong health care systems.”