South East Asia faces severe shortage of safe blood
South East Asia accounts for
25% of the world's population
but collects only 9% of the
world's blood supply, with the
result that it faces a serious
shortage of blood. It collects 7
million units a year but needs a
total of 15 million units.
The problem is further compounded by inappropriate use
of blood without separation into
its components, with 80-85% of
blood being used as whole
blood, according to Dr Neelam
Dhingra-Kumar, medical officer
in the blood transfusion safety
division of the World Health
Organization (WHO).
If blood was used more
appropriately, the number of
transfusions could be brought
down by 30%, says the International Red Cross.
The Supreme Court in India
banned the use of blood from
professional blood sellers
because they were considered a
high risk group for HIV. However, these sellers now claim to
be family members of patients
needing blood, when in fact
they are being paid to donate,
said Dr Dhingra-Kumar. With
only 61% of blood from voluntary donors, the situation
remains grim.
"Up to 30% of blood in India
comes from commercial sources,
and some proportion of this is
still untested," said Geoffrey
Dennis of the International Red
Cross. Private commercial blood
banks, often offering unscreened
blood, are allowed to flourish in
both Bangladesh and Pakistan
because these countries do not
have any national blood policy.
The quality of screening is also
not always to the desired level in
the entire region, warned Dr
Dhingra-Kumar.
Mr Dennis is also worried that
despite the fact that hepatitis C is
a serious threat, the virus is not
tested for in India, not least
because it would add to the costs.
In the screened blood in the
region the seroprevalence of
hepatitis B is 0.06-8.5% and of
hepatitis C is 1.2-3%, according to
the WHO. In certain other countries, it is still higher. In Islamabad, Pakistan, testing results in 1998 showed that 8.1% of blood
was infected with hepatitis C.
India embarked on upgrading its poor blood banking system in 1992 with a World Bank
loan of $84m (£53m) for the
AIDS-I project. The country currently has four million HIV positive people, and the government has secured another loan, of
$191m, from the World Bank
for its AIDS-II project.
Five to 10 per cent of HIV infections in South East Asia are transfusion induced.
Rohit Sharma, Bombay
studentBMJ 2000;08:131-174 May ISSN 0966-6494
