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119 countries critically short of blood


*First global analysis reveals low-income African nations were 100m units deficient
The world is in the midst of a critical shortage of blood essential for life-saving transfusions, researchers have warned.

A global report showed 119 out of 196 countries – mainly in Africa, Oceania and south Asia – do not have enough supply to meet hospital demands.

Those nations combined are more than 100million units of blood short of World Health Organisation (WHO) targets. They are all middle-to-low-income.

The WHO recommends countries have at least 10 donations per 1,000 people. But in Africa, 38 countries collect fewer than that target, researchers estimate.

South Sudan was found to have the lowest supply of blood at just 46 units per 100,000 people.


Researchers said the African nation’s need for blood was 75 times greater than its supply.

The scientists found India had the largest absolute shortage, with the country experiencing a shortfall of nearly 41million units.

They say more investment needs to be made in low and middle-income countries to expand national transfusion services.

Transfusions save millions of lives each year and replace blood that is lost through surgery or injury or provide it if your body is not making blood properly.

Patients may need a blood transfusion if they have anaemia, sickle cell disease, a bleeding disorder such as hemophilia, or cancer.

Developing countries rely on these transfusions due to a higher prevalence of blood-borne diseases and complications during pregnancy.

More than 100 million units of blood are donated each year to these nations, which make up 80 per cent of the entire world’s population.

High-income countries, home to just 16 per cent of the global population, bear the burden of this, providing 42 per cent of the blood in developing nation’s banks.

For their study, researchers from the University of Washington looked at the WHO Global Status Report on Blood Safety and Availability for every country in the world.

To estimate the total blood needs of any one country, the researchers calculated how many units of blood would be needed for 20 different medical conditions.

Taking into account their prevalence by region, the team then estimated the gap between supply and demand in each one of these nations.

They then cross referenced this with data from the WHO Global Status Report on Blood Safety and a 2017 Global Burden of Disease study.

The team based blood usage rates using United States (US) inpatient practices.

They note this may underestimate the true blood needs in developing countries where tropical diseases, Sexually Transmitted Infections (STIs) and malaria are far more common than they are in America.

But they say these initial findings give health bosses a rough estimate which can help them prepare for the future.

Their findings, published in the journal The Lancet, revealed every single country needed more blood than the WHO goal.

The team of academics calculated total blood supply around the world was around 272million units.

But with demand being 303 million units, the world was 30 million units of blood short. In the 119 countries with insufficient supply, that shortfall reached 100 million units.

And, with exponentially increasing populations and greater access to hospital care, demand is only going to increase, the researchers say.

Lead author Meghan Delaney, from the Children’s National Hospital in Washington, said: “As more people are able to access care in low and middle income countries, the demand for blood transfusions will increase further.

“And – without financial, structural and regulatory support – will widen the gap we’ve uncovered between global supply and demand of blood.”

Co-author Christina Fitzmaurice, a professor in haematology at the University of Washington, added: “Other studies have focused on blood safety, such as the risk of transmitting infections such as HIV.

“But ours is the first to identify where the most critical shortages lie, and therefore where the most work needs to be done by governments to increase donation, scale-up transfusion services, and develop alternatives.”

Writing in the study, the authors conclude: “Strategic investments are needed in many low-income and middle-income countries to expand national transfusion services, blood management systems, and alternatives to blood transfusions.

“There is a large unmet need for more government support, financially, structurally, and through establishment of a regulatory oversight to ensure supply, quality, and safety.”


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