[Date Prev][Date Next][Thread Prev][Thread Next][Date Index][Thread Index]
AFRO-NETS> Bad Blood (3)
- Subject: AFRO-NETS> Bad Blood (3)
- From: Dieter Neuvians MD <email@example.com>
- Date: Mon, 30 Oct 2000 12:41:14 -0500 (EST)
Bad Blood (3)
WHO press release on blood safety
Following the STERN article posted a couple of days ago by Wilbert
Bannenberg, WHO has issued the following press release:
26 October 2000
WHO RESPONSE TO ARTICLE IN STERN MAGAZINE ON BLOOD SAFETY
The article published today by Stern Magazine under the title "Böses
Blut" (Bad Blood) raises the issue of illegal plasma re-labelling and
trafficking, describing unscrupulous practices including substandard
manufacturing of plasma-derived drugs and their sale for patient use
with dramatic consequences. Police investigations are ongoing.
The World Health Organization (WHO) shares the concerns, which the
article highlights, particularly the importance of ensuring safe sup-
plies of blood and blood products in developing countries. The over-
whelming majority of the world's population (80%) live in developing
countries, yet have access to only 20% of the worlds safe blood sup-
ply. It is for this reason that WHO has identified blood safety as
one of its seven strategic priorities.
It is therefore unfortunate that the Stern article contains a number
of factual inaccuracies about the Zimbabwe National Blood Transfusion
Service (ZNBTS). Apart from calling into question the reliability of
the articles reporting in general, these inaccuracies may jeopardize
global efforts to improve access to safe and adequate supplies of
blood and blood products.
The Stern article challenges the selection of blood donors in Zim-
babwe by describing two prostitutes giving blood. However, according
to information provided by ZNBTS, the Stern article is incorrect. In
each of the two cited cases, its safety measures had been duly ap-
plied and recorded, although confidentiality of the database prevents
disclosure of the details of the handling of the each case.
The article says that approximately one-quarter of all adults in Zim-
babwe are HIV-positive. However, thanks to systematic selection of
possible blood donors in Zimbabwe, only 0.29% of those who pass the
questionnaire and interview selection process are found to be HIV-
positive. The blood of these donors is then rejected. This donor se-
lection process is, thus, a model, which WHO recommends all develop-
ing countries should consider. In addition, all blood donors in Zim-
babwe benefit from pre- and post-donation counselling.
Allusions to inadequate safety standards in Zimbabwe represent a
grave accusation, contradicted by statistical data. It is also unfor-
tunate that this article describes the misuse of a blood donor card
by one prostitute. The blood donor selection process is largely de-
pendent on altruistic motivation as it is based on the truthfulness
in answering a questionnaire. No safety measure in blood transfusion
can yield an absolute zero risk, therefore each and every safety
measure - blood donor selection and donation screening for viral
markers alike - is important for blood safety.
Besides the implied accusations against the ZNBTS, of further concern
is the potential impact of this article on blood safety in Zimbabwe.
Any one who undermines blood transfusion services without clear evi-
dence of their danger is jeopardizing human life by reducing the num-
ber of regular blood donors. It would indeed be tragic if Zimbabwe's
remarkable achievements were to be endangered by an article the in-
tention of which, it is assumed, is ultimately to attempt to promote
improved blood safety. Zimbabwe is one of nine countries in Africa
with a legal framework for the transfusion service, a united national
service providing equitable access to blood products all over the
The article says that Dr Jean Emmanuel, presently in charge of the
Department of Blood Safety and Clinical Technology at WHO, by sheer
coincidence, was the Director of the Zimbabwe National Blood Transfu-
sion Service (ZNBTS) during the period in which the story related by
Stern took place, namely the early to mid-1990s. In fact, Dr Emmanuel
left ZNBTS in 1989 to join WHO. Moreover, under his directorship,
Zimbabwe was one of the first countries in the world to test all do-
nations for HIV, even before France, Japan or the United Kingdom.
Zimbabwe is one of the few African countries that routinely separates
whole blood donations into red cells and plasma. The advantages of
this are that red cells can be stored in an appropriate preservation
medium for a longer period (42 days as opposed to the 35 days stated
in the article) than whole blood, and are more beneficial to the pa-
tient. Approximately 80 000 donations of 450 ml of whole blood are
collected each year in Zimbabwe (and not 80 000 litres, as stated in
the article). Meanwhile, most of the residual plasma from donated
units of blood is not required by patients in Zimbabwe. However,
there is a need for plasma for the manufacture of therapeutic prod-
ucts and for diagnostic use. Zimbabwe does not have the facilities to
manufacture its own plasma derivatives. Most of its surplus plasma is
discarded by incineration. All remaining plasma, exported from Zim-
babwe, has been clearly documented and approved by national health
authorities, with full transparency. The Zimbabwe National Blood
Transfusion Service is operating under a strict quality control sys-
tem and all tests, export documents, etc. can be viewed upon demand.
The Zimbabwe National Blood Transfusion Service is not a semi-private
institution but a nongovernmental, not-for-profit organization, des-
ignated by the Ministry of Health and Child Welfare as the sole or-
ganization in charge of blood transfusion. Therefore its only motiva-
tions are safe blood transfusion and recipient well-being.
In addition, since the beginning of blood transfusion in Zimbabwe,
the blood transfusion centres have always exclusively recruited vol-
untary, non-remunerated donors. This is in sharp contrast with the
majority of developing countries. A wealth of evidence demonstrates
that voluntary non-remunerated blood donation is a cornerstone of
For the reasons mentioned above, the ZNBTS has been designated as a
WHO Collaborating Centre. Indeed, it has recently hosted the first
quality management training course in transfusion medicine.
Further, the Stern article faults WHO for not having ever noticed the
alleged problem with the Zimbabwe plasma exports. Apart from what has
already been outlined above, if any country were to have produced and
marketed unsafe blood products, it is to national authorities to of-
ficially notify WHO.
In the case of Zimbabwe, as ZNBTS is a WHO Collaborating Centre, WHO
has up-to-date information about the nature and quality of the blood
donation practices current in that country and can, as stated above,
reassure anyone who asks of the quality of the country's blood prod-
As for other countries, WHO is working to build an international net-
work for quality management in blood transfusion and will host the
first meeting of the Global Collaboration for Blood Safety in Novem-
For further information, journalists can contact
Mr Gregory Hartl
WHO Spokesperson, Geneva
All WHO press materials and other information can be found on the WHO
Send mail for the `AFRO-NETS' conference to `firstname.lastname@example.org'.
Mail administrative requests to `email@example.com'.
For additional assistance, send mail to: `firstname.lastname@example.org'.