- NEW YORK (Reuters
Health) - A combined fear of disease and lawsuits have led most wealthy
developed nations to adopt a "zero tolerance" policy regarding
HIV contamination of the blood supply, researchers have found. But 10%
of all new HIV infections in developing countries, they say, are now due
to transfusions of tainted blood.
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- Meanwhile, governments of these developing nations are
struggling to develop and enforce measures to make their blood supplies
safer.
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- "In the developed countries I think the blood supply
situation is well handled," said study co-author Dr. Charles Bennett
of Northwestern University in Chicago, Illinois. "But in the developing
countries it's a completely different story. It's just a tragedy."
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- Bennett and his colleagues reviewed over 20 years of
blood safety records, testing standards and legislative histories in several
developed countries, including the US, France, Great Britain, Japan, Canada
and Germany, and developing countries including India, Pakistan, China,
Vietnam and Thailand.
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- The research team found that in developed nations the
initial lack of coordination among competing public health agencies has
for the most part given way to an increasingly centralized process for
blood screening for HIV, hepatitis C virus (HCV) and other infectious diseases.
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- They note that recent criminal investigations have revealed
that in most nations the organizations responsible for blood safety made
many mistakes when the AIDS epidemic began in 1981. Delays in recognizing
the risks and implementing adequate testing resulted in thousands of HIV
infections among hemophiliacs who received tainted transfusions.
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- The investigators found that more than 20 developed nations
have acknowledged such mistakes and have provided financial compensation
to victims and their families. And in their report published in the Annals
of Internal Medicine, Bennett's team concludes that cutting-edge screening
technology has made the risk of such infections extremely low today.
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- But the authors paint a very different picture when it
comes to blood safety in the developing world. Upwards of 45% of all blood
donations in poor nations go unscreened for HIV, HCV or hepatitis B, they
note. Such donations, the researchers say, are directly responsible for
the infections of hundreds of thousands of transfusion recipients.
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- Bennett and his colleagues note that as recently as 1996,
roughly 95% of the blood supply in India was deemed unsafe. And they point
to the problem of paid blood donors, who supply a major portion of the
blood pool in many developing nations. These donors, the authors note,
have an incentive to donate as much and as often as possible regardless
of their health status.
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- China is particularly vulnerable, they point out; 60%
of that nation's blood supply comes from paid donors. The researchers observed
that HIV infections in China often result from the use of old needles to
draw blood, as well as the mixing of multiple donations and readministration
of the potentially tainted blood to donors so they can give blood again
more quickly.
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- "The China story is really one of the most tragic
stories you can identify," Bennett told Reuters Health. "And
at the end of the day it could be hundreds of thousands who become infected
with HIV."
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- Bennett stressed that countries that have achieved a
safe blood supply need to reach out to help those who have yet to do so.
"The blood supply system in the developing countries need a partnership
with richer nations to develop the infrastructure," he said. "They
just can't do it on their own."
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- SOURCE: Annals of Internal Medicine 2002;136:312-319.
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- Copyright © 2002 Reuters Limited. All rights reserved.
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