AABB CEO Urges Congress to Support Improvement of Blood Safety in Africa

Testifying June 27 before the House Committee on International Relations Subcommittee on Africa, Global Human Rights and International Operations, AABB CEO Karen Shoos Lipton, JD, urged members of Congress to extend blood safety funding provided by the President’s Emergency Plan for AIDS Relief (PEPFAR) beyond the current March 2010 deadline.

Although the 14 PEPFAR focus countries and the technical assistance providers working with them have made progress, the barriers to creating sustainable blood safety programs in these developing African and Caribbean nations are substantial. Building the infrastructures and systems necessary to support these fledgling programs requires an incremental, long-term approach, said Shoos Lipton.

While the need to improve blood safety and availability in the PEPFAR countries and in all of Africa is “urgent and requires a powerful response,” Shoos Lipton told the congressional subcommittee that a 10-year commitment is necessary to ensure that PEPFAR focus countries working with AABB will be able to institute the appropriate foundations for their blood safety systems. “Sustainable blood safety and availability, unlike some other PEPFAR tracks, relies on infrastructures that do not exist or are, at best, weak,” she said, adding that an expansion in PEPFAR funding should be well-organized and deliberately phased so that it recognizes the capacity-building nature of the PEPFAR blood safety program.

Currently, AABB serves as the technical assistance provider for blood safety in six of the 14 PEPFAR focus countries, and Shoos Lipton has witnessed firsthand the challenges that these nations face. “Poor roads, unreliable electricity and water, and seasonal flooding that makes some parts of these countries inaccessible at certain times of the year are a serious threat to keeping blood safe for transfusion,” she said. 

In addition to fixing basic infrastructure problems such as lack of electricity, the PEPFAR focus countries also must build a human resources infrastructure — a system that provides a continuous source of appropriately trained and educated personnel to work in the countries’ blood centers. “In each country there are a handful of individuals who are qualified to manage a national blood program. In many cases, these individuals are so busy attending meetings that it is difficult to achieve the real work of changing the system,” explained Shoos Lipton. “The sad truth is that providing greater levels of funding without dealing with this serious limitation on capacity is simply not responsible.”

A lack of appropriate curricula, qualified teachers and equipment in medical and technical schools hinders efforts to bring qualified workers into blood centers in the PEPFAR focus countries, which also suffer from cumbersome hiring and procurement systems that involve lengthy processes related to obtaining government approval. “We are working with our PEPFAR focus countries to change their systems so that their blood centers have greater autonomy to obtain both the human and capital resources they need in a timely manner,” Shoos Lipton said.

AABB is also attempting to build “bridges and bonds” between the PEPFAR focus countries and others in an attempt to foster support systems and spur the cross-pollination of ideas. One of the association’s recommendations to Congress is to add non-PEFAR focus countries to an organized blood safety improvement program — in an incremental and sustainable manner.

“Blood is a critical health care infrastructure,” said Shoos Lipton, adding that the development of sustainable blood safety programs in the PEPFAR focus countries can serve as a mechanism for reducing transfusion-transmitted disease and bringing needed technologies to patients in these developing nations. First, however, the countries must build the infrastructures that can provide the platforms for growth, and this requires an expansion of the PEPFAR blood safety program.

Other blood safety experts also testified at the hearing. Noting the particularly high incidence of HIV and other diseases in Africa, U.S. Rep. Christopher Smith (R-N.J.), the chairman of the subcommittee, spoke on behalf of his committee in noting that support for blood safety initiatives in Africa was clearly warranted. Another leading advocate for blood safety in Africa, U.S. Rep. Chaka Fattah (D-Pa.), testified that Congress as well as the U.S. and international health community need to address the problem with greater urgency.

To read Shoos Lipton’s testimony in its entirety, visit the AABB Web site www.aabb.org under “News and Media > Latest News.” Testimony from the other witnesses can be found at wwwc.house.gov/international_relations/afhear.htm.