In the developed world, most blood is
used in the treatment of older patients.
In resource-poor countries, the majority of blood
is given to children and mothers during childbirth.
Over the past few decades ever-more sophisticated approaches to blood collection, testing and processing has ensured the routine availability of safe blood for all lucky enough to live in countries with successful economies.
Contrast this situation with the developing world. This is a world in which is found 80% of the population but only 20% of the blood supply; a supply that is neither sufficient nor safe.
Focussing on two of the most vulnerable and impacted groups illustrates the devastating consequences of this inequality:
In Sub-Saharan Africa the lifetime risk of a woman dying in labour is 1 in 39, in the developed world it is around 1 in 5,000.
300,000 women die each year during pregnancy. In the most affected countries it is estimated that up to a third or more of these deaths result from severe bleeding for which blood transfusion could be an effective intervention.
Almost 6 million children under age five die each year; that’s 16,000 every day. In poor countries, 1 in 10 children will die before their fifth birthday; in the rich world this figure is 1 in 143.
In the US and other developed countries, the majority of blood transfusions are given to those aged 50 and over; this is reversed in low-resource countries where most blood is used to treat children, who often will need transfusions to combat anaemia arising as a complication of malaria.
Lack of availability of blood certainly contributes indirectly to many deaths, but the key issue affecting children is one of blood safety.
In countries where HIV/AIDS is endemic, and malaria and hepatitis B and C are serious public health hazards, millions of units of blood are transfused without quality-assured testing for blood-borne viruses. For HIV, in contrast to a 0.1%-10% chance of acquiring HIV through sexual contact with an infected partner, or an 11-32% rate of mother-to-child transmission, the chance of acquiring HIV through transfusion of infected blood is almost a certainty; between 99-100%.