Research published in The Lancet Haematology has revealed a large gap between blood supply and demand in developing countries around the world. Looking at data from the World Health Organization and University of Washington’s Institute for Health Metrics and Evaluation, study authors evaluated transfusion needs and stores of blood products in 180 countries. Of these, 107 did not have enough blood to meet their needs. India had the greatest overall deficit, with a shortage of 41 million units.
South Sudan had the largest discrepancy between supply and demand, with a need 75 times greater than its resources, primarily due to a six-year civil war that has eroded its health care system. In Africa overall, only one country – South Africa – did not have a shortage.
Each country also faces unique issues related to its own public health challenges, disease profile, and how much blood is needed to treat each of those diseases. For example, some countries might deal with more cases of malaria, liver disease, or inherited blood diseases such as sickle cell, which require more blood products. Even countries with sufficient supply may fall short in special cases, like natural disasters or mass shootings.
Beyond emergency situations, shortages also impact treatment for chronic conditions such as cancer and HIV. “There’s a massive blood deficit in low- and middle-income countries, and what’s happening is that practice is being driven accordingly,” Evan Bloch, MD, a pathologist at Johns Hopkins Bloomberg School of Public Health, told NPR. “If you look at a high-income country like the U.S., oncology would be a major user of transfusion. But [in lower-income countries,] they simply don’t have the capacity to manage the bulk of oncology.”
Source: Roberts N, James S, Delaney M, Fitzmaurice C. The global need and availability of blood products: a modelling study. Lancet Haematol. 2019 October 17. [Epub ahead of print]; NPR, October 22, 2019.