(P-PH-9) Universal Health Coverage and Essential Medicines: Impact on Blood Availability and Safety in Resource Restricted Countries

Background/Case Studies: Despite the many blood safety initiatives and projects since the first World Health Assembly (WHA) Resolution WHA28.72 (1975), there are still remarkable differences in blood supply and safety among countries in different Human Development Index (HDI) groups. There is definitely progress, but more on the operational side than on organization, legislation, governance and leadership, and financing of the blood supply and clinical use. The latest WHO Global Status Report on Blood Safety and Availability 2016 based on data collected through a Global Database on Blood Safety linked survey shows weaknesses in five areas – availability; quality & testing; clinical use; policy, legislation & governance.

Study

Design/Methods: Three UN/WHO recent documents were reviewed and analysed as basic sources of information: WHO Global Status Report on Blood Safety and Availability, 2021; UN Universal Health Coverage (UHC) 2010 & UN 2012 Resolution 67/81; and WHO Guidelines on Management of Blood & Blood Components as Essential Medicines (EM), 2017. Impact on Blood System development in low and medium income countries (LMIC) was observed – MoH (governance), blood supply and clinical use.

Results/Findings: WHA Resolution 63.12 (2010) was adopted expressing serious concerns because large groups of patients in LMICs still have no access to safe blood and blood products, including plasma derived medicinal products (PDMP) as listed Ems (1979. During the step-up period of the UN Sustainable Development Goals (SDG) 2016-2030, a UN Resolution 67/81 (2012) on Global Health and Foreign Policy was adopted. All Member States agreed to work towards achieving UHC by 2030 as part of SDGs. This includes appropriate access to affordable and quality-assured EMs as listed in the WHO Model List since 1977 (biannual updates). In 2013, blood and labile blood components were included as EMs. WHO developed clear supportive guidelines for implementation (2017) urging Member States to take appropriate actions to ensure access for all to safe blood and blood components. In and medium income countries low modest progress has been observed in implementing the WHO guidelines and in moving towards the goal of UHC in this regard – availability and safety.

Conclusions: Implementing UHC and EMs effectively at national level, lives of hundreds of millions of people will be influenced in a positive way, leading to important improvement of quality and efficacy of the healthcare system in many LMICs. However, much remains to be done. Ensuring appropriate access to affordable and quality assured blood and blood products through a well-organized and regulated Blood System strengthening UHC and SDGs targets and should be given consideration by all stakeholders working toward achieving these targets.

Importance of research: UHC is part of the Sustaibanle Development Goals 2030 and EMs are essential for the clinical transfusion practice and should be accessibel to tghose in need. Implementation at National level should be mandatory to achieve availabiklity, accessability, safet and quality in gthe transfusion medicine practice in everyuntry, specifically in the LMICs.