I’ve written about universal health coverage (UHC) before in the context of what’s covered under UHC in one country is not the same as another [Universal health coverage gains momentum in 2016] although there are agreed basics, the essential health services to deliver “health for all”. The World Health Organization is focusing its efforts on supporting countries moving to UHC, and keeping the pressure on by running high profile events throughout 2018 on UHC beginning with World Health Day, April 7th.
Copyright: James Meiring. Winner HIFA Photography award 2016
What do wellington boots drying in the African sun have to do with blood donation in the post-Ebola era? Tell you later.
But first, as its World Blood Donor Day on June 14th, lets consider the differences between the blood transfusion services in a high income country like the UK with those in Nigeria or Sierra Leone? How has the Ebola epidemic impacted on these services?
Blood transfusion services in the UK
I think we in the UK probably take our well-established national blood service(s) somewhat for granted and only really give it a second thought when either we need to call on its use or something drastic goes wrong.
Established in 1946, the Blood Transfusion Service (BTS) in England and Wales employs over 6000 people to collect & process the blood alone. All sorts of rules and practices surround the preparation and distribution and use of that blood. We are very fortunate that over 3% of people in the UK donate that blood (1% being the figure recommended as a minimum by the W.H.O. to meet a populations needs) but even then we get regular appeals for more blood and we still suffer shortages for particular blood groups and platelets.
But, have you ever asked yourself why we need continuing fresh donations of blood and who are the usual recipients of that blood?
In 2014, in England & Wales, the 3 major “consumers” of blood were:
- 67%, to treat medical conditions including anaemia, cancer and blood disorders
- 27%, in surgery, including cardiac surgery and emergency surgery
- 6%, to treat blood loss after childbirth
The most frequently transfused patient group is over 65 years of age.
100% of the blood donated is voluntary. This is important, as the W.H.O. has declared that the foundation of a safe blood supply is 100% voluntary donation. Blood obtained this way has lower rates of infections and so reduces chances of disease transmission via blood or blood products.
How does this compare with a blood transfusion service in West Africa ?
Traffic congestion is a public health issue. It increases air pollution which is a known cause of asthma, lung cancer and cardiovascular diseases, and in particular creates "hotspots" of low air quality borne by local residents. It increases the risk of traffic accidents through poor driver behaviour and judgement.
One morning last week, I was stuck in a traffic jam several miles long on the A40 outside Oxford, caused by the super-duper high-flow-thru roundabout at Headington being brought to a halt by roadworks eliminating one lane on one exit and a traffic light failing on another!
Those of you who commute to Oxford will pick up my ironic tone: we have had to endure doubling of commuting times & traffic jams for the past 2 years as Oxford has “improved” each roundabout by turn around the ring road!
Philosophical (I wasn’t going anywhere fast), I found myself wishing the clock turned back to a time when most people lived and worked in the same town, and then I moved on to wishing for a reality where “pass me the floo powder and where is the nearest fireplace?”[Harry Potter], or “beam me up scotty!” [Star Trek] were actual options. These options would improve my quality of life, my health, and my climate. And of course everyone else’s.
It was also not lost on me, in that traffic jam, that this month [March 2016] my colleague and I had made Air Pollution the theme for our free electronic public health newsletter (to receive this, sign up here Global Health Knowledge Base).
I had just written a blog on air pollution caused by traffic jams in India, China, and why it’s the particulates, released by soot & fuel, that we measure for air quality & health. In the blog, Air pollution, can we reduce the impact of cars on urban air quality? , I had hoped that emerging economies were going to learn from the mistakes of the UK and other “developed” countries. And there I was in the mistake.
I recently attended the International Sugar Organization’s annual conference in London, hoping to hear Dr. Francesco Branca of the World Health Organization explaining the rationale for the WHO’s recommendations on how much sugar people should eat, and see what response he got from the assembled sugar industry representatives and how he responded to that. As a reasonably independent observer (CABI publishes Sugar Industry Abstracts, but does much work on nutrition and health as well) I was looking forward to this. Unfortunately, however, he didn’t turn up due to other commitments, and sent a video presentation instead.