AIDS prevention is thicker than blood. Zimbabwe

Abstract

Usually, giving blood is generous. Sometimes, however, it is lethal. In countries such as the US, India and Brazil, where blood donors can get paid by the pint, drug addicts, street dwellers and others who have little to sell except their bodies flock to for-profit blood centers. Many of these people carry the AIDS virus. A survey in the Indian state of Maharashtra revealed that 27% of blood donors tested positive for AIDS antibodies--a slightly higher rate than the same survey found among prostitutes. If 1 private blood bank tests for AIDS antibodies and turns HIV-positive volunteers away--forget about treating them--those poor and desperate enough can often find another, less scrupulous clinic. Or a clinic that doesn't do the testing properly. Although the 1988 Brazilian constitution banned the sale of blood, private clinics continue to flourish and nobody knows whose veins the blood is flowing from. The inevitable result is a frightening rate of contamination. An estimated 85% of Brazilian hemophiliacs have become infected with the HIV virus by contaminated blood or blood products. Even in countries that eschew blood sales and rely on donated supplies, the danger of HIV contamination is still present. HIV infection often does not generate antibodies for weeks; sometimes months or even years. In many 3rd World communities without adequate equipment, blood storage is impossible. The cost of testing emergency donations is so high that the choice may be narrowed--either go without testing or do without blood. Despite all these obstacles, Zimbabwe has shown that a 3rd World country where public health care takes precedence over private profit can make the blood supply network a force for reducing the spread of AIDS rather than increasing it. All blood donations in Zimbabwe were voluntary even before AIDS became an issue. When AIDS was accorded recognition as a serious issue, the country had no clinic for HIV testing. Concerned with the rapid spread of AIDS among the general population, the National Blood Transfusion Service (NBTS) began testing in 1985. Zimbabwe was the 3rd country in the world to begin routine testing. The NBTS is a nonprofit organization headed by representatives from the ministry of health, the Red Cross, and private donors. Because the NBTS was the only group in the country testing blood, many people who suspected they might be infected volunteered to donate blood just so they could have the test. Unfortunately, their suspicions were often justified. The service has found that regular donors now have a far lower incidence of HIV-positive since 1989, when alternative testing services were opened. Analysts believe much of the credit goes to the AIDS counseling given before each blood donation. Each individual is interviewed by a nurse who takes a comprehensive medical history. The education session also includes how AIDS might be contracted. The NBTS quickly discovered that the incidence of HIV antibodies was far lower among students aged 17-19. Since then, the service has thrown much of its resources into school blood campaigns. The service has also opened 5 new collection branches, 1 in each province. Samples from each donation are sent to 1 of the 2 national centers for testing. AIDS is still spreading in Zimbabwe, but thanks to the efforts of NBTS, hospital patients can feel secure.