Trends and Projects in Blood Safety in the Former Soviet Union

1. Trends and Projects in Blood Safety in the Former Soviet Union Luke Ifland, President Global Healing, Berkeley, CA

2. Overview History & Geography Reminder Regional Snapshot Global Healing Programs

3. A Brief History Lesson…

5. Soviet Union • Russia • Belarus • Ukraine • Moldova • Estonia • Latvia • Lithuania • Georgia • Armenia • Azerbaijan • Kazakhstan • Uzbekistan • Turkmenistan • Tajikistan • Kyrgyzstan

6. Soviet Union • Russia • Belarus • Ukraine • Moldova • Estonia • Latvia • Lithuania • Georgia • Armenia • Azerbaijan • Kazakhstan • Uzbekistan • Turkmenistan • Tajikistan • Kyrgyzstan The “Triune” (+Moldova)

7. Soviet Union • Russia • Belarus • Ukraine • Moldova • Estonia • Latvia • Lithuania • Georgia • Armenia • Azerbaijan • Kazakhstan • Uzbekistan • Turkmenistan • Tajikistan • Kyrgyzstan Triune+1 The Baltic States

8. Soviet Union • Russia • Belarus • Ukraine • Moldova • Estonia • Latvia • Lithuania • Georgia • Armenia • Azerbaijan • Kazakhstan • Uzbekistan • Turkmenistan • Tajikistan • Kyrgyzstan Triune+1 Caucasia Baltics

9. Soviet Union • Russia • Belarus • Ukraine • Moldova • Estonia • Latvia • Lithuania • Georgia • Armenia • Azerbaijan • Kazakhstan • Uzbekistan • Turkmenistan • Tajikistan • Kyrgyzstan Caucasia Triune+1 Baltics Central Asia

10. Soviet Union • Russia • Belarus • Ukraine • Moldova • Estonia • Latvia • Lithuania • Georgia • Armenia • Azerbaijan • Kazakhstan • Uzbekistan • Turkmenistan • Tajikistan • Kyrgyzstan Caucasia Triune+1 Baltics Central Asia

11. Regional trends

12. Healthcare Legacy of the Soviet Union • Universal coverage: Healthcare as a right • Low technology • Top-down centralization: Moscow  Republic Capitals Oblasts  Municipalities • Large pool of PhDs and MDs • No robust quality system • No professional organizations • Very few platelet transfusions

13. Baltics • Smaller populations (1.2-3.5 million) • Centralized systems • European Union integration • Robust infectious disease screening and immunohematology reference services • Directive 2005/62/EC • 100% volunteer non-remunerated blood donor (VNRBD) base, mobile collections

14. Central Asia • Strong centralization • Low-moderate relative HIV prevalence; High HBV, HCV prevalence • Weak VNRBD base

15. Triune+1 • Centralized, state-run systems • Highest rates of HIV, HBV, HCV in region • ABO/Rh testing on slides • Component therapy, with disproportionate transfusions of plasma derivatives (IVIG, thrombin, albumin) • IRL only at highest levels • Data reporting but no robust quality system at any level

16. Caucasia • High HIV, HBV, HCV prevalence • Centralized, state-run system – “Georgian Exception” • Basically no VNRBDs- no plans • Component therapy, with disproportionate transfusions of plasma derivatives (IVIG, thrombin, albumin)

17. Global Healing Projects in the Region

18. GLOBAL HEALING PROGRAM MODEL

19. Moldova Challenges • No national or institutional quality systems • Outdated compatibility testing methods • No antibody identification • No access to modern scientific/medical journals Successes • Training at 3 main hospitals, national blood center • Implement IS-crossmatch with antibody screen • Establish IRL • Build stronger relationship between Moldova & Romania

20. Ukraine Challenges Solutions Improve interface between levels of government and stakeholder organizations Stimulate university, service and religious organizations Create functioning quality service • Strong regional control, haphazard national regulation • No VNRBDs • No quality systems

21. Georgia Challenges Successes Standards, regulatory framework National & institutional recruitment programs • No standardized methodologies • No VNRBDs

22. Armenia Challenges Successes Establish Gyumri Regional Blood Bank with modern equipment Host transfusion medicine symposium • No blood center operating at international standards • Lack of modern physician guidelines for blood transfusion

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