'WHO Action Framework to advance universal access to safe, effective and quality assured blood products: how far are we?'

ABSTRACT

In response to the recommendations of WHA63.12 (2010) resolution on availability, safety and quality of blood products, the World Health Organization has steadily implemented numerous initiatives over the years to assist countries in building and strengthening their national blood systems, although with uneven success. In February 2020, WHO has developed the WHO Action Framework to Advance Universal Access to Safe, Effective and Quality-Assured Blood Products 2020-2023, which proposes a renewed effort to scale up programme implementation and improve access to blood products. The Framework aims to provide strategic direction to global efforts to address barriers to safety and availability of blood products and focuses on six strategic objectives: (1) an appropriately structured, well-coordinated and sustainably resourced national blood system;(2) an appropriate national framework of regulatory controls;(3) functioning and efficiently managed blood services;(4) effective implementation of patient blood management to optimize clinical practice of transfusion;(5) effective surveillance, haemovigilance and pharmacovigilance;and (6) partnerships, collaboration and information exchange to achieve key priorities and jointly address challenges and emerging threats at global, regional and national levels. During 2020-2021, to achieve these strategic objectives, some activities have been conducted, in the form of development written guidance as well as country assistance. Guidance on Centralization of blood donation testing and processing, and guidance on Increasing supply of plasma-derived medicinal products (PDMPs) in LMICs through fractionation of domestic plasma;Education Module on Update clinical use of blood and Policy Brief on the urgent need to implement Patient Blood Management have been published and disseminated through webinars. To assist country in implementation of WHO guidance, webinars on strengthening blood system through effective blood regulation, online training on haemovigilance system and on self-assessment using the Global Benchmarking Tools plus Blood have already been conducted. Assistance has also been given to Egypt in developing a plan for plasma fractionation. Some challenges to implement the action framework at country level still exist, for example, weak government support and commitment to the blood program, limited resources, and the Covid-19 pandemic, which hinders holding face to face meetings which are still effective for some activities. Currently some guidance is under development, and the Achilles Project, which is a WHO project to assist country in improving quality of their plasma for fractionation, will be run in Senegal, in collaboration with the International Coalition led by ISBT. As soon as the Covid-19 pandemic situation allows for face-to-face meetings, country assistance in the form of training, country visit for assessment and twinning program will be increased, to accelerate implementation of the action framework at country level.