title: Availability, safety and quality of blood for transfusion in the Americas.
abstract: OBJECTIVE
  This article has two objectives: (1) to present for countries and territories of the Region of the Americas data on the number of blood donations, proportion of voluntary blood donors versus remunerated blood donors, coverage of screening for infectious agents, and separation of donated blood into its components and (2) to explore the relationships of those characteristics with economic and organisational factors in the countries and territories.
  
  
  METHODS
  We carried out comparative analyses using population and health information gathered annually by the Pan American Health Organization (PAHO) from national health officials from the countries in the Americas, as well as economic information (gross national product (GNP) per capita) obtained from publications of the World Bank.
  
  
  RESULTS
  There is a direct correlation between the availability of blood for transfusion and GNP per capita. Seven countries with a GNP per capita above US dollar 10,000 per year account for 38% of the Regional population but 68% of the Regional blood donations. Voluntary blood donation is more common in the countries with better blood availability. There is no association between GNP per capita and coverage of screening for infectious agents. Nevertheless, of the six countries with a GNP per capita below US dollar 1,000, only one of the six screens all units for human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B surface antigen (HBsAg). Countries with a higher proportion of voluntary blood donors tend to have lower prevalence rates of infectious markers. Separation of blood into its components is also more common in countries with higher blood donation rates.
  
  
  CONCLUSIONS
  The availability, safety and quality of blood for transfusion in the Americas needs to be improved. As part of that effort, national policies and strategies must be put into place so that the resources already allocated for blood services are better utilised.
authors.affiliation: Laboratory and Blood services, Pan American Health Organisation.
authors.forename: José Ramiro
authors.initials: JR
authors.lastname: Cruz
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Pérez-Rosales
mesh_terms: D000569:Americas; D001782:Blood Donors / Q000600:supply & distribution; D001803:Blood Transfusion; D017848:Blood-Borne Pathogens / Q000302:isolation & purification; D014943:Global Health; D006402:Hematologic Diseases / Q000517:prevention & control*; D006801:Humans; D011786:Quality Control; D012449:Safety; D065227:Transfusion Reaction