For the last two years, the Committee of Blood Donation and Transfusion Stakeholders has been working all out to try and birth a blood transfusion service in the country that is well resourced and sustainable after years of complete dependence on donors.
That task has now assumed emergency proportions with the withdrawal of donor funding, exposing thousands of patients to the double jeopardy of exhausted blood supplies, or being infused with infected blood.
Joseph Wang’endo, the committee chairman, talks about the urgency of legislating for this service and what needs to be done for sustainability in an interview with special correspondent PATRICK MWANGI. Excerpts:
Describe the current situation of blood transfusion services in Kenya.
The Kenya National Blood Transfusion Service (KNBTS) is the arm of Ministry of Health (MOH) mandated to collect, screen and distribute blood to hospitals. However, it requires financial resources to do so.
Lack of adequate resources means less blood is being collected due to frequent shortage of blood bags, lack of vehicles and staff to go out for blood collection drives.
Screening has slowed down due to lack of reagents for automated machines, resorting to falling back to manual screening which is less effective, has a higher margin of error, and poses higher risk exposure to patients.
Why has Kenya been unable to collect adequate blood for its needs over the years?
We have a service that has not been responsive to blood donor’s needs. Instead of reaching out to them, we expect them to reach out to us. We need to take the service to them by establishing donation centres that are easily accessible and conducive.
Psychologically, no healthy person is prepared to go to hospital to voluntarily donate blood, which is where all blood donation centres are located.
What does the country need to do to establish a functional blood transfusion service.
We need a service that is anchored in law, and that has sound management structures and competent board and staff. The Health Act 2017 Section 80(1) has provided for this. Sound policies and guidelines will then be created around this law.
Describe the set-up of the Kenya Blood Transfusion Service as currently constituted.
The service is currently a division of the MOH that has recently been bundled together with organ transplants. The Health Act 2017 clearly distinguishes the two issues, and has separate provision for each.
Why has Kenya been heavily dependent on donor funding for such a crucial service as blood transfusion all these years?
The genesis of the service was the US embassy bombing in 1998. The US government supported the Kenya government in setting up the service, including the physical infrastructure. With the advent of HIV, blood safety became a priority in addressing the scourge.
As such, the US government, under the President’s Emergency Funds for HIV/AIDS Relief (PEFAR), continued to fund the service to the tune of Sh7.2 billion. Sadly, all this time, the Kenyan government didn’t step up, and we were at one point almost 100 per cent relying on donor funds.
Who are the members of your committee, what is the committee’s role, and what has been your contribution to restructuring of the blood transfusion services in Kenya.
The Kenya National Blood Transfusion Service Bill 2019 committee was appointed by stakeholders at a forum convened by the Director of KNBTS and blood service/ transfusion stakeholders on August 2, 2017, to discuss the newly signed Health Act 2017.
The terms of reference for the committee were to review an existing draft bill and ensure the development of a comprehensive Kenya National Blood Transfusion Service Bill in accordance with the provisions of Section 85 of the Kenya Health Act 2017.
This bill has gone through a development process that has had input from the stakeholders. The Kenya National Blood Transfusion Service Bill 2019 has been finalised and is currently in Parliament as a Private Member’s bill with the support of the Health Committee of Parliament.
The Bill has been approved by the Budget Committee and is awaiting to be gazetted ready for debate. Members of the Committee are drawn from public and private hospitals, universities, civil society and government-related agencies.
Are there examples of successful national transfusion services in Africa? What have they done differently?
Zimbabwe, Rwanda and South Africa are examples of highly successful blood services in Africa. In Zimbabwe and South Africa the services are legislated and are self-sustaining, even turning profits.
Rwanda is still highly dependent on donor funding. David Mvere, former CEO at Africa Society for Blood Transfusion (AfSBT), is quoted as saying “The future of sustainable blood services in Africa is only possible through legislation”. —[email protected]
