Supporting the National Blood Transfusion Service in the Implementation and Expansion of Blood Safety Activities in the Republic of Zambia under the Presidents Emergency Plan for AIDS Relief (PEPFAR)

Applicants Eligible for this Grant

Others (see text field entitled "Additional Information on Eligibility" for clarification)

Additional Information on Eligibility

The ZNBTS is a statutory board under the MOH and the only institution mandated to ensure efficient and effective implementation of the national blood safety strategy. Since August 2004, ZNBTS has been implementing the PEPFAR funded "Rapid Strengthening of Blood Transfusion Services Program ", a national program aimed at scaling-up safe blood transfusion services to ensure efficient, effective, equitable, and affordable access to safe blood and blood products throughout the country. The project is supported by PEPFAR, with a five year grant scheduled to end in March 2010. In Zambia, screening of blood for HIV, prior to transfusion, started in 1986 with technical and financial support from the World Health Organization (WHO). Under this program, a total of 33 blood screening laboratories were established, where blood was screened for HIV prior to transfusion into patients. However, these centers primarily focused on HIV screening only, without testing for the other transfusion transmissible infections (TTIs). Since 1988, Zambia identified the need and commenced the implementation of a comprehensive blood safety program, founded on the WHO guidelines for the establishment of national blood transfusion services. This program places an emphasis on: 1) Promotion of dependency on regular repeating VNRD from low-risk population groups, particularly regular repeating donors; 2) Development and application of stricter criteria for selection of blood donors; 3) Mandatory laboratory screening of blood for HIV, Hepatitis and Syphilis; 4) Application of appropriate technologies, methods and standards for laboratory screening and processing of blood; 5) Promotion of appropriate methods for clinical use of blood, so as to reduce blood transfusions to a bare minimum; 6) Development of appropriate national policy and legal framework to guide blood transfusion practices; and 7) Establishment of appropriate nationally coordinated blood transfusion system, with strong government support. Implementation of this strategy has been significantly accelerated by the commencement of PEPFAR support, which has already started making a significant positive impact on blood safety in Zambia. Achievements since the commencement of PEPFAR support include: - Increasing the number of blood units collected annually from 38,477 in 2004 to 90,049 at the end of March 2009; - Reduction in HIV prevalence among first time blood donors from 6.0% in 2004 to 3.8% in 2009; - ZNBTS has successfully carried out an interim reorganization and streamlining of functions. This has led to stronger and more effective national coordination, reduction in the number of facilities involved in blood collection and laboratory screening of blood, and redefinition and allocation of functions at all the levels of the blood transfusion system; - Systems strengthening in infrastructure and equipment. Various protocols and standard operating procedures have been developed and/or updated further enhancing blood safety program at every stage of the blood transfusion process; - Enhancement of the NBTS technical and managerial capacity to ensure strong national and international leadership; - Strengthen quality assurance with the introduction of external quality assessment schemes for all the blood transfusion centers, on HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV). The NBTS is the only eligible applicant that can apply for this funding opportunity due to their unique position as the official national service provider and policy advisor for safe blood collection and transfusion practices under the MOH. It is also the only entity in the Republic of Zambia that provides blood transfusion services and is capable of executing the objectives of this agreement, as exemplified by their quality of services, long history of leading this technical domain within the country working with international donors such as PEPFAR. Supporting the NBTS is furthermore consi

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