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We now have a national blood service

About results of four years’ implementation in Russia of the state program of Blood Service modernization, about its further destiny and about a modern “face” of Russian Blood Service.

- Mr Uyba, 2011 is the fourth year of Blood Service modernization program. Could you possibly name the main results of this program at the moment?

- The key result is that we have managed to overcome lack in plasma and blood in clinical institutions. Over these four years medical technologies and equipment in 87 institutions of Blood Service in all 83 subjects of the country plus 15 federal institutions were totally upgraded. By objective indications: the amount of blood procurement rose by 7 %, of plasma – by 6 %. The amount of plasma procured by hardware method – up to 75 %. It’s obvious that the rise in blood procurement is possible only thanks to blood donors. Accordingly the number of plasma donors also went up by 11 %. As a result, in all medical and healthcare institutions the use of plasma also increased (by 6 %). A very important indication is that we now have data from all subjects of Russia on quantity and quality of blood components procured. In case of emergency we can manage those stocks. As we have properly studied the donorship potential in each subject we know what reserve we can count for while calculating the government task. This will be very useful when plasma fractionation lines and the Kirov factory “Rosplazma” start working.

As for today’s situation, each of the Blood Service subject institutions represents a modern establishment equipped on European level and using standardized, universal methods of blood components procurement.

We actively introduced such technologies as virus-inactivation of plasma at large blood transfusion stations. By this we got our colleagues in other regions prepared for the next stage – virus-inactivation of other blood components. It’s very important that we raised the level of equipment, of knowledge and skills of our staff, eventually raising the level of culture of blood and its components procurement in the whole country. Today we are able to talk to our colleagues from Saint Petersburg, Chita, Far Eastern area using the same unified language. This is a tremendous result.

- At IV All-Russian Blood Service Forum you said that we could finally see the “face” of our Russian Blood Service. Does this mean that our Blood Service is different from that in Europe for example?

- You are quite right, it is. When at the very beginning of the program we were saying that we should be guided by western standards we understood that the figure 45 blood donors per thousand people is caused by a need of blood components to produce medications. But we didn’t take into consideration that even so cold “golden standard” of 25 donors per thousand is a result of a large number of high-tech operations performed every year. High-tech heart surgeries in Germany and replacement arthroplasty in France are performed several times more than in Russia. In our country only metropolises as Moscow, Saint Petersburg, Yekaterinburg can go near this rate in such surgeries but not the entire country. The regions with low rate of high-tech operations have all reasons to say that they don’t need more than 16 blood donors per thousand, at least not now. That means that for the first time since the 90s we have had a surplus of plasma. I will say once more, this is given the increased demand by clinics for blood components (platelets, red cells). When we were starting off in 2008 we didn’t realize how much blood components each region needs, but now we do.
Владимир Уйба, Руководитель Федерального медико-биологического агентства

Vladimir Uyba, Head of the Federal Medical-Biological Agency

On the other hand, we are going to intensify blood procurement as our country is in great need of blood based pharmaceuticals especially in albumin. Today in Russia albumin is transfused only in one case out of ten where it is necessary.

- One of the reasons why Russian people didn’t want to be blood donors was a fear of being infected. Have you managed to solve this matter? Which role do issues of safe transfusion play now in Blood Service?

- As for subject institutions I have already said that blood procurement there meets European standards including those of safety. Starting with the second year of the program we have understood that it’s not enough to include in it only subject institutions of Blood Service. Some regions have several blood transfusion stations which collect a lot of blood. Until they were re-equipped and added to a single data base, they use manual methods and the human factor is not ruled out. So the second stage assumes inclusion of such stations into the program. This work should be done in 2012-2014. This means that we will be able to speak about safe transfusion of blood and its components only by 2015.

- To continue the talk about a single data base – when will a person, let’s say, from Far East be able to donate blood in Moscow?

- If it is a regular donor and usually donates blood at the subject station of Vladivostok, for example, then they can donate blood in the capital even today: the system will “see” them. But this donor can also donate blood at the stations that are not in the system yet, so we won’t have complete data. This matter with blood transfusion stations has also to be solved by 2015.

- One of the main components of the program is promotion of mass free blood donation. Which of measures taken during these years would you like to emphasize?

- A lot of wonderful campaigns have been held during these four years and a lot of them have become a good tradition in several regions – “Auto-Motodonor”, “Day of donor’s full age” and others. I would like to focus on the federal campaign which has ended only recently. I’m speaking about musical contest for the best song about donorship and volunteerism “Muzarteria”. The number of people who sent their compositions to the contest is impressive – more than 600, and the scope from Yuzhno-Sakhalinsk to Kaliningrad. But the main thing is the number of compositions. This is a real discovery – all these talented children from regions who care for such social issues like donorship. No doubt, we should continue such projects.

- Which role do you think representatives of public, media and business should play in donation in future?

- I would like to start with business. The example of the FMBA’s partner the company LG Electronics is very significant. In fact, business, as represented by the company, is as full a member of donorship movement as the State itself. LG managed to involve into Donation promotion program famous people and athletes. And it is absolutely great because young people tend to look for idols. In this case, they are imitating star ambassadors and choosing healthy lifestyle and donorship. I would even say that donorship is now a kind of social mission of LG Electronics. This is confirmed by the fact that the example of the Russian branch of the company is followed in Korea and other countries. Of course we are grateful to our other partners who support promotion of voluntary blood donation: “Vester” group (Kaliningrad), the cinema net “Kinomaks” (Krasnodar), Sberbank of Russia (Kemerovo), bank “URALSIB”, OAO (Ltd.) “Saint Petersburg Telecom”, “TELE 2”, and ZAO (close corporation) “StarT-Plus” (Vologda).

And as for the journalists, it is obvious that without them we couldn’t draw attention to this subject, this program.

- The four year program is completed. What happens with Blood Service next?

- As I was saying the program will be continued. Donorship cannot put up with a break. If we shut the program we will sooner or later get in the situation similar to 2006-07. In 2012, 5 billion rubles is allocated for the program. And we will re-equip the stations as we did before – in 2012 there are 19 of them (in 8 subjects of RF). The same stations will be included into single data base. We also will continue the voluntary donorship promotion communication program. The experience gained previously has given us an impulse to initiate two new areas in the program – start of plasma fractionating lines and building of blocks for blood service institutions.

I have already said that concerning the first area we have a task to replace imported pharmaceuticals based on blood components by Russian ones. Given the stock of plasma we have and potential of institutions we are planning during two years to launch in 12 Russian subjects modern plasma fractionating lines, meeting GMP standards: in 5 subjects next year and in 7 in 2013. The calculation was made taking into account the neighbor regions which will also supply input – plasma – to the establishments where the lines for its procession will be started on. These regions “in return” will get albumin.

The second area is explained by the fact that about 40 buildings which host Blood service institutions today do not comply with public health regulation and fire safety. Should I say that expensive equipment is very difficult to mount in such buildings? The FMBA’s experience of building a block for Blood Center in Lermontovo which works successfully and 2 other projects in Karachai-Cherkess and Sochi (delivery is planned for 2012) allows us to consider this way as the best salvation. Implementation of this area is not possible without the region participation: the subject is responsible for creation of zero circle. As a result of realization of all areas of the program the country will have its own Blood Service with qualitative working conditions and blood procurement, and optimal quantitative indications.

Interviewer – Svetlana MARCHENKO
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