Assuring a safe and adequate blood supply in developing nations such as emerging markets is a daunting challenge that directly affects fundamental health metrics of a country. Numerous mortalities can be reduced when an effective national blood transfusion system is in place including leading causes of death such as maternal hemorrhage, sickle cell anemia, and malaria. There exists a circular relationship between blood supply and safety: efforts to ensure donor and recipient safety reduce the population of eligible voluntary blood donors, which in turn restricts blood supply. In this article we describe the main issues for blood supply in developing nations and emerging markets, identify the major causes and impact of transfusion transmitted infections, present a safety model that describes the relationship between defensive barriers in depth to assure safe blood, its effectiveness, and the impact it has on safe blood supply. We use twenty two nations in sub-Sahara Africa to present the safety model. Finally, we discuss strategies for blood safety and supply in developing nations.
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