Blood Transfusion Services in Uzbekistan

1. Blood Transfusion Services in Uzbekistan Professor Dr. H.Y. Karimov Research Institute of Hematology and Blood Transfusion of the Ministry of Health, Republic of Uzbekistan, Tashkent

2. Republic of Uzbekistan • Territory- 447,45 (thous. square km) • Population- 26867,8(thous.)

3. At present there are 21blood transfusion stations and 221 departments of blood transfusion at therapeutic-prophylactic structures functioning in the republic. 463medical doctors and 1093nurses of themedical personal are working in the system of blood transfusion services.

4. PROBLEMS • Decrease of numbers of voluntary non-remunerated blood donors • All existing blood banks of the republic do not correspond to international standards and requirements • Out of date methods and equipment are used

5. The government of the republic is paying great attention to the improvement of blood transfusion and hematological services. A Decree issued by the Cabinet of Ministers N 242, 5th of July of 2004 «Measures for the Implementation of Priority Directions to Improve Medical Culture in Families, Maternal Health, Birth and Healthy Population Education”, a DecreeN 515, 2nd of November of 2004 «On measures of the realization of the project “Strengthening of the health of women and children” with the participation of the Asian Development Bank». On 19th of September of 2007 the President of the Republic has signed an Order№ UP-3923«About the main directions of the reform and further realization of the state program on health care development» and in order to improve the organization of the management and increase the efficacy of medical bodies on the 2nd of October, 2007 there was an Order N PP-700 “On measures on the improvement of the organization and the activities of medical structures of the republic”.

6. In order to provide blood safety from blood transmission infections (hepatitis B and С, HIV/AIDS) several documents, which regulate the blood transfusion centers’ activities in the republic, were published. • A Law of the Republic of Uzbekistan“On donations of blood and its components”, 30 August, 2002; • A Decree of the Chief State Sanitary Doctor of the Republicof Uzbekistan N 42 on 22 of December, 2004 “On the provision of the safe donor blood and blood products in the republic of Uzbekistan”; • An Order of the Ministry of Health N 251 on 7th of June, 2006 “On the confirmation of the norm documents on blood donor services in the republic”.

7. An Order of the Ministry of Health N88 on 22 February, 2007«On confirmation of the indications for the transfusion of blood and blood products in the therapeutic-prophylactic structures”; • An Order of the Ministry of Health N162 on 12 April, 2007«On the regulation of the activities of blood transfusion centers for the provision of safe donor blood and blood products”; • An Order of the Ministry of Health N180 on 27 April, 2007“On creation of the Transfusion Committee on clinical use of blood at the Ministry of Health”. A draft of the Decree of the Cabinet of Ministers “On the improvement of blood donor services and measures on non-renumerated blood donations in the Republic of Uzbekistan” upon the confirmation of the concept of blood donor services development of the Republic of Uzbekistan and the Program of measures for the non-payment donations and blood donor services in the Republic of Uzbekistan for the period 2008-2011 was prepared.

8. Currently measures for the improvement of the blood donor system and an implementation of a national blood donor system, based on the principles of centralization, are carried out. In order to regulate the activity of the blood donor services in the transition phase and to provide the safety of the donor blood an Order of the Minister N162 on 12 April, 2007 “On regulation of the activity of blood donor centers to provide a safe donor blood and blood products” was issued.

9. At present a “Program of measures on non paid blood donations in the Republic of Uzbekistan” in the sphere of development of blood donations is developed and on 31st of January, 2008 it was signed by the Cabinet of Ministers. The Program is correlated with 14 Ministries, public organizations and foundations. It is important to coordinate the work with the population through a well organized staff. A draft of the decree of the Cabinet of Ministers “On confirmation of the regulation about a chest brooch «Uzbekiston Respublilasi Fahrij Donori” (“Honorary Donor of the Republic of Uzbekistan”) is prepared.

10. Measures planned in the frame of the Program on non-paid donor system in the Republic of Uzbekistan. • Creation (organization) of a club and youth organizations on the propaganda of non-paid donations among the young people, students and fellows of education centers, as well as educational activities at the centers of the society “Red Sickle” to promote ideas of humanism and charity among young people. • Creation of voluntary human resources in high, medium-special and professional schools and in the divisions of the Ministries of Defense, Internal Affairs and Extreme Situations.

11. creation of donor corners in high, medium-special and professional-technical schools. Preparation and publishing of a set of materials on non-paid blood donors. • organization of information educational program on non-paid blood donor among students of high, special and professional-technical schools, introduction of a competition for the best poster, best corner, best team, sport championship and other kinds of agitation work. • organization of seminars, lectures, discussions, amusement shows (including those on television, radio) about blood donations and related themes.

12. organization of a competition for the best poster, flyer, brochures, caps, etc on the themes of non-paid donors. • celebration on 14th of June, the international day of blood donor each year, stimulation of long-term blood donors and active people who work on the donor propaganda. Organization of some measures, dedicated to the “Day of Blood Donor” on 14th of June in academic schools and professional colleges. • organization and carrying out of seminars and competition entitled as “Help your friend”, “Your blood will give life for others”, and amusement, informative programs, concerts, sport competitions dedicated to non-paid blood donations. • provision of television and radio monitoring of events in the frame of the realization of the program on non-payment blood donations in the Republic of Uzbekistan.

13. As recommended by WHO and international experts of the ADB it is planned: • To restructure the net of centers and divisions of blood donor services with the creation of a National Blood Centre in Tashkent to be situated in the Republican Blood Centre of the Research Institute of Hematology and Blood Transfusion, • To create Regional Blood Centers in the country(to be situated in the blood centers of Ferghana, Samarkand, Bukhara, Kashkadarja regions and of the Republic of Karakalpakistan) • And to create blood banks in therapeutic structures, which are responsible for storage, distribution and clinical use of blood products.

14. -Perfection of the system of state order for organization of the blood donations services during peace time and during extreme situations. -expansion of financial independency of the organizations of blood donations services to increase the effectiveness. It is necessary to add that the centralization of the blood transfusion services should be done step by step.

15. First phase –centralization of the screening of donor blood which will be done in standardized laboratories transfusion stations using immuno-enzyme methods; • Second phase – gradual transition to the blood collection and preparation during trips to remote areas by the blood donations specialists. In the remote areas the blood preparation is to be done in the inter-district blood transfusion centers on the base of an agreement; • Third phase– along with the development of non-paid blood donations among the population, availability of transport and necessary consumables and equipment for preparation and storage of blood products at the district blood centers the blood preparation will be stopped to be done at therapeutic structures and will be carried out exclusively at specialized district blood transfusions centers;

16. At present the screening of donor blood for markers of transfusion transmission infections in the republic is centralized. The testing of donor blood against HIV/AIDS is done at 19 AIDS centers, 14 clinical and hospital laboratories, 4 laboratories canitary control services and 6 laboratories at blood centers. Donor blood is tested for markers of hepatitis C and B in 8 AIDS centers, 15 laboratories of clinics and hospitals, 4 laboratories of canitary control services and 15 laboratories at blood centers.

17. 2008-2009- Creation of a National Blood Center in Tashkent and a regional Blood center in Ferghana city with a volume of 50000 donations in each center per year; 2009-2010–creation of regional blood centers in Nukus, Karshi, Bukhara and Samarkand with the power to prepare 25 000 blood donations in each blood center per year. Phases of the project realization

18. Financial sources • Project ADB “Development of Woman and Child Health Care in Uzbekistan” - 7,166 Million US dollars • Co-financing sources – republican and local budget.

19. Expected results: • Creation of the National Program on Blood Safety; • Increase of number of non-renumerated blood donors; • Covering the needs of the population for safe and high quality blood products.

20. Thank you for your attention!