26 February 2024

The world needs to adopt military style responses to shortages of blood in areas deemed to be ‘blood deserts’, according to a group of senior doctors.

The Blood D.E.S.E.R.T. Coalition – Delivery via Emerging Strategies for Emergency Remote Transfusion – has set out its proposals in the journal Lancet Global Health, warning that more than half the world’s population does not have access to reliable supplies of blood for transfusion.

The World Health Organization has joined with the Royal College of Surgeons of Ireland together with hospitals in the USA, Ghana, and India for the project, alongside the US Army Surgical Research Institute. The group has undertaken video gatherings and research workshops in 11 countries over a three-month period.

They say the problem is severe in rural areas of low and middle income countries - although shortages can affect certain areas in wealthy countries too.

An area is defined as a “blood desert” when clinical need for blood transfusion cannot be met in 75% of cases.

As well as improved use of intraoperative auto-transfusion, they propose civilian ‘walking blood banks’, a military approach which has volunteers ready to give blood at short notice. Another option is delivery of blood supplies via drones, though this will require bigger investment to implement safely.

Founding director Nakul Raykar, from Boston, Massachusetts, USA, said: “As a trauma surgeon, I cannot fathom not having blood for our patients when they arrive after major injury. Unfortunately, this is the reality in most of the world, and people die unnecessary deaths. It will take decades to build and fund enough functional blood banks to meet the world’s needs. But we do not need to wait – immediate, low-cost solutions already exist that could be implemented today.

“Every single country in sub-Saharan Africa and South Asia has a significant blood shortage, and as a result, more than half of the global population doesn’t have access to basic, life-preserving medical care.

“A huge proportion of the challenges facing healthcare providers in these areas is accentuated by this single missing resource.”


Raykar NP, Raguveer V, Abdella YE, Ali-Awadh A, Arora H, Asamoah-Akuoko L, Barnes LS, Cap AP, Chowdhury A, Cooper Z, Delaney M, DelSignore M, Inam S, Ismavel VA, Jensen K, Kumar N, Lokoel G, Mammen JJ, Nathani P, Nisingizwe MP, Puyana JC, Riviello R, Roy N, Salim A, Tayou-Tagny C, Virk S, Wangamati CW. (2024) “Innovative blood transfusion strategies to address global blood deserts: a consensus statement from the Blood Delivery via Emerging Strategies for Emergency Remote Transfusion (Blood Desert) Coalition.” Lancet Global Health, doi: 10.1016/S2214-109X(23)00564-8.

Link: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(23)00564-8/fulltext

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