SANBS is truly the lifeblood of the nation

At a time when news around health developments in SA is centred on a terrifying pandemic that has drastically changed the way we live and work, we can take comfort in the fact that World Blood Donor Day on Monday gives us something not only to be proud about, but that serves as a call to action where individuals can make a positive contribution and save lives.

The SA National Blood Service (SANBS) is seen as a pillar of excellence internationally and a world leader in the blood transfusion space. SANBS (or rather its predecessors) was truly started “by the people for the people” by donors getting together to provide for the needs of patients. This meant that blood transfusion services in SA started as a vein-to-vein service of 100% voluntary nonremunerated donors, which was not always the case for blood services in other countries. We still rely on the good will of our donors, but I would like to think we have become a bit more sophisticated in our methods.

As a result of the close link between the donor on the one hand and the patient on the other, SANBS has an advantage of being able to rapidly assess how changes at the one end of this value chain impact the other end. Thus, we have been able to rapidly adapt and align our systems and processes to meet the needs of our donors and patients.

An example of this is the impact of the HIV epidemic. Collecting sufficient safe blood in a country with the biggest HIV-positive population in the world is extremely challenging, not only because the “effective” donor pool is shrunk by about 20% as compared to countries with low HIV prevalence, but also because being HIV-positive is associated with having anaemia, which places you at greater risk of needing blood.

SANBS responded to this by implementing the best testing systems for the early detection of HIV in blood and was the first country in the world to do this at the level we were doing it. Many others have now followed. Our donation testing area is world-renowned for the work we do and sets the standards for others to follow. This helps us to mitigate the risk of having to collect blood in a high HIV setting.

We have also been involved in numerous groundbreaking studies and have had some 20 research articles published across the world in international journals.

To truly live our purpose of “trusted to save lives”, we need to make sure that while we are providing for the transfusion needs of the country today, we are also preparing for the needs in the future. A key part of ensuring we are ready for the future involves research and development and then again publishing our findings for peer review.

At SANBS we have developed significant research capacity over the past few years and established multiple collaborations with local and international researchers and organisations. This has enabled SANBS to rapidly deploy new research endeavours in response to the Covid-19 pandemic.

Some of the notable work we are proud of includes a clinical trial that investigated the use of convalescent plasma in the management of Covid-19, a pre-print publication on the sero-prevalence of Covid-19 antibodies among blood donors and then a collaboration with the NICD, which led to a publication describing the serious nature of the Sars-CoV-2 501Y variant. The latter publication has been cited in more than 130 other publications from across the world.

We hope this kind innovation will help to encourage an even greater awareness of the need for blood donation among the public.

Collecting and delivering blood products safely and rapidly is an ongoing challenge. However, we always strive to be at the forefront of technology that can save lives and, as a result, we are developing protocols at our new Mt Edgecombe campus to use drones for emergency blood delivery. This will facilitate faster access to blood in rural areas where road access is difficult. This is groundbreaking science that also creates greater sustainability for medical care for the less resourced parts of our country. These drones can carry two to four units of blood and have a payload of up to 2kg depending on the distance they need to fly.

After 13 years at the SANBS the real highlight for me, however, is the small role we all play in making blood available to the hospitals in places such as the rural Eastern Cape, knowing there will be blood available should a young woman run into difficulties during childbirth. In the extraordinary cases where routine products are not the solution, to see the SANBS team jump into action to make miracles happen for these patients for whom there is no other hope, hearing the words of gratitude from the doctors, patients and their families; these are the events that leave me with a huge smile and a profound gratitude for the privilege of being part of this organisation. It’s something that every blood donor should feel, with the knowledge that when they walk out of one of our donor centres after giving blood, they have saved three people’s lives and are a part of something incredible.

Dr Karin van den Berg is the medical director for the SA National Blood Service