WHO's region of the Americas is often held up as one that has made good progress towards universal access to health care. However, when it comesto access to a safe and secure blood supply, the regional picture is mixed. Between 2009 and 2012, the number of units of blood collected in the Americas rose from 5 million to 9 million. But the increase was not evenly shared across countries. In low-income and middle-income countries of Latin America and the Caribbean, most blood comes from donors who are paid, family, or replacement (a family member or friend of the recipient donates to a blood bank to replace blood used in a.transfusion). Only four in ten blood donors in these Countries are voluntary donors. This situation raises the risk of infected blood entering the supply because paid donors are more likely to hide risky behaviours from blood banks. Poor planning might also be behind huge losses. In 2011, 799738 units of red blood cells in the region were discarded because of expiration.
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