PEPFAR Success Story
RWANDA NATIONAL CENTER FOR BLOOD TRANSFUSION (NCBT)
The United States Government (USG) through PEPFAR’ HSS/CDC funding has transformed the National Center for Blood Transfusion (NCBT) by enhancing and expanding capacity as a core activity in HIV prevention. After the 1994 genocide and prior to 2005, without a national blood policy and guidelines, Rwanda experienced perennial blood shortages, lack of testing reagents and cold chain equipment. In addition an inadequate blood transportation system from mobile collections centers and an insufficient blood production limited geographical distribution and access of safe blood.
As Rwanda rebuilt its institutions and focused on national efforts to prevent HIV transmission, safe blood became a central strategy, yet faced vast limitation due to lack of capacity and resources. The law establishing Centre National de Transfusion Sanguine (CNTS), later renamed National Center for Blood Transfusion (NCBT) facilitated mechanisms for resource mobilization for the Ministry of Health. Through Government of Rwanda (GoR) partnerships with international donors, NCBT saw increased USG funding amounting to approximately US $12,724,500 over a six year period. The support has transformed NCBT to a nationwide institution with four fully functional state of the art regional blood collection centers (RCBT) with the main headquarters and laboratories in Kigali City. This has greatly improved geographical access to safe blood in all the five provinces in Rwanda.
The success of NCBT lies in its key activities that include blood donor mobilization and recruitment of volunteer non remunerated donors, blood testing and processing, storage and distribution. NCBT ensures 100% screening of all blood donated for transfusion transmissible infections (TTIs) that include HIV, hepatitis B/C, and syphilis. The most vulnerable groups necessitating blood transfusion are mothers during delivery, neonates, children under five and expectant mothers with infections such as malaria and trauma patients. NCBT mission is to provide safe, adequate and effective blood and blood products to all patients in need. This has greatly contributed to reducing TTIs significantly thus protecting blood recipients from passively acquiring various infections. NCBT currently collects approximately 40,000 blood units per year averaging 3,500 units per month. NCBT has capacity to fractionate the blood into components (packed red blood cells, platelets and plasma) for efficient transfusion and patient care. At the moment up to 80,000 patients benefit from blood or blood products from NCBT annually. Among these are 50% mothers, 30% children and 18% others.
To ensure safe blood from vein to vein NCBT has developed and is implementing a quality management system based on international standards (American Association of Blood Banks) at all RCBTs. To support rational use of blood and blood components, NCBT conducts trainings to all transfusing facilities for public and private health professionals. Currently NCBT maintain a growing voluntary blood donor base, adequate reagents, cold-chain storage and distribution system countrywide.
NCBT has made tremendous strides in its capacity to provide safe blood to meet all national needs as per GoR policy. “Blood is free of charge” from a voluntary non-remunerated donor base. However, transforming free blood to safe blood is costly and yet must be done and is the core activity of NCBT. At the moment 90% of the NCBT budget is supported by external funds. To meet this challenge, NCBT envisions transforming to a self-sustaining institution with a cost recovery business model. NCBT is at an advanced stage of attaining international accreditation, a key step towards achieving self-sustainability. Accreditation offers an opportunity to become a regional center of expertise offering services to neighboring countries, contributing to blood transfusion medicine and technical expertise as needed.
USG is a proud partner of GoR and NCBT quietly saving lives and preventing HIV, HBV, HCV and syphilis infections to vulnerable blood recipients.
The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in Rwanda is a U.S. Government interagency partnership between the Department of State, Center for Disease Control and Prevention, U.S. Agency for International Development, Department of Defense and Peace Corps with the Government of Rwanda, local civil society and other partners. This year marks 10 years of PEPFAR support, which helps Rwanda to develop and implement sustainable, integrated, and country-led responses to HIV/AIDS and work toward achieving an AIDS-free generation.