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AJPH First Look, published online ahead of print May 2, 2006
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AJPH.2004.061630v1
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June 2006, Vol 96, No. 6 | American Journal of Public Health 984-994
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2004.061630

PUBLIC HEALTH THEN AND NOW

Blood Transfusions in the Early Years of AIDS in Sub-Saharan Africa

William H. Schneider, PhD and Ernest Drucker, PhD

William H. Schneider is with Indiana University, the Indiana University Center for Bioethics, and the Center on Philanthropy, Indianapolis. Ernest Drucker is with the Montefiore Medical Center–Albert Einstein College of Medicine, Bronx, NY.

Correspondence: Requests for reprints should be sent to William Schneider, Medical Humanities, Indiana University, 425 University Blvd, Indianapolis, IN 46202 (e-mail: whschnei{at}iupui.edu).

Blood transfusions transmit HIV more effectively than other means, yet there has been little examination of their role in the origins and early course of AIDS in sub-Saharan Africa. We review historical data in archives, government reports, and medical literature from African and European sources documenting the introduction, establishment, use, and growth of blood transfusions in sub-Saharan Africa. These data allow estimation of the geographic diffusion and growth of blood transfusions between 1940 and 1990.

By 1955, 19 African colonies and countries reported transfusion programs—with national rates of 718 to 1372 per 100 000 by 1964, and urban rates similar to those in developed countries. We estimated 1 million transfusions per year in sub-Saharan Africa by 1970 and 2 million per year by the 1980s, indicating that transfusions were widely used throughout sub-Saharan Africa during the crucial period of 1950–1970, when all epidemic strains of HIV first emerged in this region.






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