[Ensuring safe blood in the Americas].

It is a pleasure to write an introductory statement for this special issue of the Revista Panamericana de Salud Pública/Pan American Journal of Public Health devoted to blood banks. This issue will deal not only with blood banks as the places where blood is collected and processed, but also with the whole spectrum of transfusion medicine. Blood has a special place in the culture of our civilizations as symbolizing strength and the vital force of life. Its use in forms that may seem macabre to us now found its way into many ancient rituals. All physicians regard blood with some awe since so far there is no substitute for it, and its transfusion may be regarded as the first organ transplant. The history of transfusion and some of the mystique surrounding it have been set out vividly in one of the issues of Perspectives, the news magazine of the Pan American Health Organization (PAHO). I was amused by one of the special historical vignettes related to blood transfusion. The year 1492 is remembered as the year of the meeting of the two worlds, and it is less remembered as the year of perhaps the first transfusion. It is said that in that year Pope Innocent VIII was transfused for a neurological illness, but the therapy was rather ineffective, as the worthy prelate died. Fortunately, recent history deals with transfusion more kindly. Blood transfusion and blood banks have been objects of PAHO’s technical cooperation for many years. The basic focus has been on the screening of blood to prevent transmission of disease, and this was seen as falling predominantly within the technical area of laboratory services. The section on blood banks in PAHO’s Health in the Americas quadrennial publication from 1998 deals almost exclusively with the number of units of blood collected and the testing done to prevent disease transmission. At my reelection as Director of PAHO in 1998 I challenged the Organization to work towards making all the blood in the Region of the Americas safe, and PAHO’s Strategic and Programmatic Orientations, 1999–2002 referred specifically to having our technical cooperation “supporting improved safety and quality in blood bank operations.” When the PAHO Governing Bodies considered the topic in 1999, they approved a resolution urging Member Ensuring safe blood in the Americas