Rautonen Jukka
Finnish Red Cross Blood Service, Kivihaantie 7, FIN-00310 Helsinki, Finland.
Biologicals. 2010 Jan;38(1):97-9. doi: 10.1016/j.biologicals.2009.10.022. Epub 2010 Jan 13.
The relationship between free trade, self-sufficiency and safety of blood and blood components has been a perennial discussion topic in the blood service community. Traditionally, national self-sufficiency has been perceived as the ultimate goal that would also maximize safety. However, very few countries are, or can be, truly self-sufficient when self-sufficiency is understood correctly to encompass the whole value chain from the blood donor to the finished product. This is most striking when plasma derived medicines are considered. Free trade of blood products, or competition, as such can have a negative or positive effect on blood safety. Further, free trade of equipment and reagents and several plasma medicines is actually necessary to meet the domestic demand for blood and blood derivatives in most countries. Opposing free trade due to dogmatic reasons is not in the best interest of any country and will be especially harmful for the developing world. Competition between blood services in the USA has been present for decades. The more than threefold differences in blood product prices between European blood services indicate that competition is long overdue in Europe, too. This competition should be welcomed but carefully and proactively regulated to avoid putting safe and secure blood supply at risk.
自由贸易、自给自足与血液及血液成分安全之间的关系一直是血液服务领域长期讨论的话题。传统上，国家自给自足被视为最终目标，这也能使安全性最大化。然而，当正确理解自给自足涵盖从献血者到成品的整个价值链时，很少有国家是或能够真正实现自给自足的。在考虑血浆衍生药物时，这一点最为明显。血液制品的自由贸易或竞争本身可能对血液安全产生负面影响或正面影响。此外，设备、试剂以及几种血浆药物的自由贸易对于满足大多数国家国内对血液及血液衍生物的需求实际上是必要的。出于教条主义原因反对自由贸易不符合任何国家的最佳利益，对发展中世界尤其有害。美国血液服务机构之间的竞争已经存在数十年了。欧洲血液服务机构之间血液制品价格相差三倍多，这表明欧洲也早就应该引入竞争了。这种竞争应该受到欢迎，但需要谨慎且积极地进行监管，以避免危及安全可靠的血液供应。
