Self-sufficiency and blood transmitted diseases.

The Council of Europe and the EEC Council of Ministers have strongly promoted self-sufficiency for plasma products on the basis of voluntary non-remunerated donors. Several European countries have a programme of self-sufficiency with plasma products, either with national fractionation plants (e.g. Belgium, Finland) or based on contract fractionation (e.g. Norway, Slovenia). Advantages of national self-sufficiency includes epidemiological factors, economical factors and also ethical and moral issues. Self-sufficiency is one of the basic conditions for reducing the hazard of transmission of infectious diseases. Norway has been self-sufficient with coagulation factors since 1981. Price mechanisms and market forces have been important factors in ensuring the necessary plasma volume, and fractionation methods rendering high yields of factor VIII are initially preferred. This policy has resulted in a low prevalence of antibodies against human immunodeficiency virus (6%), hepatitis B virus (28%) and hepatitis C virus (41%). No Norwegian haemophiliacs have been infected with hepatitis A through FVIII concentrates.