MEDICAL DIRECTOR’S REPORT
"There is not a single aspect of our lives that has not been affected by the Covid-19 pandemic. Amidst the chaos and heartache of the year that was, there were also opportunities to embrace innovation, agility and perseverance in the SANBS family, determined to ensure that we can be trusted to save lives, even under horrific circumstances."
Dr. Karin van den Berg
INTRODUCTION
When I started at SANBS 13 years ago, I would not have thought that I would one day take up the position of Medical Director at this venerated organisation. Dr Sam Gulube, the then Medical Director, sent me off on a research programme two weeks after joining SANBS, a direction that profoundly changed the course of my career. It is the work of my predecessors, such as Dr Gulube, Dr Charlotte Ingram and Dr Jackie Thomson that not only shaped this organisation, but guided my career path which made it possible for me to take up this position today.
The National Health Act states that a blood transfusion service “must appoint a medical practitioner as medical director to be in charge of and take responsibility for its medical and related activities”. The implied trust that the Medical Director will ensure, to the best of their abilities, the safety of our donors and patients by ensuring the delivery of a safe, quality product, is a responsibility not to be taken lightly.
While the mandate of providing the country with a safe, sufficient, quality blood supply has remained at the heart of what we do, how we deliver on this mandate has changed over time. In the past, we were very inward focused, determined to ensure the safest possible products in a cost-efficient and sustainable manner. Over time, our focus moved outward, taking significant steps to ensure that our donor demographic is representative of the people of South Africa and that we consistently meet the demand for blood at all times.
Putting people first
More recently, our focus has become acutely centered on donor and patient outcomes while ensuring staff development is aligned with the future of healthcare in South Africa. Continued research in the safety of our donors have informed our new haemoglobin cut-off levels and ferritin testing programme which is aimed at ensuring we protect our donors from iron deficiency. At the same time, SANBS has actively adopted Patient Blood Management as the guiding principle for optimising patient outcomes through a patient-centred, systematic, evidence-based approach to managing and preserving a patient’s own blood, while promoting patient safety and empowerment. Our Dual Career Pathway programme aims to ensure that our staff are developed in the relevant science and healthcare disciplines in a manner that supports our mission to provide world class blood products, innovate new treatments and enhance healthcare for all the patients of South Africa.
The year under review
Covid-19 restrictions
We started this year in Lockdown Level 5 and were immediately confronted with the challenge of collecting blood from a population not allowed to leave their homes. This challenge was compounded by our need to ensure we protect our staff and donors, and managing with many staff affected by Covid-19. The lack of traditional access to donors persisted, but our team’s ability to respond with new and innovative solutions ensured that we were able to largely meet the country’s blood supply with only two short periods of constrained supply. Despite these challenges, our teams continued executing on our 5-year iHEALTh strategy with a successful, albeit slightly delayed, roll-out of the ferritin-testing programme to all the zones, a remarkable feat and testimony of the dedication of all the SANBS teams.
Innovation
Through innovation, our focus is on continuously protecting donors and patients. Within weeks of establishing the SANBS COVID Response Team, our teams led two major Covid-19 research projects. The first was an investigation into the use of convalescent plasma as a potential treatment option for Covid-19 and the other a large-scale, national sero-prevalence study, the results of which has been used by, among others, the Ministerial Advisory Committee and Modeling Consortium.
Learning and development
Protecting, while at the same time ensuring continued development of our staff was a key aspect of our deliberations and decisions. Supported by the implementation of various IT solutions, our RAD Academy was able to ensure rapid training for staff on Covid-19 and other projects. Seizing the opportunities created by these solutions, the SANBS eLearning Cafés were launched which enabled access to previously unexplored healthcare populations. Our capabilities in this area soon led to multiple educational collaborations with joint on-line workshops and webinars with a multitude of external academic and special interest groups.
Continuity of operations
SANBS continued to do what we do best, delivering safe, quality products to our patients, ensuring we keep abreast with best practice and addressing the needs of all our stakeholders. Not only did we manage to keep on track with the development of the new BECS, we were also able to produce the first batches of research-grade human platelet lysate, continued with progress on developing an independent Haemovigilance System and improved our systems for cryopreserving stem cells and performing next-generation genetic sequencing.
South Africa is gripped in the midst of the third wave which has been more devastating than either of the previous two...
Outlook/Looking forward
Confidence in the future
Although South Africa is gripped in the midst of the third wave which has been more devastating than either of the previous two, I am comforted by the trust I have in Team SANBS, and all our stakeholders, to not just persevere but to thrive, learning from lessons experienced during the pandemic which will translate to better, more efficient care going forward.
Advancement in healthcare
SANBS is certainly well positioned to leverage our digital footprint and strategic alliances to build a better future for our donors, patients and staff. The accelerated pace of digital transformation combined with the active pursuit of strategic partnerships and collaborations can and must help build sustainable systems to deliver future-proof healthcare.
In particular, our ongoing collaboration with local and international partners in the field of Patient Blood Management (PBM) culminated in SANBS being invited to the WHO PBM working group enabling SANBS to play a meaningful role in the global implementation of PBM. Advances in PBM combined with our investment in digitally supported delivery of healthcare through systems such as SMART Fridges ensures that we will continue to be at the cornerstone of healthcare delivery in South Africa. We will be focusing on ensuring that we continue the cutting edge work being done in SANBS and also strategically and collaboratively develop outreach and capacity building programmes into Africa.
CONCLUSION AND APPRECIATION
It is with equal measures of humility and pride that I write this inaugural Medical Director’s report. I am deeply aware of the legacy of those who have come before me, of the wonderful work done by the SANBS teams and of the trust our donors and patients place in us. I am immensely grateful for the trust the Board has placed in me and deeply appreciative of the support I have received from EXCO and the SANBS staff. It is the knowledge of the depth of skills, experience and commitment within SANBS that gave me the courage to take on this position of trust. It is my most ardent aspiration to responsibly steer the SANBS medical compass and mentor the new generation of SANBS leaders.