OUR BUSINESS
Medical Director’s Report
Dr. Karin van den Berg, Medical Director
Through the challenges we faced this year, SANBS remained unwavering in our commitment to deliver on our primary mandates. Guided by the iHEALTh strategy, on which we have built a good foundation for long-term sustainability, we upheld our mission to deliver exceptional quality blood and related services, cementing our position as a vital contributor to healthcare in South Africa.”
While SANBS, like the rest of the world, is steadily recovering from the COVID pandemic, we need to ensure the continued delivery of our purpose, vision and mission, guided by the iHEALTh strategy in this changed world. The challenges of South Africa are the challenges of SANBS. Amid the ever-present load shedding, water crises and socio-economic hardships, our teams are still trusted to ensure the collection, processing and issuing of products and services of exceptional quality that ensure that SANBS, a key cornerstone of healthcare in South Africa, remains rock-solid.
Our foremost responsibility is to ensure a sufficient and safe supply of blood products and related services for the patients that we serve. This is complicated by the disparate needs and demands of our two-tiered healthcare system and a notable surge in the demand for blood, particularly in the private sector, witnessed over the past year. Meeting the country’s needs is further constrained by the complexity of collecting blood in a country with the biggest HIV epidemic in the world, and the ever-increasing quadruple burden of disease, burgeoning unemployment and lack of food security. Collecting blood that does not place either the donor or the recipient in jeopardy under these circumstances remains a mammoth task, often underappreciated by the healthcare system and the public at large.
Despite these challenges, our teams did exceptional work in maintaining our “Days Cover” above levels that require implementation of “cut-backs” or restrictive issues for most of the year, even if we were unable to meet the optimal cover of five days. Ensuring the “right product for the right patient at the right time and place” under these circumstances requires dedicated, trained and qualified employees, a committed donor pool and world-class processes and systems. This past year saw us focusing on the core aspects of each of these pillars as well as the quality foundation upon which it all rests.
THE YEAR UNDER REVIEW
Reviewing the past year, SANBS has had a number of achievements, but also a few challenges.
Deriving income from alternative revenue streams
Beyond the core SANBS business, our alternative revenue streams performed exceptionally well under very difficult circumstances. The service mix of our Cellular Therapies and Novel Products areas is slowly changing, reflecting the decrease in HIV-related conditions requiring our services, with the concurrent increase in the demand for stem cell transplants reflecting the maturation of our strategy to provide “one-stop shop” type services to specialists who do not routinely perform autologous stem cell transplants. Our teams successfully reapplied for a D43 National Institutes of Health Fogarty grant to further develop research capacity in SANBS and our partners at the University of Cape Town.
Deliberate and intentional, continued investment in our people
We are our people – deliberate, continued investment in our people is key to SANBS’s success in delivering on our mandate. This year, we saw the culmination of several years of investment in the SANBS RAD Academy paying off with the formal launch of the academy, during which some of the early successes of the Academy were showcased. In addition, we progressed the Dual Career Pathway pilot project with the appointment of three subject matter experts (SME) in the Specialised Laboratory Service area and hope to expand the project to other areas over the next few years.
Unfortunately, the project fell behind schedule, in part as these SMEs were deployed to the BECS project, but also by the loss of one of the incumbents who emigrated, a growing risk facing SANBS, especially as we further invest in our people. Similarly, the recruitment and retention of highly specialised skills continue to face competition from the private sector, both locally and internationally.
An organisation with exceptionally strong intellectual capital
Over the past year, we have successfully continued our strategy of expanding research and publication capacity among a growing proportion of SANBS employees and divisions, with 14 publications in peer-reviewed scientific journals, with a number of these being authored/co-authored by first-time authors. Acknowledgement of SANBS as a centre of excellence is rapidly being confirmed by national and international peers and stakeholders through ever-increasing invitations to participate, present or lead national and international meetings, publications and working groups.
For the first time, the annual Haemovigilance Report, a mandatory requirement, was authored by the Independent Haemovigilance Committee. Historically, SANBS and the Western Cape Blood Service drafted the report which details adverse events and outcomes associated with the collection and transfusion of blood and blood products. Having the Independent Haemovigilance Committee produce this report provides the South African public with an added layer of comfort that SANBS is not “marking its own homework”, and introduces a new level of independent oversight of the workings of blood services in South Africa.
Significant investment in our manufactured capital continues
Unfortunately, the BECS project is behind schedule, but tremendous effort is being expended into ensuring that the new timelines for November 2023 will be met. On a more positive note, we successfully concluded the SMART Fridge pilot project with the first SMART Fridge being handed over to the Rahima Moosa Mother and Child Hospital and plans to deploy an additional ten fridges over the next few years. The successful completion of the Blood Bank Automation project saw a significant improvement in our crossmatch turn-around-times.
To ensure the health and safety of our donors, we revisited the #IronStrong project and expanded it to address all aspects of donor iron. The revised, board-approved new Donor Iron Strategy will focus on providing donors with better quality iron tablets, improved communication with donors and employees, education on understanding the importance of iron, and further research into factors associated with and the outcomes of iron deficiency among blood donors.
Furthermore, besides the various expansion projects to increase the donor pool through investment in additional donor teams equipped with the necessary resources and support, we also developed a revised Platelet Strategy specifically aimed at ensuring a sufficient platelet supply. The latter involved a comprehensive approach to optimise collections and production, growing donor pools and educating clinicians on the appropriate use of this extremely scarce resource.
Awareness of our impact on the environment
At SANBS we are acutely aware of the impact we have on our environment. One aspect of this is the biological waste requiring incineration we generate through our business processes, a significant portion of which relates to the discarding of used test reagents, consumables and products that fail quality standards. Active management of discards at each step of the business process has resulted in overall discard rates below 5%, which compares very favourably with international standards. We are also actively managing our carbon footprint by revisiting the need for travel made possible by one of the positive legacies of COVID, namely the willingness to engage in virtual meetings, training and education.
Our social contribution and relationships built on trust
At our heart, SANBS is about people. In the words of one of our directors, “SANBS is about people being trusted to save lives”. To be able to do so, SANBS needs to forge relationships built on trust with all our stakeholders, not least of which is our donor and patient communities. We are proud that without exception SANBS provides the same level of care to both the private and public sector – those in need of blood can be assured that they will receive the same quality products and services, regardless of their circumstances.
Furthermore, we are in the final stages of the development of the first short learning programme on Patient Blood Management developed in Africa for Africa. This key collaboration with the University of the Free State (UFS) will contribute to not only the appropriate use of blood and blood products, but also the improvement of patient outcomes by improving the knowledge of clinicians in managing the conditions leading to the need for blood transfusions. This internationally peer-reviewed programme, developed by employees from SANBS and the UFS, commenced in August 2023.
LOOKING FORWARD
As we move forward, we remain dedicated to fulfilling our mission of delivering a reliable supply of blood and blood products, while prioritising safety, quality and the evolving needs of our diverse stakeholders. With our unwavering commitment to excellence, we strive to establish SANBS as a recognised centre of excellence in the field of blood transfusion.
By continuously improving our processes, embracing innovative technologies and fostering a culture of continuous learning, we aim to set new benchmarks for quality, efficiency and service in the blood service sector.
CONCLUSION AND APPRECIATION
We express our heartfelt appreciation to our selfless blood donors whose generosity saves lives and offers hope to those in need. To our patients, we stand by you with unwavering support and a commitment to the highest standard of care. To our exceptional employees, who embody compassion and professionalism, we acknowledge the vital role you play in our mission’s success. Together, we forge ahead, united in our shared purpose of making a positive impact on the lives of individuals and the communities we serve.
Dr Karin van den Berg
MEDICAL DIRECTOR
