Achilles Project for Improving Quality of Blood for Transfusion and Plasma for Fractionation

The lack of safe and quality-assured of blood products has, in the past, been the 'Achilles Heel' of transfusion services and associated industries in the developed world. 

Comparable levels of quality, safety and availability do not yet exist in most low- and middle-income countries. Patients continue to be exposed to the risk of transfusion-transmitted infections and other severe adverse events related to transfusion and plasma-derived medicinal products (PDMPs) treatment. Moreover, patient`s access to PDMPs is limited or non-existent since the plasma collected, which is potentially available for manufacture, often does not meet the necessary quality standards, thus cannot be fractionated and must be discarded.

In 2009 WHO initiated the Achilles Project to increase the global supply of domestic plasma suitable for fractionation through advancements in collection and processing of blood donations. Learning from the success of this project in South Africa and Indonesia, activities to revitalize the Achilles Project are identified in the Action Framework as well as a Strategic Objective to support partnerships, collaboration and information exchange to achieve key priorities.

The goal of the project is to raise the practices of blood establishments and plasma collecting centers to the international standards required for plasma for fractionation, through effective blood regulation. As the quality of plasma increases, quality of red cells and other blood components for transfusion will also increase and, as a result, transfusion safety improves. As plasma wastage will essentially be eliminated, and local plasma will be used in fractionation of PDMPs for the benefit of local health systems, financial advantages can also be anticipated to accrue.

International Society of Blood Transfusion (ISBT) is a non-governmental organization in official relations with WHO. ISBT is hosting and coordinating initiatives and activities of the International Coalition for Safe Plasma Proteins (ICSPP) as a cooperation of willing partners committed to advancing access to safe plasma protein products in LMICs.

WHO and ISBT has been engaged in a collaboration and in cooperative activities to advance access to safe plasma protein products in low-and middle- income countries in alignment with the WHO Achilles Project from 2022-2025.

The Collaboration aims to:

1. support introduction of currently available production technologies of safe PPPs and situationally tailored fractionation approaches into LMICs;
2. facilitate implementation, durability and sustainability of these advancements in LMICs;
3. empower LMICs to progressively alleviate existing supply gaps and shortages of safe PPPs.