by Brian Witte, Ph.D.
For all its brutal cost in human suffering, the unfolding zika epidemic has provided a rich source of learning materials for the nation’s blood supply. In one sense, it is profoundly reassuring to the speed with which US regulatory agencies, pharmaceutical companies, and individual members of the blood supplier community have worked together to address an unfolding crisis.
The zika epidemic has also emphasized the importance of a nationally-integrated blood supply system. As evidence of domestically-acquired infections mounted in the specific neighborhoods in Miami, and in the absence of a test with full FDA approval, the only option was to defer blood collection from Miami-Dade and Broward counties. No interruption of blood supply was observed due to the ability of OneBlood, the main regional blood collection organization, to move supplies from surrounding regions.
The response highlights one of the main concerns to arise from this crisis: dependence on hyper-local sources of critical components creates vulnerabilities. When the local supply is compromised, those vital components must be sourced from elsewhere.
Other fields have been forced to confront such so-called Single-Point-Vulnerabilities. The 2011 Japanese tsunami was foremost a human catastrophe. It also, however, created a logistics nightmare for the high tech companies that relied on products produced in Miyagi prefecture. Within days, General Motors was shutting down assembly plants and Hewlett-Packard was scrambling to find computer chips for essential components.
Agriculture, too, has experienced complications from over-reliance on a single resource. By 1844, over 90% of the population of Ireland was dependent on a single high-yielding variety of potato. The lack of genetic diversity in the potato crop ensured that potato blight, once established, spread rapidly through the fields. When the crop failed, it failed all across Ireland, and there was no alternative food source. The Irish Potato Famine illustrates a well-known concept in ecology that less-complex systems are vulnerable to sudden, catastrophic failure when key conditions change.
The response, advocated by supply chain experts and ecologists, is to emphasize diversity. A manufacturing plant that relies on material from different regions of the world will be more resilient in the face of catastrophe in one region. A farmer that cultivates multiple plants is less likely to face ruin when one crop fails. Even outside of emergencies, more diverse ecosystems tend to be healthier and more robust.
The blood supply in the U.S. is critical, even foundational, to our health system. Local threats to availability of blood products will continue to occur as new diseases emerge. The zika threat continues to evolve, and in the longer term the range of disease transmitting mosquitoes will continue to expand. Severe weather emergencies, and their impact on blood collection and availability, are predicted to increase in number and severity. We also live in uncertain times with increasing threats from terrorism and seemingly random mass-casualty attacks.
The U.S. has an amazing infrastructure for responding to disaster and emergency. It can only grow stronger by fostering greater interconnectivity among its parts. Just as GM discovered it could not create new parts suppliers overnight, hospitals and blood banks cannot wait for disaster to force new alliances. Connectedness, multi-source, diversification – all themes that build strength and resilience in an uncertain world.
Sun, Lena H. "FDA Temporarily Halts Blood Donation in Two Florida Counties over Zika Fears." The Washington Post. N.p., 28 July 2016. Web. 20 Sept. 2016.
Lohr, Steve. "Stress Test for the Global Supply Chain." New York Times 19 Mar. 2011: n. pag. 19 Mar. 2011. Web. 16 Sept. 2016.
McCann, Kevin Shear. "The Diversity–stability Debate." Nature 405.6783 (2000): 228-33.
Savitz, Eric. "Japan One Year Later: The Long View On Tech Supply Chains." Forbes. Forbes Magazine, 13 Mar. 2012. Web. 20 Sept. 2016.
"Great Famine (Ireland)." Wikipedia. Wikimedia Foundation, n.d. Web. 21 Sept. 2016.