In various clinical situations, including trauma, surgery, and chronic diseases, the administration of appropriate blood transfusions plays a crucial role in enhancing patient recovery and improving survival outcomes. A stable supply of blood products is essential to ensure timely transfusions; for this purpose, systematic and long-term management and response at the national level are being implemented.

The Minister of Health and Welfare is required to establish and promote policies on the stable supply and management of blood products based on Article 4(3) of the Blood Management Act. To this end, the National Institute of Organ, Tissue, and Blood Management, under the Ministry of Health and Welfare, monitors the nation's blood supply and demand in real-time through the Korean Blood Monitoring System (Blood Supply Monitoring System + Transfusion Stability Management) and continuously assesses the safety of transfusions. The Blood Supply Monitoring System ensures stable blood donors and maintains a stable blood supply, systematically managing usage, inventory, and disposal by requiring medical institutions to report blood usage information.

Transfusion safety management establishes a strict supervision system for the entire process of manufacturing blood products to minimize blood-borne infections and transfusion-related adverse events. It actively encourages medical institutions to manage patient blood to ensure that transfusions are appropriate for the patient's condition.

Since blood products can only be obtained through blood donations, public health crises, including Covid-19 and rapid demographic changes, can lead to instability in the blood supply. A study simulating the nation's blood supply and demand from 2021 to 2050, based on data from the Korean Red Cross and the Health Insurance Review and Assessment Service (HIRA), found that the supply is expected to decline from 2.6 million units in 2021 to 1.4 million units in 2050, while demand is expected to peak at 5.1 million units in 2045.

In response to this supply-demand imbalance, the Ministry of Health and Welfare has established and implemented a five-year national blood management plan to efficiently and stably manage the supply and demand of blood. The first Basic Blood Management Plan (2021-2025) was established in 2020 and is currently being implemented. The second Basic Blood Management Plan (2026-2030) is in the formulation stage. These plans cover the entire process from blood donation to transfusion, with strengthening national blood management accountability as a key goal.

Specifically, the plans clarify the responsibilities of central and local governments in creating and promoting a culture of blood donation, as well as establishing a real-time blood information linkage system to monitor blood usage. Additionally, the establishment of blood transfusion management rooms in medical institutions will be mandatory, and a national management system will be implemented to ensure the proper and safe administration of blood transfusions. In particular, in preparation for a blood supply and demand crisis, the country has established a crisis level and clarified the roles of each institution in advance, enabling a systematic response.

Korea, Japan, and Australia are representative examples of systematic blood management at the national level.

Japan has a legal framework in place to ensure a stable supply of safe blood products, with the Ministry of Health, Labor, and Welfare establishing and managing the basic policies for the blood business. In Australia, the Therapeutic Goods Administration is responsible for developing and implementing the National Blood Authority (NBA) Corporate Plan, which is based on the National Blood Agreement.

Australia's National Blood and Blood Product Wastage Reduction Strategy, implemented from 2013 to 2017, reduced the demand for red blood cells by more than 21 percent, resulting in savings of about 94 million Australian dollars (AUD) to the government. Building on these achievements, the National Blood Product Management Improvement Strategy (2018-2024) aims to reduce the wastage of blood products and strengthen the supply system to meet clinical demand reliably. Specifically, the strategy aims to streamline blood product management across Australia by increasing efficiency in the manufacturing and distribution processes, improving inventory management, and promoting the appropriate use of blood products.

To sum up, as blood products are irreplaceable and entirely dependent on blood donations, it is essential to build a reliable supply infrastructure based on public ownership to ensure a continuous supply, even in the face of changing healthcare needs or social crises. In addition, a national, round-the-clock surveillance system is essential for assessing and managing transfusions, ensuring they are administered appropriately and safely. Such an integrated national blood management system would be a key foundation for ensuring that everyone in the country has access to timely and safe transfusions when needed.