Management of hemophilia in resource-limited countries

SUMMARY Hemophilia is a rare congenital bleeding disorder that requires lifelong treatment. Prevalence is not affected by race, ethnicity or socioeconomics. However, there are considerably fewer hemophiliacs diagnosed in resource-limited countries than in the developed world. Management requires replacement therapy that many developing countries find difficult to provide. While the developed world has moved to using recombinant therapy, many developing countries are struggling to provide plasma to the hemophiliacs, let alone plasma-derived fractionated factor concentrate. Financial constraint is the major cause of these disparities. This is understandable as more pressing public health issues such as infectious diseases affect a larger population and require more urgent attention. However, there have been successes. Some developing countries are able to provide plasma through their blood transfusion program while some managed to secure government support to provide factor concentrates. Management protocols are developed to ensure their effective use. The World Federation of Hemophilia and national hemophilia societies have helped focus attention to the hemophiliacs and increase awareness on the management of their condition. Strong leadership and the development of a national program that includes proper planning and implementation can bring about improvement in the care of hemophiliacs in resource-limited countries that would help them achieve their full potential and not be a social and economic burden to these countries.