The two largest blood suppliers, the Red Cross and ABC, each collect about  45 percent of the nation’s blood supply, and roughly 10 percent is supplied  by other independent blood centers, the Department of Defense, and  hospitals that have their own blood banks. For example, after  the September 11 attacks, FDA issued emergency guidelines to speed the  delivery of blood to areas affected by the attacks. The Blood Supply Has Increased and Remains Generally Adequate

Available data indicate that the nation’s blood supply has increased and  remains generally adequate. Although no one data source has comprehensively tracked the nation’s  blood supply in the past, all of the sources we identified indicated that the  national supply has grown in recent years and was at historically high  levels before the surge in donations that occurred after September 11. The number of units of blood collected annually  increased from 12.4 million in 1997 to an estimated 15 million in 2001. The annual number of units that were available but not transfused  remained at about 1 million units. According to NBDRC data, collections for the first half of  2002 have been similar to the same period in 2001. The  nationwide blood supply was substantially greater than needed for  transfusions. Blood Suppliers Are Focusing Emergency Planning on Maintaining Adequate Inventory

Incorporating the lessons learned from past disasters, blood suppliers and  the federal government are reevaluating how blood is collected during and  after disasters and are focusing on maintaining a consistently adequate  inventory in local blood banks in preparation for disasters and not  collecting more blood after a disaster than is medically necessary. Since September 11, federal public health agencies and blood suppliers  have been critical of their responses to prior disasters and have begun to  plan for a more effective response to future emergencies. Through an  interorganizational task force organized by AABB in late 2001, the focus  has begun to shift away from increasing blood collections in an emergency  to maintaining an adequate inventory of blood at all times. The Red Cross expects to increase  annual collections by 9 percent during each of the next 5 years. The blood community’s  response to disasters can be improved, and the community is beginning to  take the necessary steps to learn from past experiences.
What GAO Found

The terrorist attacks of September 11 underscored the critical importance of a safe and adequate supply of blood for transfusions. In recent years, an average of 8 million volunteers have donated more than 14 million units of blood annually, and 4.5 million patients per year have received life-saving blood transfusions, according to the American Association of Blood Banks. Ninety percent of the U.S. blood supply is collected by two blood suppliers, the American National Red Cross and the independent blood banks affiliated with America's Blood Centers. Within the federal government, the Food and Drug Administration is responsible for overseeing the safety of the nation's blood supply. The surge in donations after the terrorist attacks added an estimated 500,000 units to annual collections in 2001. The experience illustrated that large numbers of Americans are willing to donate blood in response to disasters. However, because very few of the units donated immediately after September 11 were needed by the survivors, this experience has also raised concerns among blood suppliers and within the government about how best to manage and prepare the blood supply for emergencies. Data indicate that the blood supply has increased in the past 5 years and that it remains generally adequate. Blood collections increased 21 percent from 1997 to 2001, and collections in the first half of 2002 appear to have been roughly equivalent to the same period in 2001. Blood suppliers and the federal government have begun to reevaluate how blood is collected during and after disasters to avoid repeating this experience and also to ensure that enough blood is available during emergencies. A task force, including members from federal agencies and blood suppliers, has been formed to coordinate the response in future emergencies to the need for blood. Insights from the experiences of September 11 and other disasters have led the task force to conclude that the need for blood in most emergencies can be best met by maintaining an adequate blood inventory at all times, rather than increasing blood collections following a disaster.