3.1 Introduction

Pathogen inactivation (PI) has been described as a promising new technology for reducing transfusion-transmitted (TT-) infections (TTIs) and non-infectious transfusion-related adverse events in Sub-Saharan Africa [89]. PI uses UV light, often in combination with an additive, to inactivate pathogens in blood components or whole blood [90]. The health-economic consequences of PI of plasma and platelet components have been estimated for different health systems, including Poland and Canada [18,19]. Compared to the European and North American settings where prior analyses of PI have focused, health systems in sub-Saharan Africa often experience greater resource constraints, greater baseline rates of certain transfusion-related adverse events, and more frequent blood shortages [91,92]. Furthermore, the common practice of transfusing whole blood rather than derived products limits the applicability of platelet and plasma PI [93]. For these reasons, whole blood PI may be a more appropriate technology for sub-Saharan Africa. A recent randomized trial has analyzed the effectiveness of whole blood PI for averting TT-malaria in Ghana [94]. However, no health-economic assessment has been published for whole blood PI in any context, nor for any PI modality in sub-Saharan Africa. We developed a decision-analytic model to estimate how the addition of whole blood PI to the existing blood safety program in Ghana would impact the number of transfusion-related adverse events and total healthcare expenditures.