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Tranexamic acid treatment for trauma being ignored by global health bodies, argue experts

A cheap treatment for a disease that kills more people each year than HIV/AIDS, malaria, and tuberculosis combined is being largely ignored by , argue researchers on bmj.com.

from the London School of Hygiene and Tropical Medicine and colleagues say the response from the , United Nations, World Bank, and Unicef “has been limp or absent.”

A study published in 2010 (known as the CRASH-2 trial) found safely reduces death in patients with life-threatening traumatic bleeding by one third.

If all patients admitted to hospital with traumatic bleeding worldwide received tranexamic acid within three hours, there would be at least 100,000 fewer trauma deaths a year.

It is more cost effective than antiretroviral treatment for HIV, and nearly as cost effective as bed nets for malaria prevention. Wider use of tranexamic acid in surgery would also save blood and be a safer alternative to transfusions.

Within weeks of the publication of these findings, the British army was using tranexamic acid on the battlefield, and two years later it has been widely implemented throughout the NHS.

It has since been added to the World Health Organization’s list of essential medicines, yet there has been no concerted action to make the treatment freely available to all those who need it, argue Roberts and colleagues.

They describe the global response as “limp or absent” and ask why these bodies have not been more enthusiastic about tackling this particular health scourge.

They call for “a new mode of thinking” towards people centred care, “aimed at achieving the best health given the available resources.”

“The CRASH-2 trial was funded by UK taxpayers, and UK taxpayers have been the first to benefit,” say the authors. “However, the trial was only possible because hundreds of doctors and nurses in 40 countries worked together in the interests of patients everywhere to recruit the 20,211 patients, 3,076 of whom died, thus turning a private tragedy into a public good that must now be used to inform global policy.”


Observations: Tranexamic acid in trauma: we need stronger global health policy