Blood From The Heart Is Safe
The Pan American Health Organization (PAHO) today called on people in the Americas to support voluntary, altruistic, and repeated blood donation as the only way to ensure a safe and sufficient blood supply.
PAHO issued the call on World Blood Donor Day, which is celebrated each year on June 14 to recognize and thank people who donate blood voluntarily and without remuneration.
Studies show that blood donated by altruistic volunteers is much safer than blood donated by paid donors or family and friends of patients who need blood. Because of chronic shortages of blood in Latin America and the Caribbean, however, most countries depend on family replacement donation for the bulk of their blood supply. Changing this practice is the most important blood safety challenge facing the region today.
"We hope that the countries in the Americas Region are able to reach the goal of getting 100% altruistic blood donations during 2010, a goal set by PAHO's Directing Council in October 2008," said Dr. Jose Ramiro Cruz, PAHO Advisor on Blood Services.
In observance of World Blood Donor Day, PAHO is making the following recommendations:
* Countries that have not reached 100% voluntary blood donations should seek innovative ways to promote community and youth participation in blood donation and develop national blood donation programs to help increase the number of volunteers;
* Family replacement should gradually be substituted by altruistic donation, and paid donation should be eliminated;
* Countries that have reach 100% altruistic blood donation should strengthen efforts to increase the number of regular donors to maintain a stable donor population that can meet national needs for blood and blood components, under normal conditions and in emergencies;
* Countries that are creating or expanding programs to supply blood components should base these programs on 100% voluntary and unpaid donations;
* Countries that have well developed mechanisms to procure blood products should cooperate with other countries to guarantee sufficient supplies of blood products based on voluntary donation.
Every day in Latin America, hospitals tell their patients they must recruit friends and family members to donate blood before the patient undergoes a procedure. The practice, known as family replacement, is considered essential. Unfortunately, like blood from paid donors, blood from family replacement donors is less safe than blood from those who donate for nothing more or less than the general public good.
Data from the World Health Organization (WHO) show a higher prevalence of HIV and other pathogens in the blood of paid and replacement donors than in blood from "altruistic" donors. A study in Ecuador found that the blood from banks that depend 100% on replacement donors was 12,000 times more likely to test positive for HIV or hepatitis B or C than blood from banks that had at least 60% altruistic donors.
Nevertheless, in the majority of Latin American and Caribbean countries, between 50% and 90% or more of available blood is from replacement donors. Along with the serious problem of blood shortages, reducing these percentages drastically is the most important blood safety challenge facing the region today.
Both problems can be solved by increasing the proportion of blood from altruistic donors.
Why is blood from altruistic donors so much safer?
Every blood bank asks potential donors a series of screening questions to find out if there is any reason to doubt that their blood is safe. The problem is that both replacement and paid donors tend to hide risky behaviors from blood bank personnel. Paid donors don't want to hurt their chances of earning some cash, while replacement donors may feel pressure to comply with family requests to give blood but be embarrassed to admit risky behaviors to blood bank personnel. In some cases, families have trouble recruiting donors and end up paying donors with cash. In contrast, voluntary donors whose only motivation is to give the gift of blood have no reason to give false answers to screening questions.
In developed countries, most blood is obtained from altruistic donors, and about 5% of their populations donate blood each year. Countries in Latin America and the Caribbean, however, rely heavily on paid and replacement donations and, on average, collect blood from only 1.4% of their populations. Countries need to collect blood from the equivalent of 3-5% of their populations yearly to maintain an adequate blood supply.
PAHO and the Red Cross federation are working to help countries in Latin America and the Caribbean address the problem of chronic blood shortages and reliance on family replacement donation. These efforts face important challenges:
Attitudes of potential donors: Many people in the region believe that giving blood can make a donor gain or lose weight. Others think giving blood means giving away part of one's life. PAHO has supported sociocultural research to develop social marketing campaigns that are culturally sensitive and aimed at the lowest-risk populations.
Blood bank practices: Lack of training and the absence of structured questionnaires can lead blood bank staff to turn away potential donors for reasons that are not always valid. Moreover, because the safest donors are repeat donors, altruistic donors must be treated with courtesy and respect. Well-trained staff are essential for making donors feel safe and comfortable.
Blood bank outreach: Mobile teams are needed to collect blood in workplaces, social clubs, churches, and other meeting places. Indeed, there are very good reasons to take blood collection out of the hospital environment, creating blood banks that are more accessible and donor-friendly.
Latin America and the Caribbean have made great strides in blood safety in recent years. Widespread screening has significantly reduced the risks of transfusions throughout the region. The challenge now is to make sure that every country has a safe, ample, and timely supply of blood available to all its inhabitants. Working together—PAHO, the Red Cross, ministries of health, and others—to promote voluntary, repeated altruistic donation will go a long way toward achieving that goal.
PAHO has designated Paraguay as the host country for the regional celebration of World Blood Donor Day 2009, in which other countries of the region will participate with local and national events.
World Blood Donor Day
The first World Blood Donor Day was celebrated on June 14, 2004, building on the success of International Blood Donor Day, observed annually since 1995, and World Health Day 2000, which was devoted to the theme of blood safety. These initiatives and the expanded interest they generated helped lead to the adoption by the 2005 World Health Assembly of resolution WHA58.13, which established an annual celebration of World Blood Donor Day and urged broader international support for blood safety.
World Blood Donor Day is sponsored jointly by four founding agencies: the World Health Organization, the International Federation of Red Cross and Red Crescent Societies, the International Federation of Blood Donor Organizations and the International Society of Blood Transfusion.