Blood services

Improving the safety of the world's blood supply

Every day millions of people require blood transfusions. Most transfusions save lives, but they can also put a patient at risk if blood is contaminated by an infectious disease. Up to 5 per cent of HIV infections in the developing world, for example, may still be due to transfusion of contaminated blood. Maintaining a safe blood supply, therefore, is in the interest of every public health official.

Safe blood may generally be described as having no traces of viruses, parasites, drugs, alcohol, chemical substances or other factors that may cause harm to the recipient. A crucial element in ensuring safety is to know as much as possible about the source of donated blood.

A system of voluntary, regular non-remunerated blood donation is widely recognized as a critical factor in quality blood service delivery. Blood coming from family or replacement donors and especially paid donors is known to have a higher incidence and prevalence of transfusion-transmissible infections. Blood coming from a voluntary system is, in general, less likely to contain HIV, hepatitis B or other harmful factors.

Not only is the blood likely to be safer from voluntary donors but such a system has another advantage: it cuts down on the amount of blood that has to be discarded because of evidence of infectious disease markers in that way reducing the cost of collection programmes.

More than 75 million units of blood are collected annually worldwide. Red Cross and Red Crescent societies gather directly an estimated 30 per cent while another 30 per cent is donated through organizations and services supported by National Societies. To ensure the safety of the blood supply, the International Federation of Red Cross and Red Crescent Societies has made the elimination of the use of paid donors and the conversion of family and replacement donors to voluntary ones a high priority.

Our unique advantage

After World War II, blood donation and transfusion became an important area of activity for many National Societies. The AIDS epidemic caught many in the health sector unaware of the risks associated with distributing blood not tested for the HIV/AIDS virus. Thousands of people were infected with the virus as a result. This tragedy led the momentum to improve the quality of blood services worlwide.

The International Red Cross and Red Crescent Movement is uniquely placed to contribute to improving the world's blood supply. A number of comparative advantages enable the Movement to achieve this:

• The Red Cross and Red Crescent emblems, for many people, represent an institution where they can generously give their blood to save the lives of others, confident that it will be properly managed.
• With the largest humanitarian network of volunteers, the Federation and its members have a considerable experience with volunteer retention, motivation and support. The knowledge gained from this experience is equally relevant for blood donors.
• A strong link with local stakeholders has helped National Societies identify high risk populations for contaminated blood thereby eliminating them as potential donors. Other actions, such as ensuring alternative testing sites are available for HIV/AIDS, have also contributed significantly to this objective.

Consistent with Strategy 2010, the Federation is building on its comparative advantages to advocate for and implement programmes which promote voluntary, non-remunerated blood donation. This includes:

• Knowledge sharing
  The Federation is pursuing efforts to share its experience to improve blood safety worldwide. As part of this effort, it is developing a distance learning course studying the various methods of recruitment, retention and motivation of voluntary, non-remunerated blood donors.
• Quality control systems
  The 57 Red Cross and Red Crescent societies running blood processing centres are striving to implement quality control systems throughout the collection chain, in accordance with the aims of the "Quality provision of blood services" policy adopted by the Federation's General Assembly in November 1999. A commitment to the Federation's blood policy is seen as necessary to implement and maintain the highest standards of quality, safety, efficacy and efficiency.
  
  The goal is that all patients in need of blood or blood products, wherever they are, will have an adequate and safe supply of this gift of life. A system based on voluntary, non-remunerated blood donation is still recognized as the foundation for a safe blood supply and the Federation, together with its National Societies pursue their commitment in a variety of activities.
• Promotion of safe blood
  Raising awareness about safe blood is still an emerging area of knowledge and practice. The Federation is able to do this through regular communications to all National Societies with such publications as the specialized newsletter, "Transfusion International". This document focuses extensively on voluntary blood donor recruitment. It has an estimated readership of between 10,000 and 15,000, reaching a diverse audience involved in blood service delivery.
• Using emergencies to increase regular blood donation
  The need for an effective blood service becomes most acute during emergencies whether war, natural disasters or large-scale accidents. Often in these situations, the system is overwhelmed and National Societies are called upon to increase blood supplies. Many people interested in donating blood during this period give spontaneously to the Red Cross and Red Crescent and some of them, later become regular non-remunerated donors.

Our partners
For the past 20 years, the Federation has worked to promote the practice of voluntary non-remunerated blood donations worldwide. Close partnerships with the International Society of Blood Transfusion (ISBT) and the International Federation of Blood Donor Organizations has contributed to the success of the International Federation efforts. As a result, it is now possible to envisage the gradual phasing out of the use of paid donors as soon as countries construct and implement national blood policies.

The International Federation launched, in April 2000, together with the WHO, a long-term campaign to help address important issues regarding blood safety. The blood safety slogan and theme for this campaign is "Safe blood starts with me....blood saves lives". As a direct result of this initiative, a globally recognized symbol is available to help sensitize the public to the need for safer blood donations. The momentum generated by events during the launch on World Health Day also helped to foster further collaboration and partnerships to assist those countries most in need of ensuring a safer blood supply.