WORLD HEALTH DAY 2000
7th April 2000

Safe blood starts with me
Blood saves lives

On this radio page you can find a wide-ranging selection of authoritative opinions about World Health Day 2000. This high-quality broadcast material is freely offered to you by WHO, with the added benefit of verbatim transcriptions of statements. The World Health Organization has joined forces with the International Federation of Red Cross and Red Crescent Societies to help focus attention on this year’s theme "Safe Blood".

«At the beginning of this new millenium, we should like to ask people everywhere to safeguard their health by caring for that precious life source, their blood. Good nutrition, a healthy life style, proper prevention and early treatment of disease all contribute to healthy blood.»

Dr Gro Harlem Brundtland                        Mr George Weber
Director General                                                          Secretary General

 

On this page you can find:

Dr Jean C. Emmanuel (WHO Director of Blood Safety and Clinical Technology)

Dr Luc Noel (WHO Coordinator Blood Transfusion Safety Unit)

Mr Peter Carolan (IFRC Senior Officer, Blood Department)

Ms Marcela García (IFRC Blood Department)

Dr Jean C. Emmanuel
WHO Director of Blood Safety and Clinical Technology
  wav  mp3 Real Audio
(download only)
Much of the world’s blood supply is unsafe
«In general, the reason why the blood supply is unsafe is that there isn’t a nationally coordinated, organized blood transfusion service in many parts of the world. The reason for this is that there is a lack of government commitment and suppport. And this also brings with it the adequate budget, the trained staff and all the requisites that one requires in the form of buildings and staff and so on. (0’27’’)
emmanuel1.wav emmanuel1.mp3 emmanuel1.rm
Major problems with unsafe blood supply»
«Well, the major problem that everyone is aware of, is of course the HIV. HIV has raised an awareness not only on ethical issues but also on safety issues for those who are receiving blood. And with it also come other serious infections such as hepatitis B, hepatitis C and in some of the Latin-American countries the Chagas Disease» (0’’20’’)

emmanuel2.wav emmanuel2.mp3 emmanuel2.rm
Dr Luc Noel
WHO Coordinator Blood Transfusion Safety
Blood transfusion: a new priority
«
The Blood Transfusion Safety Unit of WHO is extremely happy that «blood transfusion» is recognized as a new priority for the World Health Organization… because transfusion involves the population of the world, is needed both in developing and developed countries and it still requires efforts to be available as a therapy to everybody in every country» (0’24’’)
noel1.wav noel1.mp3 noel1.rm
This year’s theme is all-embracing
«Safe blood starts with me».
This does very well express why WHO and the International Federation of Red Cross and Red Crescent Societies work together. «Safe blood starts with me» concerns everybody because the resource of blood products is a community resource and may be used by anybody who needs it among us and we are all owners of this resource. Transfusion is a vector of altruism in society. I mean, it’s a gift that has nothing to do with your wallet» (0’39’’)
noel2.wav noel2.mp3 noel2.rm
Facts and Figures
«Well, globally we estimate that 75 million units of blood are donated each year. Only 40% of the global blood suplly is donated in countries with low and medium health development indexes. It means that 80% of the global population has access to only 20% of the global supply of safe blood.
We figure out that at least 13 million units of blood donated each year are not tested for the main transmissible viruses. But one should make it very clear that the issue in blood safety is not only that of transmissible diseases which nowadays are very very low risk in those countries that can apply the best safety measures» (0’49’’)
noel3.wav noel3.mp3 noel3.rm
Transmissible infections and availability of blood
«The residual risk for HIV transmission by transfusion in developed countries is around or less than 1 over a million, which is definitely a very small risk by any standards. But the real isssue is what happens in those countries which do not have the means to test the blood, who may not have a sustainable transfusion system, who may not have the kits, and who still need transfusions! In short: there are two issues. Transmissible infections by transfusions of blood borne pathogens is one issue. But the other one, that is often forgotten is that of availability of blood» (0’44’’)
noel4.wav noel4.mp3 noel4.rm
A safe, reliable transfusion service IS essential
«The experience of the WHO team identifies very clearly the conditions to have a safe, reliable transfusion service. The first thing is to select the donors, and select them among people that are motivated by altruism. I mean they have to be non-remunerated, only motivated by the will to help somebody else. Anybody giving blood should imagine behind the system, behind the transfusion service, the people who will actually collect the blood from them… that there is a patient! There may be a baby, maybe a mother, maybe a grandmother, or a grandfather. That’s where you can really go through the selection process, because there needs to be a selection process. The other factor is obviously that ALL donations should be tested. All donations are not tested systematically in the world today» (0’55’’)

noel5.wav

noel5.mp3 noel5.rm
Blood safety also includes injection safety
«This is an important issue: blood safety in WHO is certainly blood transfusion safety but it’s also injection safety. We know that the re-use of needles and syringes –and not adequate sterilisation- can carry from one patient to the other a virus, particularly hepatitis B, hepatitis C and, in some circumstances, even HIV. And there’s an ongoing effort to develop the use of auto-disabling syringes and to train people in properly sterilising needles and syringes. Properly destroying waste management is also an issue in this area» (0’53’’)

«One important action in injection safety is to restrict injections to situations where they are mandated, when they are necessary. And this means clinicians’ training and public training as well» (0’15’’)

noel6.wav noel6.mp3 noel6.rm
noel7.wav noel7.mp3 noel7.rm
Safe blood donations begin with safe blood donors
«Well, if you are conscious of your health and you really think you should help others by giving blood, obviously you should think about the risk of having transmissible viruses in your blood. Anybody who has an adventurous sexual life, for example, should definitely not be a blood donor» (0’25’’)
noel8.wav noel8.mp3 noel8.rm
Transfusion’s only aim: to save the patient’s life
«The only good transfusion is the one you cannot make without. The only good transfusion is the one that saves the patient. And whenever you can use another solution, for example, crystalloids to maintain the blood pressure, you should use it. A large part of our time is dedicated to help clinicians to use blood products and blood for the best indications» (0’25’’)

 

noel9.wav noel9.mp3 noel9.rm
Mr Peter Carolan
IFRC Senior Officer Blood Department
       
Global campaign = global responsibility
«We’re not just looking at people who work in blood services or hospitals to take responsability. The whole issue belongs clearly with every individual. It is relevant for a politician, a teacher, a Health Minister, a teenager, it applies to journalists, film stars or sporting heroes, it can apply to an adult or a young person… because the business of blood safety belongs to the whole community. It is the community that needs a safe and adequate blood supply but it is the blood service that needs the cooperation of the community to deliver.
Certainly, the message is meant for clinicians so that blood is only used when it is absolutely necessary but «safe blood starts with me» applies literally to everyone. After all at any moment we could be patients requiring blood to save our lives… we would want it to be available and as safe as possible» (0’56’’)
carolan1.wav  carolan1.mp3 carolan1.rm
Key elements in the community
«In order to manage blood supplies, a lot of key elements in the community have to work together: blood experts, politicians, people like media experts, educators, community leaders, individuals and then –together- we can build a global safe and adequate blood supply. It really can be done!» (0’20’’)
carolan2.wav  carolan2.mp3 carolan2.rm
World-wide action by the Red Cross
and Red Crescent societies

«Well over one hundred of our national societies are directly involved in blood services from the recruitment of voluntary donors and the participation in community or schools education programmes right through to the provision of national blood services. But all National Societies (176 in total) along with numerous other organizations are helping too. Numerous community health programmes… strategies to control diseases like measles, cholera, meningitis, AIDS, hepatitis or social programmes for adolescents, prostitutes, street children and people with drug or alcohol problems» (0’38’’)
carolan3.wav  carolan3.mp3 carolan3.rm
A healthy lifestyle for safe blood supply
«All these efforts are contributing towards the gradual establishment of so-called low-risk populations. Health promotion programmes aimed at encouraging healthy lifestyles help expand low risk populations and it is only from such populations that a community can rely on for a safe blood supply» (0’20’’)
 carolan4.wav carolan4.mp3 carolan4.rm
Developing countries in particular face common barriers to achieve a safe blood supply
«There are some fundamental issues and the lack of national blood policy often gives rise to problems as indeed does the existence of payment for blood. The proliferation of commercial blood banks in some regions must be addressed quickly by governments.
But also in so many instances there is a hidden pay system which we call «replacement donors». What really happens is the onus for procuring blood for a patient is sometimes placed on patient’s friends or relatives. These people may have someone in their family who needs blood regularly and often in despair they have to resort to paid donors to ensure the needs of their relatives are met» (0’39’’)
 carolan5.wav carolan5.wav carolan5.rm
Can a day like World Health Day solve these difficulties? Is there any point on focussing on these issues for one day?
«I really think that today and next year (it being the International Year of Volunteers) gives a timely window for the world to reflect on the value of voluntary non-remunerated blood donors in the whole scheme of blood service delivery. The safest blood donor has proved to be a regular voluntary donor. World Health Day provides everyone with an opportunity now to say «thank you», thank you to voluntary blood donors. You know, it is not just doctors and nurses who saves lives. Voluntary donors are co-health workers with the professionals in the health care system and should not be taken for granted.
Indeed nor should it be assumed that a system based on voluntary non-remunerated blood donation is cheap. So, World Health Day actually provides an opportunity to remind those in charge of funding that ongoing education campaigns at various levels are all necessary to ensure an adequate and safe blood supply» (0’58’’)
carolan6.wav  carolan6.mp3 carolan6.rm
How best to encourage voluntary blood donation
«This is a huge problem for our Societies that are involved directly in the recruitment of voluntary blood donors. We need the support of governments and other organizations to create a new generation of new blood donors and to protect the efforts that have gone over many decades in establishing voluntary blood donor panels. It means education and legislation to ban paid blood donation» (0’24’’)
carolan7.wav  carolan7.mp3 carolan7.rm
IN SPANISH
Ms Marcela García
IFRC Blood Department
The main challenges to promote blood donation
«Las dificultades es los programas de educación que tienen que ser constantes. No pueden ser puntuales, o campañas. En consecuencia, se tiene que adentrar desde la educación primaria para sensibilizar a la persona sobre la donación de sangre y cuando ya sea adolescente, la persona haya interiorizado esa necesidad y lo haga efectivo en las donaciones de sangre. Entonces creo que la limitacion que hemos encontrado es que los programas obedecen a necesidades puntuales, que no perseveran a través del tiempo y, en cierto modo, esto hace que las personas pierdan el interés sobre la donación de sangre» (0’41’’)
garcia1.wav garcia1.mp3 garcia1.rm
A great supporting role in blood transfusion services
«El gobierno es el último responsable de la salud de los ciudadanos. Sin embargo, en lo que a sangre se refiere, en muchos países el gobierno ha delegado esa responsabilidad a las sociedades nacionales de la Cruz Roja. Podemos citar varios ejemplos. En Honduras, por ejemplo, en Ecuador también, en Australia, en Japón… Entonces, ahí es donde nosotros –como institución auxiliadora del poder público y manteniendo nuestros principios y nuestra filosofía- ayudamos a desarrollar y contribuímos en la seguridad transfusional» (0’35’’)
garcia2.wav  garcia2.mp3 garcia2.rm
Room for improvement
«En primer lugar, mejorar la base de la donación. El donante de sangre es el pilar sobre el cual se construyen los servicios de transfusión en el mundo. En la medida en que tengamos mejor calidad de donantes, gente sana, gente que esté comprometida con la donación, que done su sangre permanentemente. En consecuencia, la sangre que ha sido analizada por un mayor tiempo, da una base más sólida a ese programa.
Y en segundo, yo diría que hay que mejorar los procedimientos que se tienen dentro del manejo del banco de sangre. Hay muy buena tecnología disponible y no con ésto yo quiero decir que se hace necesario establecer sistemas de sangre sofisticados. Pero podemos establecer reglas mínimas en los procedimientos en los bancos de sangre» (0’54’’)
garcia3.wav  garcia3.mp3 garcia3.rm
Voluntary donation is vital
«La importancia de la donación voluntaria radica en que muchas de las infecciones que se pueden transmitir por sangre no son detectadas por el laboratorio. En consecuencia, la honestidad con que la persona responda al interrogante es vital para determinar si esta persona dona sangre o no. Si la persona tiene algún interés por donar, es posible que oculte ciertos síntomas o señales de un proceso infeccioso. Si, por el contrario, la persona su único deseo es de ayudar a alguien más, va a ser honesto y claro en su respuesta.
Por otro lado, la donación de sangre también debe cumplir con lo que se establece en el Código de Etica, para proteger tanto al donante como al receptor» (0'40'') 
garcia4.wav garcia4.mp3 garcia4.rm

For complete background information, see:
www.who.int/world-health-day/

For the Press Release, see:
http://www.who.int/inf-pr-2000/en/pr2000-25.html

 

    Copyright © WHO/OMSContact WHO