Self-sufficiency in blood supply based on voluntary unpaid donors: an achievable goal

June 2013

France and Sri Lanka, this year and next year’s host countries for World Blood Donor Day, are self-sufficient in blood supply through voluntary unpaid blood donation.

Every year, France is able to treat a million patients with around three million units of locally collected blood and blood products. It is one of the 60 countries collecting 100% of its blood supply from voluntary unpaid blood donors.

An advertisement (poster) promoting blood donation from France’s Etablissement Français du Sang
Etablissement Français du Sang

World Blood Donor Day, held on 14 June every year, with France as this year’s host country, has played a major role in promoting the goal of self-sufficiency in blood supply based on voluntary unpaid donors around the world.

It is an opportunity to raise awareness of the need for safe blood and blood products and to thank voluntary, unpaid donors who give blood on a regular basis. In this tenth anniversary year, the campaign slogan is: “Give the gift of life: donate blood”.

“Blood donation is religiously and culturally accepted and very much a valued concept”

Dr Namal Bandara, Sri Lankan National Blood Transfusion Service

All countries need a regular supply of safe blood. In low-income countries, the biggest demand is for blood transfusions to treat severe anaemia in children under 5 years old, and to manage pregnancy related complications. In high-income countries, transfusions are most commonly used for supportive care in cardiovascular and transplant surgery, massive trauma and cancer treatment.

And as Dr Neelam Dhingra of the World Health Organization points out: “Blood donation by regular, voluntary unpaid donors is the cornerstone of an adequate and safe blood supply.”

Self-sufficiency in blood and blood products in France and Sri Lanka

Through its national blood service, the Etablissement Français du Sang (EFS), France has promoted voluntary unpaid blood donation – and has been self-sufficient – since the 1950s. A key factor in this achievement has been intensive public awareness campaigns whose focus has more recently shifted from “urgent” calls for donation (the lifespan of blood constituents is short – from 5 to 42 days) through traditional media to more frequent seasonal campaigns, which use widespread publicity as well as Facebook, Twitter, smartphone apps and YouTube to encourage people to give blood. Blood is collected at 153 fixed-site collection areas and via 40 000 mobile sessions a year.

Since the establishment of World Blood Donor Day in 2004, there has been an upsurge in voluntary unpaid blood donations, particularly in low and middle-income countries.

A Buddhist monk donates blood in Sri Lanka
Shraddha Rudhira Dana

Sri Lanka, which will be the host country for the global event of World Blood Donor Day in 2014, has achieved remarkable success in reaching a self-sufficient blood supply in just ten years. The National Blood Transfusion Service (NBTS) now collects over 350 000 donations every year, up from just over 150 000 ten years ago. The proportion of voluntary donations has risen from 39% to 97% since 2003.

A key success factor in this rapid rise to self-sufficiency has been the establishment of a centrally- coordinated national transfusion service and people’s understanding of the need for blood donation. In addition, says Dr Namal Bandara, NBTS Medical Officer, Sri Lankans attach special importance to the act of blood donation. “Because most Sri Lankans follow Buddhism, blood donation is religiously and culturally accepted and very much a valued concept,” he says.

Novel approaches to blood donor recruitment

Sri Lankan schoolchildren observe a blood donation demonstration at a national educational exhibition on blood donation.
Sri Lankan National Blood Transfusion Service

Every month, on the day there is a full moon, people are encouraged to give blood. Social groups organize blood donation sessions on this day on their own premises - often temples, schools or universities – which results in 85% of all donations in Sri Lanka being collected at mobile sessions.

Sri Lanka’s other innovations in recruiting blood donors include a card system (silver/gold/platinum) for milestone achievers in blood donation, a Facebook fan page, free cardiopulmonary resuscitation (CPR) training in target potential donor venues, and annual health checkups for selected donors.

Although these incentives have all worked, NBTS has still found that the most efficient way to recruit blood donors is through existing donors and donation organizers acting as personal messengers. “ ‘Thank you for your donation and come with your friend next time’ seems to be a very simple yet efficient way of recruiting,” Dr Bandara says.