Encouraging Voluntary Blood Donation
Voluntary donation is the key to a safe and plentiful blood supply.
In the US and many other developed countries, the principle of unpaid, volunteer donors (often referred to as voluntary non-remunerated blood donation – VNRBD) is firmly established.
This responds to the concern that a blood donor who is coerced into donation by social pressure or the prospect of payment (and who may therefore have cause to hide any number of issues or behaviours such as pre-existing conditions, high-risk sexual practises or drug use) is inherently less safe than a donor who agrees to donate for entirely benevolent reasons
This is especially so where testing is not available and the only way to avoid the risk of transmitting blood-borne disease is to accept blood solely from “safe” (or at least lower risk) donor populations.
However, only a handful of low-income countries have exclusively VNRBD programs and the majority rely on either paid or “replacement” donors – the latter nominally involving family members donating to replace blood used by a relative but frequently, in practice, impossible to distinguish from paid donation.
With almost 1 billion people living in extreme poverty, “professional” blood donors proliferate and are to be found waiting outside the doors of many developing-world hospitals, only too happy to present as a helpful brother or cousin.
It is estimated that in over 70 countries the majority of blood comes from paid or replacement donors. In a world where tens of millions live with HIV/AIDS, the risk to the patient is obvious.
This helps to explain estimates that each year blood transfusion will result in tens of thousands of new HIV infections – a direct result of receiving contaminated blood.