Club 25... whereblood donorslove life!World HealthOrganization
Introduction The spread of HIV in the 1980’s caused blood services acrossthe world to seek new strategies to collect the safest blood possible.A variety of strategies have been implemented and in some casescostly and sophisticated advertising campaigns have resulted indismal failures, while others have had limited success. Countriesacross the world are continually evaluating their blood donorrecruitment and motivation strategies in the light of currentdemands for blood and blood products and in some cases areduction in available eligible donors: this being due to thestringent criteria in place to protect blood safety. With this as a very brief backdrop to the challenges facingthose tasked with the collection of the safest blood possible it isfascinating to find that often the best solutions can also be thecheapest! Introducing… “Club 25” where young blood donors indeed love life and are happy to share their time, their blood, their energy and their ideas! In 1989, Zimbabwe started targeting a previously untappedpool of low-risk donors and one such school-age blood donor atthe time suggested it might be a good idea if young people pledgedto give 25 blood donations by age of 25 years. Very soon many stu-dents started committing themselves to this idea and the forma-tion of the first “Pledge 25 Club” took place. Now around 70% ofblood collected in Zimbabwe is donated by school students andPledge 25 Club members. The accompanying video and this leaflet provide an overviewof how this initiative is now having appeal to teenagers across theworld. It is interesting that the initiative has been particularly suc-2 Club 25... where blood donors love life!
cessful in keeping young people protected from HIV and otherinfections because part of their pledge is that they will maintainhealthy life-styles in order to provide the safest blood. Indeed inZimbabwe the HIV infection rates among blood donors fell from4.45% in 1989 to 0.61% in 2001, in a country where infectionrate in the sexually active population was 33.7% at the time. Elsewhere, such as in neighboring South Africa the results arejust as impressive: young people aged 16-25 years are providingabout 24% of the national blood supply. This video will introduceyou to various Club 25 programmes and examine their progress inthree different countries, South Africa, the Philippines andMalawi. In preparation for World Blood Donor Day 14 June 2005,where we will again acknowledge the role of all voluntary blooddonors, it seems appropriate to introduce an approach to blooddonor motivation and HIV/AIDS education which may provideguidance to other organizations wishing to introduce similar pro-grammes. The philosophy behind the Club 25 Programmes is tobe open and honest with young people, providing clear guidelinesabout blood donation criteria and similarly facts about the bestHIV/AIDS protection based on the evidence available, and thenallowing young people to make their choices based on this evi-dence. One very important consideration in setting up a Club 25 Programme is that on no account is the Blood Service used as the place to find out if one is HIV positive. This would only be counter productive and attract the wrong target population. Club 25... where blood donors love life! 3
In summary it appears that Club 25 Programmes are using anevidence based approach to stimulate youth to take responsibilityfor their own actions. This ultimately has an impact in the com-munity in which they live and so far the impact in maintainingblood supplies and in stopping the spread the HIV/AIDS is prov-ing to be significant, at least in some parts of the world. Club/pledge 25…worldwide activities as at November 2004 Zimbabwe Botswana Zambia South Africa India Indonesia Malawi Uganda Haiti Philippines Togo Pilot programmes are also underway elsewhere and with YOUR help this list will be extended before World Blood Donor Day 14 June 2005. Start now and establish a Club 25 programme in your country!1 Stoneburner and Low-Beer, Population-Level HIV Declines and Behavioral Risk Avoidance in Uganda, Science 2004 304: 714-718 Science Journal4 Club 25... where blood donors love life!
Overviewwith country examples: Models of various kinds exist but generally they follow a simi-lar structure as per this very simple example: Models of various kinds exist but generally they follow a similar structure as per this very simple example: 1. The Club elects a national and provincial administra- tive committee to organize activities, for example a National Youth Blood Donor Day. 2. Peer promoters are elected to assist the Blood Service in the recruitment of voluntary, non-remunerated blood donors from low-risk populations and in turn the Blood Service supervises and supports the Club. Operationally the Club functions according to local needs butthe following example from South Africa helps to illustrate the roleof the Blood Service and the responsibilities of Club Members: Adapting Pledge 25 Club to South Africa The idea started in Zimbabwe. In the late 1990s, the bloodservice there revealed some interesting data and strategies in theoverall context of reducing the HIV rate and retaining youngdonors. The service had reduced the HIV rate among Zimbabweblood donors from about 21 per cent to 1.1 per cent includingnew donors (in a country where 20-26 per cent of people agedbetween 15-49 years were living with HIV/AIDS, and with ratesclimbing). They had identified young people as a low-risk group Club 25... where blood donors love life! 5
but they had also observed they ceased donating after they leftschool. So the first Pledge 25 Club was established, for schoolleavers who pledged to donate 25 times in their lifetime. As part of the pledge, the young people had to remain sero-negative in order to achieve their objective and within a short peri-od there was a significant increase in both club membership andblood donor retention among school leavers. Some time afterwards the “club concept” was then introducedin South Africa under the title of Club 25, and in general it oper-ates as follows: Approximate age of Club members: 18-25 years Recruitment for Club 25 is aimed at current donors who are leaving school or who have left school and already donated three or more units.. Donors (21 years or younger) who are no longer at school can also join the programme as long as they have previously given three units of blood. Club 25 members must ensure they lead a safe lifestyle in order to remain safe blood donors and meet the cri- teria for donor eligibility. Club 25 members must commit to donate a minimum of two units per year with the aim of donating 20 units by the end of their twenty-fifth year (ie all donations must be made before they reach 26 years.Teamwork In South Africa Club 25 is very much a team exercise, involv-ing various elements within the blood service. In involves thedonor staff in recruiting new members, the Corporate PublicRelations/Donor Marketing Department in special efforts toretain members as donors and to educate them to commit tohealthy lifestyles and a Club 25 newsletter to reinforce education6 Club 25... where blood donors love life!
and to remind donors of their commitment. Finally, telerecruitersalso play a key role by contacting the young donors and remind-ing them about their first donation during the January-Marchperiod and again for subsequent donations later in the year.The process After blood donors leave school they sign up as Club 25 mem-bers and give their first donation as part of the club. They receivea bag from the Blood Banks of South Africa as token of theirappreciation for their support and commitment. On their 20thdonation, a Club 25 member receives a nationally recognised Club25 medal and there is also a quarterly Club 25 newsletter to keepall members informed about blood donation drives and activities.One of the primary functions of this newsletter is to remind thesedonors of their commitment and to continually provide them withinformation on risk behaviour: the focus is on the importance ofdonating blood regularly and living a safe lifestyle.Results The launching of Club 25, conducted on National YouthBlood Donor Day, 4 December 1999, involved twenty branches ofSANBS and all centres reported that Club 25 was well received.Despite the cultural diversity of South Africa the National BloodService (SANBS) has been successful in creating a concept thatappeals to a target age group across all ethnic boundaries. SANBS has had some years to develop the concept and watchthe programme grow. Latest statistics indicate that Club 25 is cer-tainly making an impact on the quality and quantity of the coun-try’s blood supply. Moreover, it is also clear that the Blood Centreis playing a significant role in educating young people about riskbehaviour and ensure they remain free of the HIV/AIDS scourgethat has taken hold of the continent. Club 25... where blood donors love life! 7
Latest data In 4 years: 35,193 active donors on Club 25 donor panel. 177,426 donations from Club 25 members. Increase in 18-25 year old donors on SANBS donor panel from 6% to 15%. Decrease in HIV prevalence of Club 25 panel to 0.04%: SANBS donor panel to 0.07%: South Africa country 26 – 28%.A similar modelin the Philippines “Pledge 25” has recently become a project of the PhilippineNational Red Cross (PNRC)-Red Cross Youth Department (RCY)in support of the drive on voluntary blood donation. It consists ofa group of young blood donors who pledge to regularly donateblood 3 to 4 times a year starting the age of 18 until they reach 25years old. After this period, they will be joining other blood donorgroups for their regular blood donations.Objectives To organize a youth group as a link with Red Cross to tap the youth sector as regular donors of the PNRC. To create a group of young blood donor recruiters. To interface the youth program with the NBS. To promote the participation of women in voluntary blood donation. To instill into both young and old alike, the value of saving others’ lives by voluntary blood donation.8 Club 25... where blood donors love life!
Representation Members mostly represent various youth groups, either gov-ernment or non-government. But also accepted are young peoplewho do not belong to any youth organization. There are thou-sands of active members nationwide, and these young people arealso actively participating in other various worthwhile Red CrossYouth activities. Each member receives an attractive ID card aftertheir second donation, and a pin is given after the third donation.A regular Pledge 25 blood donor will receive a different design ofpin every year after the third donation.ResultsPledge 25 membershipsfor year 1999, 2000, 2001, 2002: Nationwide membership Year Luzon Visayas Mindanao Total 1999 1,038 353 960 2,351 2000 1,249 624 555 2,428 2001 815 913 271 1,999 2002 1525 605 820 2,950 January-June 2003 266 386 120 772 Over – All total 4,893 2,881 2,726 10,500 Club 25... where blood donors love life! 9
HIV/AIDS prevention: it is your choice! Based on current evidence available there are three broad cate- gories of risk concerning HIV/AIDS (No Risk, Low Risk and High Risk) and the chart opposite tries to identify these categories to enable young people especially make their choice in terms of appropriate protection where sexual relationships are concerned. Generally Club 25 Programmes include guidelines for young people to ensure they remain eligible as blood donors by leading healthy life-styles and the Blood Service can play an important role in providing HIV/AIDS education materials. In this way young people themselves become “HIV/AIDS” peer educators and their role in the community is even more significant than “saving lives by blood donation”... they now also play a vital role in health pro- motion as well! The Club 25 Programme, though only just beginning in some cases, appears to be a most economical model in terms of public health care. With young people playing such valuable roles in help- ing to secure a safe and adequate blood supply, and in creating a culture of healthy lifestyles among their peers, World Blood Donor Day, 14 June 2005 seems be a good opportunity for governments, policymakers and blood programmes to include them in their mes- sage of thanks to all blood donors. Thank you to all Pledge/Club 25 members!10 Club 25... where blood donors love life!