This document discusses voluntary non-remunerated blood donation (VNRBD) and the goal of achieving 100% VNRBD globally by 2020. It notes that 52 countries currently collect less than 25% of their blood supply through voluntary donations. Challenges to achieving full voluntary donation include lack of funding and infrastructure for blood services. Solutions proposed are establishing a World Blood Donor Day, legislation to phase out paid donation, and public awareness campaigns to recruit more voluntary donors. Priorities for action include forming national advisory committees, training donor recruiters, and promoting collaboration between stakeholders.

1. Salwa Hindawi
Professor of Haematology & Transfusion
Medicine
King Abdulaziz University, Jeddah
Saudi Arabia
Voluntary Non remunerated Blood
Donation (VNRBD)
Salwa Hindawi 2019

2. Introduction
 In most developing countries 50-80% of supplied
blood is used for obstetrics emergencies
 Worldwide, >100 million people sustain injuries each
year and >5 million die from violence and injury.
 RTAs are the 2nd leading cause of death and a leading
cause of serious injury for both sexes aged 5–29y.
 Uncontrolled bleeding accounts for >40% of trauma
related deaths.
Salwa Hindawi 2019

3. Introduction
 Globally, up to 4 million people have been infected
with HIV by the transfusion of unsafe blood.
 The prevalence of hepatitis B, hepatitis C and syphilis
in donated blood is still unacceptably high in many
developing countries.
 Many countries lack policies, procedures or resources
for ensuring the safety of blood.
Salwa Hindawi 2019

4. Introduction
 Blood transfusion saves lives, but the transfusion
of unsafe blood puts lives at risk because HIV,
hepatitis B, hepatitis C, syphilis, malaria and other
infections can be transmitted to the recipients
through transfusion.
 The Fifty-eighth World Health Assembly
Resolution WHA28.7 2urged the development of
national blood services based on VNBD.
Salwa Hindawi 2019

5. Achieving 100% VNRBD Through:
 WHO Global Consultation on 100% Voluntary Non-
Remunerated Donation of Blood and Blood Components, 9-11
June 2009, Melbourne, Australia
 Launch of the WHO-IFRCS publication: Towards 100%
Voluntary Blood Donation: A Global Framework for Action
 World Blood Donor Day 14 June 2009: WBDD global event to
be held in Australia
 Theme 'Achievement of 100 per cent voluntary non-remunerated
donation of blood and blood components'
Salwa Hindawi 2019

6. Definition of VNRBD
 Persons who give blood, plasma or other blood
components of their own free well and receive no
payment for it, either in the form of cash, or in
kind which could be considered as substitute for
money.
 Small tokens, refreshments and reimbursements of
direct travel costs are compatible with voluntary,
non-remunerated blood donation.
Salwa Hindawi 2019

7. Global Blood Supply
Human Development Index (HDI)
High HDI
(n=62)
54.5 M (64%)
Medium HDI
(n=73)
29.7 M (35%)
Low HDI
(n=27)
1.2 M (1%)
High HDI Medium HDI Low HDI
WHO-BSI/GDBS 2006/07
Total Blood Collection: 85 millions (162 Countries)

8. Global Population and Blood Supply
24%
64%
67%
35%
9%
2%
0%
10%
20%
30%
40%
50%
60%
70%
%
High HDI Medium HDI Low HDI
% Population % Donations WHO-BSI/GDBS 2006/07

9. WB donations vs Apheresis , by HDI
category
0
10,000,000
20,000,000
30,000,000
40,000,000
50,000,000
60,000,000
Numberofdonations
High HDI Medium HDI Low HDI
HDI category
Whole Blood Apheresis
17.7%
2.2%
> 93% of the apheresis donations collected in developed countries
0.2%
WHO-BSI/GDBS 2006/07

10. Discard of blood
TTI
24%
Date expiry
28%
Faulty collection
15%
Storage/transport
problem
1%
Others
32%
WHO-BSI/GDBS 2006/07
3.3 million donations discarded

11. Types of Blood Donations, by HDI
93.7%
4.3%
2.0%
76.8%
22.0%
1.2%
69.2%
29.3%
1.5%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
%
High HDI Medium HDI Low HDI
Voluntary non-remunerated Family/replacement Paid
54.6 million
1.45 billion
29.7 million
3.96 billion
1.2 million
0.52 billion
Donations
Populations
WHO-BSI/GDBS 2006/07

12. Percentage of voluntary NR blood donation, by HDI
13 30 9
6 14 5
6 11 2
6 5 1
6 8 4
35 14 8
0 10 20 30 40 50 60
No. of countries
<25%
25%-<50%
50%-<75%
75%-<90%
90%-<100%
100%
%ofvoluntarynonremunerateddonations
High HDI (n=72) Medium HDI (n=82) Low HDI (n=29)
57
18
52
WHO-BSI/GDBS 2006/07

13.  111 countries show↑ in number blood donations by
voluntary NR blood donors (2006/7 vs. 2004/5)
 32 of these 111 countries (all these 32 countries are
developing or transitional countries) have shown
more than double the number of voluntary donations
as compared to 2004
 11 countries report >10% increase in voluntary NR
blood donations in 2007, as compared to 2006
Type of Blood Donations
Salwa Hindawi 2019

14.  52 countries collect < 25% of their blood supplies
from voluntary NR blood donations
 31 countries still report collecting paid donations in
2007, > 1 million in total
Type of Blood Donations
Salwa Hindawi 2019

16. Vision and Mission
 Achievement of 100% Voluntary Non-remunerated
Blood Donation Globally by 2020
 Promote and support the establishment of effective
VNRBD programs to improve access to safe and
sufficient blood supplies
 Provide guidance and support countries seeking to:
 establish effective VNRBD programmes
 phase out family/replacement blood donation
 eliminate paid "donation"
Salwa Hindawi 2019

17. Challenges
 Lack of political commitment and support, policy and
legislation.
 Fragmentation, lack of structure, coordination and quality,
and low efficiency in blood services
 Lack of adequate budget
 absence of a comprehensive blood donor programme
 inadequate financial resources and lack of trained human
resources
 Inadequate infrastructure, facilities and system to provide
quality care to blood donors
 Lack of outreach community programmes and effective
communication with potential blood donors
Salwa Hindawi 2019

18. Continuing Challenges
 Considerable reliance on family replacement and paid donations in
many countries
 High prevalence of TTIs in the some region and risk of transmission
through unsafe blood
 Shrinking VNRB donor base
 Balancing supply and safety in this globalised world
 This leads to
 Blood shortages, low donation rates, high discard rates
 Low rates of voluntary blood donation
 Lack of trust in the blood service
Salwa Hindawi 2019

19. Solutions
 the establishment of an annual World Blood Donor Day, to
be celebrated on 14 June each year.
 blood donor day should be an integral part of the national
blood donor recruitment programme.
 to establish or strengthen systems for the recruitment and
retention of voluntary non remunerated blood donors and
the implementation of stringent criteria for donor selection.
Salwa Hindawi 2019

20. Solutions
 to introduce legislation, where needed, to eliminate
paid blood donation except in limited circumstances of
medical necessity and, in such cases, to require
mention in the informed consent and to be agreed and
signed by the transfusion recipient.
 to ensure the proper use of blood transfusion in
clinical practice so as to avoid abuse of blood
transfusion, which may result in a shortage of blood
and hence stimulate the need for paid
blood donation.
Salwa Hindawi 2019

21. Solutions
 to support the full implementation of well-organized,
nationally coordinated and sustainable blood programs
with appropriate regulatory systems
 INVITES private agencies to provide adequate funding for
initiatives to promote voluntary, non remunerated blood
donation.
Salwa Hindawi 2019

22. Priorities for action to achieve 100%
VNRBD:
1-Active National Advisory Committee:
A Panel of experts is needed in all countries to help in
development of national policies, and to follow up
their implementation.
2- Awareness Campaigns on regular bases to involve
people from the society and media to promote better
education and knowledge about voluntary blood
donation.
3- Training programs for donor recruiters to help in
develop needed skills for recruitment and donor
retention.
Salwa Hindawi 2019

23. Recommendations to all key stakeholders
 To have an expert personal at WHO working office in
each country to advise and monitor the implementation
of WHO recommendations.
 To promote collaboration and partnership at all levels
nationally and internationally.
 To support financially all activities related to
development of 100% voluntary non- remunerated blood
donation.
Salwa Hindawi 2019

24. Conclusion
Safe blood comes from safe donor (volunteer non-
remounted donor) to have a safe donor we will need:
 Adequate resources.
 Mobile units.
 Education materials.
 Media coverage .
 Total management for adequate safe blood supply.
Salwa Hindawi 2019

25. Who should join Donor recruitment
program?
Salwa Hindawi 2019

26. References:
 WHO Global Consultation on 100% Voluntary
Non-Remunerated Donation of Blood and Blood
Components, 9-11 June 2009, Melbourne,
Australia
 World Health Organisation official website.
Salwa Hindawi 2019

27. Saudi Society of Transfusion Medicine
(SSTM)
Please join us to help in upgrading and
improving blood transfusion services in the
Kingdom of Saudi Arabia.
Website:
www.sstm.org.sa
E-mail:
sstm_2009@hotmail.com
Salwa Hindawi 2019

28. Salwa Hindawi 2019