(2011), "Argentina - More blood, more life: Argentina’s hunt for new donors", International Journal of Health Care Quality Assurance, Vol. 24 No. 8. https://doi.org/10.1108/ijhcqa.2011.06224haa.003
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Copyright © 2011, Emerald Group Publishing Limited
Argentina - More blood, more life: Argentina’s hunt for new donors
Article Type: News and views From: International Journal of Health Care Quality Assurance, Volume 24, Issue 8
Keywords: Blood donor programmes, Blood donation, Public health awareness
Argentina has become the first Latin American country to host World Blood Donor Day, gathering specialists in hematology, medical technology and transfusion medicine from around the world.
World Blood Donor Day was established by the World Health Assembly in 2004. Its purpose is to recognise individuals who voluntarily donate blood, and to strengthen national programmes for collecting, processing and distributing sufficient safe blood for all patients who require transfusions.
According to Dr Andrés J. Leibovich, Undersecretary of Policy, Regulation and Control of the National Ministery of Health and President of the Local Organising Committee of World Blood Donor’s Day, the event was “a trigger for us and entire Latin America to actively work on the theme of blood donation.”
The theme for this year’s campaign was ‘más sangre, más vida’ (more blood, more life), in line with Argentina’s drive to create awareness about blood donation and increase the number of voluntary donors.
In Argentina 5,000 people need a blood donor every day. Since 2002, the “Plan Nacional de Sangre” (Nation Blood Plan) has put blood donation officially on the agenda of the National Ministry of Health.
Dr Mabel Maschio, Executive Coordinator of the National Blood Plan at the Health Ministery, says that since the introduction of the national blood plan, the number of voluntary blood donors in Argentina already risen six or seven-fold.
“Today, Argentina has 950,000 donors a year and the aim is increase this into one million donors,” states Leibovich.
One blood donation can save the lives of approximately three people, but experts worry that demographic changes will put a strain on supplies in the future.
Dr Horacio J. Salamone, Head of Transfusion Medicine of the Fundación Favoloro hospital, explained: “A person can give blood from the age of 18 to 65. So because of an ageing and longer-living population, demand for blood will increase, while the number of those who are able to give blood will decrease, relatively.”
Faced with these concerns, the government is directing more funds to the national programme. In 2004, US$35million was set aside to take the national blood plan through to 2010. This year, Minister of Health, Dr. Juan Luis Manzur, allocated US$100million for the next four years.
There are also autonomous blood banks under development in 18 of the country’s 23 provinces, adding to the four that already exist in Buenos Aires. In total, Argentina has approximately 400 places for blood donation (including those in hospitals or other health centres, among others).
According to Leibovich, the new funds will be used for everything that is lacking at the moment: including the transformation and construction of blood bank centres, equipment, promotional campaigns.
“We want to increase the amount of donors from 25 per thousand persons to 30 per thousand,” adds Maschio. “That will equalise supply with demand.”
“However, at the moment from these 25 people, approximately 70 percent are replacement donors. Our main challenge is to change the type of donors rather than the quantity.”
The current system of blood donation in Argentina primarily involves so-called “replacement donors” – those who give blood at the request of a relative, friend or acquaintance who needs a transfusion or surgical intervention. However, the health ministry is trying to encourage a system of voluntary and habitual donation, a system the World Health Organisation says is both safer and more sustainable in the long term.
Salamone, who in 1997 implemented a voluntary blood donor program at his hospital, says there are a number of problems with relying on replacement donors: “Often the donor feels pressured and obligated to carry out the act, either due to family, work or social pressure, since the blood can be of huge importance and even save lives. This may influence the answers in the questionnaire concerning the medical background of the donor.”
“Moreover, the system does not foresee the need for all patients, such as emergency situations and patients from distant geographical areas.”
A voluntary blood donor does not know anyone who needs treatment at that point yet gives blood on regular basis, typically more than once a year. Voluntary donor systems are commonplace in European countries, but throughout Latin-America, with the exception of Cuba and Nicaragua, countries typically still mainly use family/replacement donors.
“This has a lot to do with the fact that [to implement] a voluntary donation system requires time, effort and financial resources,” explains Salamone. “In many Latin-American countries there were other health problems which were more severe and therefore got priority.”
There is also the issue of ensuring that blood used in transfusions is safe, meaning that the blood is from a donor who is free from any form of transmittable infections or diseases.
Since 1975, the WHO has been at the forefront of the movement to improve global blood safety. Their Blood Transfusion Safety (BTS) programme focuses on the blood system strengthening, including national blood policy, plans, quality, education, training, universal access to safe blood transfusion, quality systems and voluntary non-remunerated blood donation, among others. By means of the Pan-American Heath Organisation this programme will be implemented throughout Latin-America.
Dr Oscar Walter Torres, head of the Argentine Blood Bank (AAHI) and the International Society Blood Transfusion (ISBT) of South-America, says this is already an established control in many countries:
When in 1985, HIV and its risk on infections became more known, people became more aware of the importance of safe blood. In Europe, for example, because of the two world wars they went though, people were more aware of the importance of safe blood.
Torres says this type of awareness is still lacking here: “they were educated in this subject far more than we are. Many people in Argentina and other Latin-American countries simply do not know enough about this.”
“In our country each year $13million is lost due to blood donors whose blood is not safe,” adds Leibovich. From this year, the National Administration of Medication, Nutrition and Medical Technology (ANMAT) will be charged with inspecting the blood banks of Argentina, improving the control over the blood used in transfusions.
As part of these controls, in Argentina – as in most other countries – homosexuals cannot donate blood. Research showed that gay people are ten times more likely to have a transmittable disease than heterosexual people, and, on average a person who is gay has a 10 percent chance of having HIV (for heterosexuals this figure is 0.5 percent).
Maschio adds: “However, these statistics are only based on gay and heterosexual singles. The statistics for gay and heterosexual couples, who do not have sexual contact with other people, will probably be significantly different. Plans to investigate this phenomenon already exist and will hopefully be realised in the near future.”
Education and information the key
These are the types of issues that are misunderstood in Argentina and, according to Maschio, there is a need to inform and educate people, making promotion and communication key factors in the programme.
The importance of this education is reflected in the differences in percentages of voluntary donors throughout the country. According to Leibovich, in the North-western province of Jujuy, which actively promotes blood donation and educates people on the issue, 52 percent of the donors are already voluntary based.
Evidence suggests that the main reason people do not donate is not because they are afraid or have prejudices, but simply because they have never been asked.
Furthermore, Salamone adds that in his experience, only around a quarter of those who say they want to be a voluntary donor actually become one. “That is why people have to be informed and stimulated constantly. (Voluntary) blood donation has to be focus of the government’s agenda and of the agenda of the people.”
Looking at the example of Spain, she says: “in 1975 a voluntary-based blood donor system was being encouraged and by the nineties the percentage of voluntary blood donors was already at 85 percent. Nowadays it is 100 percent.”
By making the issue highly visible to Argentine society, those involved in this year’s World Blood Donor Day hope it will provide a boost in the search for more blood donors, and support efforts to transform the donor system.
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