SEATTLE — Concerns over infectious diseases are prompting some countries to impose bans on blood donation. In August, Greece banned donations in twelve districts in response to recent cases of malaria. The disease had been eradicated in Greece for several decades, but recent budget cuts have directed funds away from the tools and practices needed to kill mosquitos. In the entire year of 2015, the country experienced 85 cases.
Since the start of 2016, 65 people have been diagnosed, although 61 of them were immigrants or travelers who contracted the disease abroad. Nonetheless, Greek officials banned blood donation in Farkadona, Trikaia, Palma, Evrota, Halkidaia, Thiva, Tempe, Marathonos, Western Achaia, Andravida-Kyllini, Lagada and Pylaia.
Blood donation continues to be one of the most necessary and sustainable public health resources, regardless of current circumstances. The World Health Organization (WHO) reiterates that blood donations can be used to treat a variety of conditions, including complications of pregnancy and childbirth, anemia, trauma after manmade and natural disasters and blood loss following complicated surgery. Regular blood transfusions can also treat chronic illnesses such as thalassemia and sickle cell disease and can be used to make blood clotting factors for people with hemophilia.
For its myriad life-saving uses, the WHO encourages every nation to maintain a regular blood supply. The challenge is that donated blood must be used within 42 days (platelets specifically must be used within five). Regular blood donations are required by a sustainable number of healthy donors in order to ensure the availability of safe blood whenever it is needed. This isn’t necessarily a problem in high-income countries, which yield about 50 percent of all blood donations.
However, less than 20 percent of the global population lives in high-income countries. The remaining 6 billion live in middle to low-income countries where it is harder for public health efforts to sustain a large enough supply of donated blood.
A 2013 study conducted at the University of Benin in Nigeria explored the attitudes and practices of blood donation amongst healthcare workers in the area. They found unpaid volunteers, who contributed five percent of all donations in the country, are more likely to donate out of pure altruism and to be self-aware of the risks that certain conditions pose to recipients of their blood. In contrast, remunerated donors were more likely to lie about or withhold information pertaining to their own health that could disqualify them from donating and receiving compensation.
The important takeaway of the study is that Nigeria, and other nations with similar socioeconomic conditions, are overdependent on remunerated blood donations despite the way in which incentivized donation can undermine safe blood transfusions.
And, because they are frequently under-resourced, health facilities in the developing world cannot utilize advanced blood testing techniques like pathogen nucleic acid detection, which screens donated blood for transmissible diseases with greater success than other screening methods. They also frequently lack the logistical resources to administer transfusions within a 42-day window if supplies are few and far between.
Voluntary blood donation has always been a major public health priority but has become increasingly important in the wake of recent epidemics. Greece’s regional ban on blood donation, arguably a pragmatic response to current circumstances, decreases the already scarce supply of safe blood around the world.
The good news is that some countries are making incredible strides in blood donation policies. Northern Ireland, for instance, is set to lift the lifelong ban on blood donation for men who have sex with men on Thursday, September 8.
Historically, men who have sex with men were forbidden from donating blood due to the prevalence of HIV/AIDS amongst their demographic. Northern Ireland is joining the likes of England, Scotland and Wales, who have also overturned what many consider a stigmatizing and homophobic policy. By the end of the week, men who have not had a sexual encounter with another man in the last 12 months will be free to give the invaluable gift of blood.
– Jessica Levitan