While most were unaware of it, June 14^th was “World Blood Donor Day”, celebrated internationally to encourage those eligible to donate blood at least once a year.  Indeed, although 95% of Americans either receive blood during their lifetime, or know someone who has, only about 8% of Americans currently donate blood.  The requirements are fairly simple: be 16 or older, weigh at least 110 pounds, and enjoy good health.  Apart from doing the right thing, donating blood includes free screening for infectious diseases such as HIV and hepatitis.

The need for “good” blood around the world is critical.  The World Health Organization (WHO) makes a strong statement on blood transfusion safety and places the responsibility for enforcing it on the health administrators around the globe to “galvanize entire communities towards regular and non-remunerated blood donations.”  Just yesterday, one of our clients in China inquired about the reliability of blood in that country.  In fact, some of the blood collected in China may still be contaminated with the HIV virus.  Over the past twenty years, hundreds of cases with dozens of deaths have been traced to blood collected from those in China willing to sell their blood.  Following a government ban on imported blood products in the mid 1980s, literally thousands of blood and plasma collection stations popped up in China offering remuneration for donors. 

These unregulated centers used an unusual method of collecting blood and then reinfusing donors with pooled red blood cells after the plasma had been removed.  The technique was practiced in order to speed recovery following donation but is thought to have infected hundreds of thousands of donors and those who received blood transfusions.  Although Chinese authorities have endeavored to ban this practice and close illegal blood donation stations, the problem has not gone away.  A report published in 2007 claimed that China’s blood supply is still not being properly monitored for HIV.  The demand for blood products is growing, and the supply is short which “creates an economic incentive for hospitals to rely on illegal, untested blood donations.”

China is not alone.  The World Health Organization estimates that 5 – 10% of all HIV infections in Africa occur as a result of unsafe blood transfusions.  In addition, countless thousands are infected with hepatitis and/or malaria due to the lack of proper screening.  The organization “Safe Blood for Africa” is attempting to correct the problem by encouraging voluntary blood donations from adequately screened applicants and discouraging facilities from using untested blood.

The United States, Canada, Japan, France and a host of other developed countries experienced similar problems with contaminated blood from for-profit centers in the late 1970s and early 1980s before adequate screening for HIV and hepatitis was available.  We can only hope that emerging countries learn quickly from the experience of others.  In the meantime, the international traveler must be aware that significant risks still exist from getting blood products in many parts of the world.