REPORT from the meeting of the open ended EXECUTIVE COUNCIL

Friday July 1, 2005 at the National institute of Blood Transfusion PARIS

After the reception of the participants and the attribution of the files, the meeting was opened at 9.40 am.

The General Secretary of the French Federation for the Voluntary Blood Donation, Jean-Marie DURANT, after having greeted all the delegations and having welcomed to them, gives them communication of practical information concerning the places of the various meetings, the food, the accommodation, the memory gift and the general organization of the three days.

He specifies that 34 national Associations are represented, with 152 participants including 72 coming from Africa, South America and Europe.

Then, the President of the French Federation, José COLL, address himself to all the participants in these terms: (extracts)

" C’est un grand honneur pour les Donneurs de Sang Bénévoles que je représente d’avoir pu organiser ce Congrès, placé sous le haut patronage de Monsieur le Président de la République Française, parrainé par Monsieur le Ministre de la Santé et dont la participation, notamment en nombre de délégations étrangères, est tout à fait exceptionnelle.

L’intérêt suscité par ce Congrès montre à mon sens que la FIODS se trouve en 2005 à un tournant de son histoire.

Le temps est en effet révolu d’une organisation du don du sang qui peut encore se contenter de traiter son champ d’action exclusivement dans un pays sans ouverture à d’autres espaces.

La mondialisation, dont les effets ne sont pas à l’évidence toujours positifs, parce qu’elle ignore souvent l’homme et impose fréquemment la loi du profit, se fonde cependant sur une réalité qui ne peut être ni niée ni combattue : la libre circulation des biens et des personnes.

Ainsi les systèmes de santé doivent-ils s’adapter à cette réalité et subvenir en qualité et quantité suffisantes, aux besoins des prescripteurs thérapeutiques quels que soient les lieux.

Encore faut-il que cette harmonisation se fasse "par le haut" c’est à dire en visant l’excellence et non "par le bas" c’est à dire en acceptant le pis aller du minimum indispensable à l’homme.

Encore faut-il également que l’accès aux soins, aux médicaments, aux produits sanguins, soit proposé selon des objectifs de Santé Publique et non en fonction des moyens financiers dont disposent les patients.

Dès lors le rôle d’une organisation telle que la FIODS devient évident en tant que maillon indispensable de la chaîne de solidarité mondiale qui devrait permettre à tous les peuples, sans distinction de race, de religion et de frontière, de revendiquer un droit à la santé sans lequel aucune liberté ne peut exister.

L’exercice de cette mission comporte selon nous trois exigences :

une exigence de représentativité aussi large que possible,

une exigence de défense sans concession de nos valeurs d’éthique,

une exigence d’efficacité dans la mise en œuvre de nos projets.

Ce Congrès doit être celui de la réponse concrète à ces questions dans une unité retrouvée et dans la volonté de faire de la FIODS la seule organisation représentative des donneurs de sang dans le monde."

Then the Secretary General, Niels MIKKELSEN, proceeds to the roll call of the associations present, then points out the programme for these working days.

He stresses the vote of the statutory modifications which will take place on July 2 at an Extraordinary General Assembly. All the documents (Statutes and Rules of Procedures) for this purpose were sent to all member associations, within the prescribed forms and times. He stresses that the modifications and the additions are carried in red, while the suppressions are written in blue.

In his turn, President Pasquale COLAMARTINO intervenes to make an assessment of his mandate and to recall the principal subjects which were covered during the three years of work as the head of the IFBDO:

Reinforcement of the international relations

A strategy of dialogue and consultation with international organizations – governmental and medical – was initiated in order to reinforce the partnership with the NGOs; co-operation with the WHO, co-operation with the European Union, co-operation with the Council of Europe, co-operation with the NGOs which work traditionally in the field of blood, co-operation with IFRCS, co-operation with the organizations of patients, without forgetting the activate collaboration with the International Society for of the Blood Transfusion (ISBT).

Development of the programs of international co-operation

Project EURO BLOOD-NET which has as a principal objective the institution of a European network to arrive at self-sufficiency in blood and blood products in the European Union.

Program BLOOD-MED which relates to the co-operation between NGOs which work in the Mediterranean countries for the promotion of voluntary non-remunerated Blood Donation.

Program EURO BLOOD which interests the co-operation between NGOs which work in the European countries for the promotion of voluntary non-remunerated Blood Donation.

Reinforcement of the internal organization

Institution of an administrative office and representation of the IFBDO in PARIS.

Coordination of the activities at the continental level which will permit to reinforce the role of the Continental Committees, to represent, as well as possible, the problems and the social dynamic of the countries on which they depend, while making possible for the IFBDO to define the most convenient interventions for the development of the work programmes at the national and international level.

The International Committee of Young people (IYC)

Created and set up in 2004, this Committee will have the role of coordinating the policies of the young people inside the IFBDO and of developing international projects, to support the creation of organization of young Blood Donors in all the Member States.

Web site and internal communication

This site is well organized and contains information about our IFBDO; it is of course perfectible and must be reflecting more the activities also in the national Associations.

Policy of fund collection

Currently, the only resources come from the contributions of the adherent Members of the IFBDO and they are definitely insufficient to allow the concretization of the programs of development.

Other sources must quickly be found: sponsoring, financings granted to NGOs, etc...

Pilot project "LIFE"

The realization of this project is registered in the programs supported by the European Union, but was unfortunately not supported by the Commission.

Institution of an IFBDO-Foundation

Envisaged for the strategic program 2002-2004, this foundation will permit to support the development programmes of the Members Organizations of the IFBDO.

Reform Statutes

In front of the serious problems encountered legally speaking, it was decided to carry out a cleaning of the Statutes and the Rules of Procedures and to modify certain articles of them in order to put them in conformity with the legislation in force, and more particularly to fulfil the requirements formulated by the Service of the Interior of the Principality of Monaco, where the IFBDO has its registered office.

Action plans 2005/2008

The programs envisaged and not yet carried out, will be engaged during the period running on 2005 to 2008.

Before President P. COLAMARTINO declares the meeting closed, the General Secretary specifies that the full powers given by the countries, which could not do the trip, are valid for all the three days meetings.

Raised meeting at 11.15 am to allow the session of the Continental Committees meetings.

Resumption of the Executive Council work at 02.30 pm (open session).

The General Secretary recalls the questions envisaged on the agenda, which is unanimously accepted by the participants.

Point on the consultations in progress with the Principality of Monaco

President Pasquale COLAMARTINO makes a short recall of the situation in which the IFBDO is currently situated with respect to the legality of the Statutes which govern us and which could not be recorded in Monaco in so far as at the time of the General meeting of RABAT, the quorum was not reached.

So the Adviser of the Interior of the Monegasque Government could only regard as being valid the Statutes of 1975, published to the JO of May 16, 1975, those voted in Paris in 1996 not included as an appendix the official report of the Extraordinary General Meeting which had adopted them.

With the assistance and the participation of Christine BOGGIANO of the Association of Blood Donors of Monaco, contacts were made with the Services of the Interior which gave us the procedure to leave this situation somewhat embarrassing for our Federation.

If the Extraordinary General Meeting is favourable on the for the adoption of the statutory modifications which will be proposed to it on Saturday July 2, then, from this moment , it will be possible to consider the future with more serenity.

The General Secretary adds that the new Statutes, as soon as accepted by the Extraordinary General meeting, will come into force at once.

Interventions of the Personalities which made us the honor of their presence

Professor Philippe ROUGER, General manager of the National Institute of Blood Transfusion

"Je voudrais vous dire ce que représente le BENEVOLAT, pour nous chercheurs, ce que les Donneurs de Sang Bénévoles représentent en France et en Europe.

Nous travaillons beaucoup dans le cadre d’un réseau qui est le réseau européen des Sociétés Savantes de Médecine Transfusionnelle et la notion de bénévolat est pour nous essentielle en Europe ; c’est un chapitre du Livre.

Comme vous le savez, le Bénévolat est une notion fragile. Déjà en Europe, dans cinq pays de l’Union Européenne, le Bénévolat est discuté. En Allemagne, Autriche, Grèce, Suède, il y a aujourd’hui des dons de plaquettes et de globules rouges qui ne sont plus bénévoles.

Et d’autres pays se posent la question de savoir si la rémunération du don de sang serait la solution pour être autosuffisant ?

Or, nous savons bien que lorsque le Bénévolat disparaît, même partiellement, il ne revient jamais totalement.

Le Bénévolat est donc une vraie valeur de l’homme et les professionnels qui sont les acteurs de terrain sur l’action des Donneurs de Sang Bénévoles dans le monde entier pour préserver cette valeur que certains considèrent comme obsolète.

Soyez donc très fermes dans chacun de vos pays pour ce que Bénévolat reste la base du Don du Sang et du Don d’Organes.

Nous avons tous pu lire les informations concernant la Chine et d’autres pays d’Asie où le don du sang et le don d’organes sont de plus en plus rémunérés. Or, ces pays sont des pays en pleine croissance, ce qui signifie que le bénévolat est une valeur qui doit être défendue, par nous tous, jour après jour. Merci et bon courage."

Within the framework of the oral questions, President J COLL, at first, likes to point out the position of France and thus of the French Federation for the Voluntary Blood Donation in respect and defence of the Voluntary Work.

This said, when the Voluntary Work should be defended outside, we would need well to have a certain number of medico-technical arguments which help us in this hard task.

However, can we affirm that the blood donation resulting from the Voluntary work has a rate of infectuosity which is lower than those coming from remunerated donations?

Professor Ph ROUGER reports the discussion which took place on this subject a few days before at the Congress of the blood transfusion, which was held in St Malo and which shows clearly supported by scientific documentation, that infectious markers - at least for the viruses of hepatitis C, of the VIH, hepatitis B, the B-19 viruses, - are very significantly higher when the donation is systematically remunerated.

The factor of the difference is 1 to 5, even 1 to 10.

Professor Patrick HERVE, President of the French Establishment of Blood (EFS)

"Je suis très heureux de vous rencontrer à l’occasion de votre Congrès. Les actions de la FIODS sont essentielles compte-tenu du contexte mondial et compte-tenu des problèmes importants rencontrés de par le monde en terme de transfusion sanguine.

L’EFS, établissement public crée en 2000 suite à une loi de sécurité sanitaire, a été substitué à l’AFS (Agence Française du Sang) et comprend 8 500 personnes qui y travaillent (médecins, infirmières, personnel administratif) ; le réseau comporte 14 établissements régionaux en Métropole, 4 établissements dans les départements d’Outre-Mer, ce qui représente 165 sites transfusionnels répartis sur l’ensemble du territoire français.

Depuis plusieurs années, l’EFS s’investit énormément pour aider un certain nombre de pays émergents dans lesquels un support puisse être apporté en terme de technologies et de formations.

La création de bourses particulières est à l’étude pour recevoir en France un certain nombre de cadres médico-techniques qui souhaiteraient avoir une formation complémentaire.

Je voudrais également vous dire combien je vous suis reconnaissant de votre action en tous points de notre monde, difficile, actions menées souvent dans des conditions complexes. Votre rôle et vos actions sont essentiels pour conduire à ce que le Don de Sang devienne le plus souvent un don bénévole, gratuit et dans lequel on puisse avoir, en tous points de la terre, un accès à la transfusion sanguine qui soit satisfaisant et qui soit surtout équitable. C’est par l’accès beaucoup plus facile à la transfusion sanguine que l’on arrivera à réduire cette inégalité gravissime, d’un pays à l’autre.

Solennellement, je voudrais vous dire combien l’EFS souhaite s’investir de façon importante dans toutes ces actions internationales, car c’est l’une des missions essentielles de l’EFS. Mais ceci est fait bien sûr avec l’invitation formelle des gouvernements des pays qui désirent l’aide et la présence de l’EFS."

Then, he presents the excuses of the Ministry for Health, Xavier BERTRAND, who could not come to attend work of this Congress. He reads his message:

"Messieurs les Présidents,

Mesdames et Messieurs,

Chers Administrateurs,

C’est un honneur pour la France d’accueillir votre Congrès, placé sous l’égide de la Fédération Française pour le Don de sang Bénévole, que je tiens à saluer.

Bénévolat, volontariat et anonymat sont les valeurs fondamentales et incontournables du don de sang. Ce sont également des garanties supplémentaires pour la sécurité transfusionnelle.

C’est pourquoi, si notre engagement et notre soutien à l’égard de votre action sont anciens, ils ne sont pas issus d’un hasard historique, mais bien du partage de valeurs humanistes et républicaines.

La position de la France s’appuie sur votre charte fondatrice du 4 décembre 1955, par laquelle Roger GUENIN, votre premier Président, a mis en place les bases de votre organisation sur la non-discrimination ethnique, politique ou religieuse. L’esprit de votre Fédération est donc de promouvoir un don de sang anonyme, volontaire, et altruiste, quel que soit le continent. Car, force est de constater que les soixante-quinze millions d’unités de sang prélevées chaque année dans le monde, le sont dans des conditions très inégales.

Vous devez souvent défendre le bénévolat, remis en cause par certains, en rappelant que s’il est source de contraintes supplémentaires, les gains en sécurité sont inappréciables. Vous assurez ainsi une meilleure garantie de la maîtrise pour les patients et un plus grand respect de l’éthique pour les donneurs.

Alors que de multiples tentatives se développent pour commercialiser tout ou partie du corps humain, votre préoccupation éthique quotidienne est essentielle. Grâce à votre action, cette exigence s’inscrit, au-delà de nos frontières, dans un horizon européen et mondial. Vous participez ainsi, à maintenir l’Homme, et le respect de sa dignité, au cœur de toute action publique de santé.

Les faits sont là. Le bénévolat transfusionnel permet chaque année de sauver vingt millions de vies. C’est grâce à vos organisations nationales et à la coordination au sein de la Fédération Internationale des Organisations de Donneurs de Sang Bénévoles, que peut se développer le don du sang, action de l’homme au service de l’homme.

ous le savez, Monsieur le Président, la France soutient et défend votre démarche, votre philosophie, et vos actions au niveau le plus élevé des instituons européennes et internationales.

Je ne peux donc, ici, que vous remercier et encourager votre mouvement qui cherche à fédérer de nouveaux pays autour de ces valeurs fondamentales. Afin de préserver cet acquis, votre Fédération doit continuer à jouer un rôle majeur auprès des différents Etats que vous représenter et des acteurs de la politique de santé publique. A l’occasion de votre 50ème anniversaire, je souhaite donc rendre hommage à votre mobilisation et vous dire toute ma confiance pour les combats futurs que nous aurons à mener.

Je suis certain que ce Congrès répondra à toutes vos attentes et qu’il définira une ambition commune pour le don du sang et pour la Fédération Internationale des Organisations de Donneurs de Sang (FIODS).

Je vous souhaite de fructueux échanges et vous assure de mon entier engagement à soutenir votre action."

Doctor Alain BEAUPLET, Director of the International Businesses in the EFS

(accompanied by Doctor Christina MARTINEZ of the Ministry in charge of the transfusional organization of Chile)

The actions of co-operation and exchanges which are carried out within the EFS pass by a basic postulate which says that, whatever the country, the blood transfusion is fundamental.

When the responsibles of mission of the EFS meet a Minister for the Health which is not well-informed of what the transfusion is, they insist on this fundamental link in the chain of health which is the transfusion, because there is no heavy operation, nor heavy medical treatment without transfusion. It is thus important to have a transfusion of the highest level of which depends the highest level for health in a given country.

At the interior of the transfusional chain, there are several activities, each one of it having to be also at a high level.

That goes from the Donor to the Receiver, while passing by all the phases of blood sample, preparation, qualification of the products and distribution.

Thus it is necessary to know to answer the transfusional request, that it is of course quantitative, to have the sufficient quantities of blood when we need it.

Discussions are in progress, on this subject, with the WHO because the quantity of blood depends on the life expectancy in a country. It was noted that 60 % of the consumption of the blood products take place after 60 years, which means that it is the oldest population which consumes the most blood. As in general the life expectancy increases, the old population increases while the population in age to give decreases.

It is fundamental that a movement as the IFBDO is active, because tomorrow it may have difficulties for answering at the request for blood.

The second subject to answer is WHO, and in order to know the requirements in blood products for a country, it is also necessary to know the distribution of the hospitals and the private clinics in the country concerned. Indeed, a vast territory including a weak and scattered population, and having only one center of care, will need less stocks of blood products than an area with strong density of population.

The quantity criteria of blood products must be matched of the quality criteria; however all the countries are not on the same qualitative level and the problems are different from a country to another.

Thus it is necessary, each time, to bring a qualitative response compared to the country concerned.

The situation is flagrant: the developed countries, which represent 17 % of the world population, have 60 % of the 75 million units of blood collected in the world. And in corollary, 83 % of the world population have access only to 40 % of the resources of the blood of the world, hence dramas which exist for lack of blood at disposal (there are still many women who die of haemorrhages post-childbirth).

All this must encourage us to improve health all over the world, especially when we know that 43 % of the blood used in the world is not tested today.

It is thus necessary to work, all together and to cooperate, advance on the way of quality in the various countries.

The EFS proposes to accompany some actions over the duration and in the condition that there is engagement of the governments of the countries which request assistances.

The EFS can help a country to be structured in the plan of the blood transfusion, to reflect together on a territorial organization, the infrastructures most adapted, the accompaniment in the fields legal, legislative and lawful, on the formations to be set up in the quality field. It is an institutional step, of State in State.

Foreign trainees can also be accommodated in the establishments of the EFS and exchange the way to realize processes.

But to be able to understand the quality of the blood transfusion in a country, it is necessary to have relevant indicators: for example, the blood collection, the candidates selection and the blood sample, and this in order to be able to follow the impact of the action undertaken.

All these indicators are then indexed and observed on tables: their consultation by the Personnel makes it possible to note the progression carried out, concludes Doctor A. BEAUPLET.

President J.COLL would wish that the map of the countries in which the EFS intervenes, could be superimposed with the one of the countries in which exist associations of blood bonors, members of the IFBDO, and this in the aim of sitting a collaboration between the Federations from various countries and the EFS because it is important that Associations of Blood Donors can create in the countries concerned, beyond the excellent work made by the EFS.

A. BEAUPLET answers that this request is self-evident and proposes that this assembling is placed at the disposal of the IFBDO but also of the FFDSB.

Resumption of the subjects of the agenda of the Executive Council

Program of work 2005-2008

After having made a rapid point on the activities carried out during the mandature which is completed, the Secretary General N MIKKELSEN explains the essential axes of the program 2005-2008 which will be articulated around regional conferences about:

- research of funds for the operation of the IFBDO and the sponsoring of the events such as:

- annual general assembly, in the various Member States,

- forum of the young organizer-donors,

- regional conferences,

- continental conferences,

- exchanges and development of materials of propaganda,

- development and extension of a standard legislation on associations and the laws on blood,

- influence policies of the WHO.

G MARECHAL (France) appreciates favourably to the content of the program, but considers it regrettable that it does not comprise the question, however essential and paramount for its execution, relating to the creation of new Associations.

N MIKKELSEN points out the two methods currently used for recruitment: the Anglo-Saxon model which is based on the payment of people in charge of the recruitment but which gives very few results; the other model, where recruitment is done by Associations’ voluntaries.

With the question raised by Malika MAZZINE about the base of the regional conferences, N MIKKELSEN indicates that this idea rises from the evaluation made on the level of adherent Associations and the IFBDO to set up trainers who will have the responsibility of support and relay in these areas. The actions of the IFBDO are all the more important today where it is noted a fall and a reduction of the actions led by WHO and the Red Cross.

There are many requests for actions of recruitment of new Donors.

The IFBDO represents 50 countries out of 190 that exists.

The requirements in blood products are very important in some countries of the world; the IFBDO cannot remain passive.

P. CHIRCOP (Malta) estimates that the IFBDO is on the good way if we endeavour to concentrate our efforts on sensitising the non-remunerated blood donation which must be done initially on a national scale by associating all the actors of the life it.

The co-operation of the greatest number creates a spirit and at the same time a motivation.

Presentation of the statutory modifications

This will be done at the time of the General Assembly.

The agenda being exhausted, the meeting is raised at 04.15 pm..

the General Secretary

Jean-Marie DURANT