The 6^th International Forum of Young Blood Donors and Volunteers took place in Carthage, Tunisia from the 17^st to 20^th of August, 2006.

It counted with 53 participants from 13 Country Delegations: Brazil, Burkina Faso, Denmark, Estonia, France, Greece, Iceland, Italy, Kosova, Lithuania, Maroc, Romania and Tunisia.

The report below is a sum up of workshops, activities and results achieved. The complete report of each workshop can be found with the IYC members.

20h00 – Opening and market

The organization thanked the participants and invited each delegation to shortly present itself.

After the presentations the Market started. Each Country made a stand with advertisement materials, and the participants had the opportunity to exchange information about their associations.

The Tunisian Association gave 2 International Merit for blood and there was the presentation of a Children Choral.

There was a presentation about the IYC and its projects to the participants and a space for questions and observations was opened. Suggestions about fundraising by big and international companies and the website were made, as well as questions about the representatives and remarks about next year election.

The participants were invited to participate getting involved with the IYC projects.

A presentation on the subject was made and than a practical activity was proposed, the creation of three different projects by the participants (a youth forum, a blood drive in a university and an international circle of donation). Than the participants were invited to present the difficulties they found during the activity, being the main: difficult to communicate, too big groups, pressure of time, etc. The main objective was to show the problems they might find while trying to plan and write a project.

The participants from the three Countries present (Italy, Denmark and France) exchanged information about the projects and structure in their organizations, specially concerning young people.

Mr. Niels Mikkelsen, president of IFBDO, presented his lecture about the subject. As donor rights we highlight:

Highlights considering donors expectations:

Some things are important to be remembered:

The participants were ask to give one example of recruitment in their Country and after divided in groups to a practical activity: to come up with a new project for recruitment, these were the suggestions:

A presentation on the subject was made and than a practical activity was proposed, to consider the IYC poster created last year and answer these 3 questions (conclusions below):

A presentation of the structure of a youth group inside the IFBDO was made and than participants were divided and asked to answer 5 questions (conclusions below) that would help the IYC in its future:

Italy. Has a great structure in pyramidal stile and the young people does lot’s of activities.

Kosova. Is trying to increase the number of donors.

France: Does different activities, sport, cultural activities, projects in schools (from 10 years old).

Denmark. Is very organized, has representatives from all regions and all are gathered in a Youth Committee, that also does lot’s of activities.

Estonia. Does not get money for the government, so it tries to find as many sponsors at possible. There are not many young volunteers and they work more or less alone.

Iceland. No youth program, the blood bank does the recruitment. The young people work more or less alone

Greece. Many local associations and no national committee, but is working in making one.

It is important to contact the organizations personally, and schedule meetings with them.

The representatives from all the Countries present discussed:

The details of the discussion can be seen in the meeting report.

A quick sum up of the event was made to all the participants. The organization thanked all young people and asked for the evaluation.

The host organization gave medals and traditional plates to all delegations and the event was officially ended.

There was a trip for the participants to the center of Tunis after the trips delegations left according to their plans

Leticia Ferreira Mikkel Andersen Kadi Grichin

Young Delegate Financial Secretary Secretary

The 6^th International Forum of Young Blood Donors and Volunteers took place in Carthage, Tunisia from the 17^st to 20^th of August, 2006.

It counted with 53 participants from 13 Country Delegations: Brazil, Burkina Faso, Denmark, Estonia, France, Greece, Iceland, Italy, Kosova, Lithuania, Maroc, Romania and Tunisia.

The report below is a sum up of workshops, activities and results achieved. The complete report of each workshop can be found with the IYC members.

20h00 – Opening and market

The organization thanked the participants and invited each delegation to shortly present itself.

After the presentations the Market started. Each Country made a stand with advertisement materials, and the participants had the opportunity to exchange information about their associations.

The Tunisian Association gave 2 International Merit for blood and there was the presentation of a Children Choral.

There was a presentation about the IYC and its projects to the participants and a space for questions and observations was opened. Suggestions about fundraising by big and international companies and the website were made, as well as questions about the representatives and remarks about next year election.

The participants were invited to participate getting involved with the IYC projects.

A presentation on the subject was made and than a practical activity was proposed, the creation of three different projects by the participants (a youth forum, a blood drive in a university and an international circle of donation). Than the participants were invited to present the difficulties they found during the activity, being the main: difficult to communicate, too big groups, pressure of time, etc. The main objective was to show the problems they might find while trying to plan and write a project.

The participants from the three Countries present (Italy, Denmark and France) exchanged information about the projects and structure in their organizations, specially concerning young people.

Mr. Niels Mikkelsen, president of IFBDO, presented his lecture about the subject. As donor rights we highlight:

Highlights considering donors expectations:

Some things are important to be remembered:

The participants were ask to give one example of recruitment in their Country and after divided in groups to a practical activity: to come up with a new project for recruitment, these were the suggestions:

A presentation on the subject was made and than a practical activity was proposed, to consider the IYC poster created last year and answer these 3 questions (conclusions below):

A presentation of the structure of a youth group inside the IFBDO was made and than participants were divided and asked to answer 5 questions (conclusions below) that would help the IYC in its future:

Italy. Has a great structure in pyramidal stile and the young people does lot’s of activities.

Kosova. Is trying to increase the number of donors.

France: Does different activities, sport, cultural activities, projects in schools (from 10 years old).

Denmark. Is very organized, has representatives from all regions and all are gathered in a Youth Committee, that also does lot’s of activities.

Estonia. Does not get money for the government, so it tries to find as many sponsors at possible. There are not many young volunteers and they work more or less alone.

Iceland. No youth program, the blood bank does the recruitment. The young people work more or less alone

Greece. Many local associations and no national committee, but is working in making one.

It is important to contact the organizations personally, and schedule meetings with them.

The representatives from all the Countries present discussed:

The details of the discussion can be seen in the meeting report.

A quick sum up of the event was made to all the participants. The organization thanked all young people and asked for the evaluation.

The host organization gave medals and traditional plates to all delegations and the event was officially ended.

There was a trip for the participants to the center of Tunis after the trips delegations left according to their plans

Leticia Ferreira Mikkel Andersen Kadi Grichin

Young Delegate Financial Secretary Secretary

by Niels Mikkelsen, President of the the IFBDO and Secretary General of "the Blood Donors in Denmark"

The World has a number of different legal systems using different interpretations. For this reason I will not go too much into detail of Human Rights in individual nations, but stick to the International/Universal human rights and their implication on blood donation and donor deferral.

The issue of blood donation and Human rights has not been much discussed so far in international law. But let me start with a general definition of Human Rights: Human Rights traditionally involves the protection of individual human beings against improper actions by the State, as implemented i. a. by legislators, government agencies, doctors, hospitals etc

+ a number of regional (continental) Human Rights Conventions

All these provisions are to be transformed into national binding legislation by UN member states.

To help them has been created a number of international implementing bodies, i.a. :

+ plus a number of regional (continental) implementing bodies : e.g. European Court on Human Rights in Strasbourg, France.

World Health Assembly Resolution WHA 28.72:

- urging all Member States to promote the development of national blood transfusion services based on voluntary non-remunerated blood donation!

I think we all agree with this, that no-one should ever be forced to become a donor - neither for family or economical or any other reason.

My favourite quote from 2002 WHO AIDE MEMOIRE for National Blood Programmes:

Again the WHO underlines the fact, that it is up the UN member states to fulfil their obligations - also in the blood field - under International Law.

An example of implementation into binding legislation of the international norms can be found in the European Union Treaty of Nice, Article 3. , which forbids any commercialisation of the human body or any part of it (within the European Union)…

At this stage I would like to make an important distinction:

that between paid donation and non-remunerated donation

Special Human Rights discussion concerning paid donations:

Personally, I find the sale of human blood unethical opening up for unsafe practices and giving the act of blood donation a low reputation. It is, nevertheless, a fact, that many countries still (have to) allow for paid blood donation.

When donors are paid, blood is not a gift, but a simple piece of merchandise. …Any rights over the blood is transferred to the buyer – after the donation. The blood bank can do as it wants.

Right of property, is mentioned in the Universal Declaration in Article 17, but not to found in the two UN Covenants. However, the right to property is found i.a. in the African, the Inter-american and the European Human Rights conventions, and property is a right that all states should respect:

In our context, the property to be protected by the State is the human body, and any person "owns" his own body and its parts. You own your blood until it is given (as gift) to a patient and has entered another body - or until you have sold it!

The buyer of blood, e.g. commercial blood banks, can take commercial considerations of course, but must also respect rules for free trade, equal market access etc. But the Human Right rules for respect of person still apply, also, and can not be overruled by free trade considerations

WTO- rules could, however, be interpreted, so that any member state has right to sell products, for instance based on paid plasma donation, in any WTO member state. The same is not true for gifts, and I believe, that if you want to prevent international trade in human blood and blood products, non-remuneration can be an effective barrier to avoid such unethical trade.

An example of this can be found in the European Union, which is committed to free internal trade, but has passed legislation in Directive 2002/98, which allow member states to stop for import of blood and blood products, if products come from paid donation. But this is seen only as a safety measure.

But EU law – and many national laws - also assures the right to equal access to the market. This also go for individuals, who want to sell their blood - so reasons for deferral has be interpreted narrowly, when you are in a market situation.

In this situation the individual has a right to sell his blood! He might even be cheaper than others, and perhaps there could even be a legal requirement that blood is supplied under official bidding under general competition law.

This present special problems with plasma – and plasma products – since there is a huge international market for these products. It is – in my mid – highly unethical, that a piece of the body can become a piece of merchandise.

This is where I would like to remind you of World Health Assembly Resolution WHA 28.72:

- urging all Member States to promote the development of national blood transfusion services based on voluntary non-remunerated blood donation ! This obligation was voted by ministers of health, and I believe that all succeeding ministers are obliged to respect this provision, as it was passed by our highest authority on health.

Luckily, many countries and the EU (in the Nice Treaty article 3) specifically forbids commercialisation of the body or parts of it as such – and blood and plasma is a part of the body. The curative effect of human blood is due to its origin in (another) human body – and as stated in the Universal Declaration "the dignity and the worth of the human being" should be respected. The implications of trade in blood or any other part of the body can be disasterous for recruiting donors. Why give anything for free, when it is later traded as a piece of merchandise. I believe that all parts of the body should be treated equally – and that trade in organs etc. is highly unethical.

The situation is less complicated in countries which practice – or have made it mandatory – that all blood donation should be non-remunerated:

Non-remunerated blood is a gift, which is owned by the donor, but which the blood transfusion system processes to the benefit of a number of patients. The gift only exits, if the blood system cooperates with the donor (and accepts his donation). So it is OK, that the blood system can make demands to the donor, if the system shall use staff, money and time to service the donation.

As stated by the EU in its Directive 2002/98: "Modern blood transfusion practice has been founded on the principles of voluntary donor services, anonymity of both donor and recipient, benevolence of the donor, and the absence of profit on the part of the establishments involved in blood transfusion services"

In such an environment, where blood is a non-remunerated gift from one human being to another, no individual has the right to give blood. The gift has to be accepted by the blood service - and if it does not want it, the donor only has the right to have a proper explanation for this.

The main problem with donor rights in donor deferral is, that is also a human right, that no-one should be discriminated against. This is made clear in both UN Covenants - but most clearly in the Covenant on Economical, Social and Cultural rights, which specifically (in article 2) forbids discrimination for any status ....(the Covenant on Political and Civil rights only speaks of "without *distinction", which is easier to deal with in binding legislation.)

Unfortunately there can be a many reasons possible discrimination when deferring donors (legal discrimination – in contradiction of prevailing human rights)

Because of age

Because of sexual orientation (male homosexuals versus female homosexuals and heterosexuals)

Because of sexual risk behaviour (multiple partners, prostitution, status of women, trafficking in persons)

Because of origin (for instance if you were born in countries where Malaria is prevalent)

Because of prolonged stay (e.g. in the UK, 1980-1996 because of a theoretical risk for transmission of Creutzfelt-Jacobs new variant).

Because of travels (in Malaria areas, West Nile Virus areas etc. etc.)

Because of residence (only blood from your own country - self sufficiency in each country)

Because of language (must be able to participate in a one-on-one interview with a medically trained person)

Because of lack of intellect (mentally retarded or psychic disturbances, lack of education)

Discrimination for practical reasons (economic discrimination)

Because of opening hours (can not get off from work or study in time)

Because of distance/ location of blood bank (too far away, low cost benefit for blood bank)

Discrimination for the sake of the donor (respect for the donors own body)

Maximum number of donations per year (varies much from country to country)

Size (under 50 kg)

When deferring these donors, the doctors (and the blood system and the legislator) have to deal with a clear problem of "competing" human rights:

The patients right to safe blood (or the safest possible blood as outlined i.a. i the universal declaration article 3, Right to Life, and the Right to Health, article 25), competes with the right not to be discriminated against. (Both UN Covenants and a number of regional conventions).

But, as I see it, the choice is not so difficult: The right not to be discriminated against is very important, but consideration for the safety of the patient has to prevail … The blood system is made to help the patient, not to help the donor. And any members of the groups, who have been discriminated against, will probably agree, that if they were the patients to receive blood, they would also think, that blood banks should take all possible precautions to ensure the safest possible blood.

Any sensible judge or doctor would come to the result, that the rights of the patient has to prevail, even if the deferred have the right to an explanation based on scientific data.

The so-called "precautionary principle" has no founding in Human Rights law, as far as I can see. That principle is made to protect politicians and doctors, but has no scientific evidence. To the extent, where the precautionary principle prevents the blood services to provide adequate blood for patients needs, I actually think it is against the patient’s rights to life and to health and medical care of the highest attainable standard.

Attention should also be given to the dignity of the donor. The social act of non-remunerated blood donation often gives the donor higher self-esteem, a good feeling and a health check too - (plus good sandwiches in some countries, and wine or beer in others). So when you turn him away, this has to be for scientifically valid reasons - and he should always have proper information about the deferral criteria before and after deferral.

Other cases , where blood donation is not voluntary = breach of Human Right of respect of person!

Is a newcomer among human rights, but increasingly important. Unfortunately, the patients right to sufficient amounts of safe blood is not met in a number of countries in the world – and that is a very serious human rights issue under any of the Human Rights conventions!

Unfortunately, there is a also a relationship between social economic conditions and deferral

In countries with a High Development Index levels of information to potential donors is higher too. This gives a larger potential donor group to choose from and the blood banks can be more critical. There are generally fewer risks (HIV; HCV etc), so the blood banks can be more critical towards the donors.

The right to education also apply do blood donors!

(A most important subject, but here I will refer to my talk this morning…)

Just mention one example of implementation : EU Directive 2002/98 (And the follow-up EU –Commission Directives) contain rules about what all European donors should be informed about. The contain a long list of important issues, which are there to protect the safety of the donor and of the patient. This lays the burden of information and education on the Member States.

General solutions to avoid discriminations and other breaches of Human Rights provisions:

Better tests (but they often are very expensive, if you want to eliminate the window-period as much as possible. Better tests would allow more people to give blood, though.).

Virus-inactivation can hinder some of the discriminations – but this procedure will be very expensive also (and may have other risks to patients such as antibodies to the virus-inactivated blood cells)

Adequate information to potential donors (so that they don’t come to the blood bank at all) – will eliminate some of the disturbance, people feel, when they are deferred as donors .

But the best solution is a very large number of regular donors. The blood banks and the patients get safer donations, lower bleeding frequency per donor, better economy (less bags to be trown away) fewer self-deferrals, and less outdating of blood (though targeted bleedings to need).

Potential donors should know, that if they can not give blood, they can give sweat .. so even if they are deferred as donors, they can help your blood system as a volunteers helping to recruit and retain other donors. The important is, that there is a large panel of donors, who are available when needed. The aim is to have the necessary number of safe donors, so that there is enough blood - always.

As mentioned in the beginning, the implementation of all Human Rights are a national obligation.

My suggestion is, that all nations should have a blood law enumerating basic principles such as non-remuneration, voluntary anonymous donation, rights of patients, rights of donors (including insurance and right to treatment after accidents), obligations of the state, the hospital systems, the blood system, the voluntary donor organisations, the Red Cross etc.

(Enforcement within the European Union (after the Amsterdam and Nice treaties in force) – Directive 2202/98 and technical directive – new legislation still being developed).

Internationally: States should support the efforts of the WHO and UNESCO. Individuals can make a complaint to the UN Human Rights Committee or have a Study made by a special Rapporteur to the UN Human Rights Commission.

As an important service to the donors, there must be full insurance for the blood-donors to cover expenditures rising from personal injuries to a donor before, during or after the donation. You may note, that in the Danish blood supply we have statistically approximately 3 injuries pr. 100.000 donations which entail permanent damage to the donor. We have approximately 5 serious events per 100.000 transfusions, so it is almost as dangerous to be a donor as to be a receiver of blood! Never the less, almost all resources are used to increase safety on the patient side, which in some cases for political reasons leads to large – and very unnecessary - expenses.

Should an injury occur personal contact should be taken immediately from the blood bank to assist the donor with economical or physical problems arising from the injury. Our experience shows, that proper treatment should be initiated at the earliest possible date to lower the risk for permanent damage to the donor.

All accidents/unintended happenings must be reported. A smaller accident for each 3.000 donations (but only one in 33.000 give permanent damage. Damage from vasovagale accidents and damage from needles (proportion 1 to 7)

Use the reporting systematically (since 1997) –basis for recommendations on how to avoid accidents in the future – more international cooperation needed – because accidents do happen in all blood banks!

The blood services should, of course, avoid accidents as much as possible (it is probably more dangerous to be a donor than a patient – but the most dangerous in the Danish system is the administration to patients of blood components (wrong component to the patient)

Donor-association should correspond largely to the number of bleeding-facilities, normally at local hospitals. Their main tasks include donor-recruitment, contact with blood bank-staff, local press-contacts, distribution of tokens, donor-parties and other donor-retention activities.

The local associations could be regrouped in regional committees and in a national organization. The national organization (or the regional or the local association) should negotiate a detailed agreement about conditions for blood-donation with the relevant government agency, which has responsibility for health care and hospitals, including blood-banks.

The local donor organizations should be represented democratically on the regional and national level, and sufficient administrative support should be available for the national and regional organizations and their decision-makers.

This si a very Anglosaxon way of laying a part of the responsibility for any mishaps on the donor himself (he has accepted the risk. This is NOT satisfying, as the responsibility of accidents of any mishaps is with the administrating doctors - and the blood centre.

In the end it is a national obligation to have proper blood service (WHO resolutions , EU rules etc). Including proper insurance of the donors ...

It is of the highest importance, that proper procedures are made for direct information and counseling to the donor, when abnormal test results are obtained.

EU directive - very important .. to be followed all around the world. The donor has a right to know. A basic right to be informed a.s.a.p. Donors do not wish to spread disease to others ..

And get treatment a.s.a.p. as well.

But of course blood donation should never be used to obtain discreet HIV test or the like. Misuse of the blood bank service for this purpose should be discouraged in all ways

Most nations have laws to protects confidential personal information, not least about sexual practices, illness etc. All needed internationally (EU Directive a good example of this)

It is very problematic, if blood banks have established a system, where an earlier refusal to donate pop-up automatically. Such systems are

1) Difficult to control - the right for the donor to know about this-

2) Not very relevant in practice

3) But mistakes would be most harmful (the computer says, that you can not donate! –thatis no a proper explanation)

The precautionary principle:

Donors ask, if they are deferred for precautinary reasons: Am I sick ?? – and have I spread the disease to other human beings?? Especially the last question has haunted many donors, who gave blood after 1980 –and who are suddenly deferred because of the UK-criteria – or because they had earlien received blood themselves.

The precautionary principle is made to ensure the backs of the doctors and the politicians – to the detriments of patients (who have less blood available for treatment) - and to the donors.

How do you know ?? Who are the donors ?

He must be well informed. Information is the key incentive to a well functioning blood supply. A coherent information-policy should be part of the media strategy of blood banks and donor-associations - also in their everyday contact with donors.

NO waste, NO un-necessary transfusions, and NO scandals. The reputation of the blood services must be high !!! Accreditation and transparency

All blood must be tested and there must be full traceability from donor to patient.

Any relevant abnormal findings shall be reported to the donor.

Donors take pride in national self-sufficiency.

The WHO has consistently from 1975 and onwards recommended voluntary, non-remunerated blood donation – and national self-sufficiency.

National self-sufficiency in blood-products is an important aim for ethical and for safety reasons:

But also for the donors, who come back, if they can take pride in a healthy blood supply for their own society.

Ministers of Health have, accordingly, taken upon them to ensure, that sufficient public funds are made available to cover the needs for recruitment and retention

A large donor population allows the blood collectors to select the donors critically. Good conditions for donor-deferral is the safest - and cheapest - way to obtain optimal security. The use of family-donors, first-time donors and spontaneous donors should simply be avoided.

Funds for recruitment money are best administered by voluntary organizations. Volunteers are cheaper than paid recruiters.

I am strongly adverse to direct payment to donors: It degrades the act of blood donation – and appeals to groups of the population, which we least want to see as donors.

Blood donors feel strongly about quality and efficiency in the blood services.

The reputation of the blood system is everything: Scandals, shortages and dramatic appeals should be avoided – and the media should be used professionally.

The safety of the donor and the recipient is primordial – and the donor should be well informed of what happens, if an accident occur – including insurance, practical help, medical treatment etc.

There must be no waste and minimal outdating

Use the best equipment possible – in accordance with local economical circumstances

Donors can "smell" inefficiency – and waiting in long lines should be avoided at all cost (especially if an appointment has been made, which most donors want).

Efficient service include a friendly environment, donor friendly opening hours, pleasant rooms and beds, and well equipped waiting rooms – before and after donation. And it would help if taxi-pickups arrive in time, that opening hours were followed, that parking-spaces were reserved for the donors, that beverages and food were OK, that letters were sent to the right addresses – with correct data etc.

Donors should be recognized continuously – and especially when they expect special recognition (for 10, 25, 50, 75, 100 donations etc.). Directed press-coverage should be sought on such occasions in order to higher the self-esteem of the donors.

Donors expect to be serviced by trained, medical professionals, before, during and after donation – and the methodological medical check-up should be taken seriously.

Donors should be very well informed – leaflets, posters and questionnaires should be 100 % correct – and have a professional look. E-mail and web-sites should be used for quick up-date of information. Donors are thinking human beings and should be respected as such !

High public visibility, be competent, professional, and reliable each country.

The organization should have a offensively media strategy

Phone- and fax, SMS and e-mail service and a home-page

a donor magazine should be mailed to all the donors (relevant information, recruitment, picks up any moves and gives the donors a feeling of belonging to the blood supply

Think Globally, act locally: Use the World Blood Donors Day on June 14, a national campaignI

Appeal especially to young people: establish a group of young ambassadors or a CLUB 25.

It is essential, that volunteers are engaged in the promotion of non-remunerated blood donation. 1. larger networks

2. bring in fellow volunteers

3. Very often paid recruiters are underpaid

4) you just can not recruit very well by telephone !! You need personal contact.

If you want their confidence, donors should know, that there are strong ethical principles governing your national blood system. We are, after all, dealing with a part of the human body, which should be given special respect. This is especially well written in the European Nice-treaty, which in article 3 about the Right to Respect for Human Integrity under point 3 specifically forbids commercialisation of the Human Body on any parts of it as such:

Blood is a part of the Human Body – and has therapeutic value with properties that can only be developed by a human being.

I am a fervent believer in anonymous, voluntary, non-remunerated blood donation, as defined by the Council of Europe in Recommendation (95)14: " Donation is considered voluntary and non-remunerated, if the person gives blood, plasma or cellular components of his/her own free will and receives no payment for it, either in the form of cash, or kind which could be considered a substitute for money. This would include time off work other than that reasonably needed for the donation and travel. Small tokens, refreshments and reimbursement of direct travel costs are compatible with voluntary, non-remunerated donation"

This definition – and a lot of other good advice for your blood system – can be found in my "bible": the "Guide to the preparation, use and quality assurance of blood components, which the Council of Europe has recently published in its 9^th edition.

The principle of voluntary, unpaid donation has been strongly supported by the European Parliament and the EU Council of Ministers in December 2002 in the new EU Directive 2002/98 on blood safety, and I expect that the European Union in the coming years will take a number of initiatives to supplement the good work of the Council of Europe, using their expertise - and cooperating with voluntary donor organizations in Europe.

National donor organizations should - in co-operation with national health authorities - establish the necessary guidelines for blood-donation. It is natural in a democratic society that an organization is allowed to protect the legitimate interest of the blood-donors, as donors are an essential part of the blood supply. The guidelines established should i. a. guarantee full anonymity of data collected, and ensure that donors have no other legal obligations than to answer questions about their health to the best of their knowledge. The end-use of blood and blood products should be clearly indicated, and – as stated by the EU in its new Directive: "Modern blood transfusion practice has been founded on the principles of voluntary donor services, anonymity of both donor and recipient, benevolence of the donor, and the absence of profit on the part of the establishments involved in blood transfusion services"

Blood is a gift from the donor to an unknown receiver, and it should never – in any of its components - be treated like a piece of merchandise, if you want your donors to come back !