To talk about blood donation programs in Mexico is to talk about a 40-year-old unfinished story, a story that can be looked at from two different points of view: frustration and opportunity. Every time, our country falls more and more behind, with a 2.83% altruistic blood donation rate, compared to other Latin American countries. According to the information published by the Pan American Health Organization (PAHO),1 countries with a lower gross domestic product (GDP) have developed successful nationwide donation programs. This is the case in Nicaragua, which has accomplished a 100% rate of altruistic donation.2 Moreover, the indicator established by the World Health Organization (WHO) to define a country as self-sufficient in blood donation has not been reached by Mexico.3
The fact that in the four decades since the creation of the Altruistic Blood Donor National Program (PRONADOSA by its Spanish acronym) there have not been advances in altruistic blood donation shows a lack of interest and political will to consolidate a national program to educate and motivate the population in what is by excellence a humanitarian gesture.
It is for this reason that the article “Attitude, knowledge and perception of the altruistic donation of blood in a city in Northeastern Mexico” is of utmost interest. In this document the authors found that 80% of the people surveyed referred to not remembering any information or advertisement inviting them to donate blood altruistically, and that 50% did not know about the donation process.
Handing out the blame for the low level of penetration of a social program like blood donation would be useless. Instead, it would be more productive to emulate other countries’ efforts and advances in terms of creating, not only a program, but also a whole culture toward organ and tissue donation, including blood.
The solidarity of the Mexican population is uncontested, as evidenced in the events which occurred in 1985 during the days following the earthquake in Mexico City, and more recently the tragic events in Ayotzinapa.4 What we are missing is trust, which civil society must regain, in the government and its national programs, among them, blood donation. Despite the fact that altruistic donation promotion is in the National Development Plan and the Official Mexican Standard (NOM),5 the results will not be certain unless the involved parties (health and education authorities, healthcare workers, medical associations – specifically the Mexican Association for Transfusion Medicine and the Mexican Association for the Study of Hematology) join forces with civil organizations, medical supplies manufacturers and blood bank suppliers to work toward a common objective, which is to achieve a greater degree of safety of the blood transfused in our country, where altruistic blood donation plays a major role.
Nevertheless, care must be taken when dealing with improvisation, because voluntary donation itself does not ensure the reduction of risk of infection associated with blood donation. A clear example of this is Brazil, where they have been alerted to the presence of pseudo-altruistic blood donors, who are only looking to undergo free infectious screening tests, because they are a part of the population with risk factors.6 However, the fact remains that it is repeated altruistic blood donation which will reduce the relative risk of blood transfusion.
Nowadays, we have easy access to the best technology to perform infectious serology tests. However, this will not be enough to ensure the reduction of risks. It is important to have a blood supply from more trustworthy sources than the ones we already have with family replacement, which on occasion involves paid donors, even though this is expressly prohibited by General Health Law.7
Today we face the possibility of transcending and leaving a legacy in blood safety advances for future Mexican generations; for this reason, commendable programs and efforts like those achieved in the states of Chihuahua, Veracruz and Chiapas regarding altruistic donation will have to encourage and guide us to accomplish positive results in this noble cause. However, none of this will be possible without the leadership of the National Center for Blood Transfusion, through a coordinated program which must be evaluated periodically, and the results made public. Only in this way we will be proud of having accomplished the most noble of tasks in the field of transfusion medicine whose results we have been waiting for over 40 years.