Report from the Commission to the Council and the European Parliament - Report on the promotion by Member States of voluntary unpaid blood donations
Date: 2006-05-17
Institutions: European Commission
Subjects: EU Member State, blood transfusion, public awareness campaign, public health, report

COMMISSION OF THE EUROPEAN COMMUNITIES 

Brussels, 17.5.2006 
COM(2006) 217 final 

REPORT FROM THE COMMISSION TO THE COUNCIL AND THE EUROPEAN 
PARLIAMENT 

Report on the promotion by Member States of voluntary unpaid blood donations 

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REPORT FROM THE COMMISSION TO THE COUNCIL AND THE EUROPEAN 
PARLIAMENT 

Report on the promotion by Member States of voluntary unpaid blood donations 

TABLE OF CONTENTS 

1. 

2. 

2.1. 

2.2. 

2.3. 

2.4. 

2.5. 

2.6. 

3. 

3.1. 

3.2. 

3.3. 

3.4. 

4. 

Introduction .................................................................................................................. 3 

voluntary and unpaid donations ................................................................................... 3 

No payment .................................................................................................................. 3 

Expense allowance ....................................................................................................... 3 

Time off work .............................................................................................................. 4 

Refreshments................................................................................................................ 5 

Acknowledgements ...................................................................................................... 5 

Conclusion.................................................................................................................... 5 

Promotion of voluntary unpaid blood donation ........................................................... 5 

Information campaigns................................................................................................. 5 

Special days.................................................................................................................. 6 

Student awareness ........................................................................................................ 7 

Conclusion.................................................................................................................... 7 

Commission action....................................................................................................... 7 

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1. 

INTRODUCTION 

In accordance with Directive 2002/98/EC of the European Parliament and of the Council of 
27 January 2003 setting standards of quality and safety for the collection, testing, processing, 
storage  and  distribution  of  human  blood  and  blood  components  and  amending  Directive 
2001/83/EC1  this  report  summarises  the  measures  taken  by  Member  States  to  encourage 
voluntary  unpaid  donations  and  identifies  the  measures  the  Commission  intends  to  take  in 
order  to  promote  self-sufficiency  in  the  European  Community  through  voluntary  unpaid 
donations.  

2. 

VOLUNTARY AND UNPAID DONATIONS  

Voluntary unpaid donations have long been a tradition in many EU Member States. Reported 
as  being  accepted  practise  for  over  50  years  in  France,  Luxembourg,  Northern  Ireland, 
Slovenia  and  the  former  Czechoslovakia,  it  also  has  a  longstanding  history  in  Belgium, 
Denmark,  England,  Finland  and  the  Netherlands.  The  practise  was  introduced  in  Cyprus  in 
1977, Spain and Malta in the 1980’s, Italy, Portugal, Greece and Estonia in the 1990’s. 

2.1. 

No payment 

In France, blood donation cannot give rise to any remuneration, direct or indirect. In addition 
to  any  payment  in  cash,  any  provision  of  purchase/reduction  vouchers  or  other  documents 
allowing an advantage given by a third party, as well as any donation of an object of value, 
any benefit or granting of advantages are prohibited. 

All  blood  donations  in  the  United  Kingdom  are  collected  on  a  voluntary  basis  with  no 
remuneration. In Austria, whole blood donors are not remunerated, while an amendment made 
to  the  Transfusions  Act  in  Germany  in  February  2005  stipulates  that  donations  shall  be 
unpaid. 

In  Slovakia,  all  donations  organized  by  the  national  transfusion  service  are  voluntary  and 
unpaid.  About  4%  of  donations  provided  by  Transfusion  Departments  are  paid.  These  are 
mostly thrombocytopheresis donations or rare cases. 

2.2. 

Expense allowance 

The principle of voluntary and unpaid donations does not exclude compensation for donors, if 
it is limited to making good the expenses and inconveniences related to the donation. Several 
Member  States  reimburse  travel  expenses.  In  the  Czech  Republic,  compensation  for  travel 
expenses  and  lost  financial  gain  are  legal  but  not  frequent  in  practice.  A  blood  donor  may 
request  tax  relief  if  the  lost  gain  is  not  sought  during  donation  (circa  10€  per  donation; 
maximum  50-70 €  annually  as  per  individual  tax  rate).  The  proportion  of  blood  donors 
requesting ‘tax relief’ is estimated at 60% as many donations are from people not paying taxes 
(e.g. students). Some donors ask for direct lost time compensation. 

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OJ L33, 8.2.2003. p.30 

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Hungarian  blood  collection  establishments  reimburse  justified  and  certified  travel  expenses 
according  to  flat  rates  established  by  the  Director  General  of  the  national  blood  transfusion 
service. Travel expenses are reimbursed even if the donor is found to be ineligible to donate. 

In 1999, the Lithuanian Government provided the opportunity for those who donated blood on 
voluntary  unpaid  basis  40  times  and  actively  took  part  in  promoting  voluntary  unpaid 
donations, to apply for a State pension. However, in June 2004, an amendment of the Act on 
Compensations to Blood Donors significantly reduced compensations. 

In France, reimbursement to blood donors for travel expenses, except flat-rate reimbursement, 
is authorised. 

The Transfusion Act in Germany stipulates that donors may be given an expense allowance 
based on the incurred expenditure and the particular type of donation. The allowance should 
not exceed € 25 for a whole blood donation. A 2001 resolution of the Arbeitskreis Blut stated 
that  ‘it  has  not  been  scientifically  proven  that  granting  an  expense  allowance  for  blood  and 
plasma  donors  in  Germany  is  detrimental  to  the  safety  of  blood  and  plasma  products’.  It  is 
reported that, granting this allowance has not shown any indication of an effect on prevalence 
and incidence data relating to the groups of donors. 

In Sweden, some blood donation centres are phasing out the traditional payment of SEK 30 
(approx. €3) but maintaining it for apheresis donors of thrombocytes and granulocytes. This 
payment  is  not  considered  an  incentive  to  donate  blood  but  almost  covers  public  transport 
costs  to  and  from  the  donation  centre.  In  Austria,  plasma  donors  receive  up  to  €25  and 
thrombocyte  donors  up  to  €50  per  donation  when  donating  in  a  plasmapheresis  or 
thrombocyte-apheresis centre. 

In  the  Netherlands,  current  legislation  forbids  reimbursement  of  costs  other  than  those 
reasonably acceptable. Luxembourg discontinued the reimbursement of travel costs at the end 
of the eighties. 

2.3. 

Time off work 

In  the  Czech  Republic,  an  employee  is  allowed  free  time  only  for  blood  donation  and 
recovery.  In  Slovenia,  an  employee  may  be  absent  from  work  on  the  day  of  donation  with 
compensation  by  the  employer,  payable  by  the  health  insurance.  Latvia  allows  employees 
who  donate  in  a  medical  treatment  institution  to  have  a  rest  day  on  the  day  following  the 
donation,  which  can  be  added  to  the  employee’s  annual  paid  leave,  while  retaining  average 
earnings. In Luxembourg, the time off from work depends on the employer with a maximum 
of  four  hours.  In  Malta,  employers  are  encouraged  to  allow  workers  the  required  time  off 
work to donate. The previous practice of allowing employees a day off work to donate blood 
has been discontinued. 

In France, the remuneration paid by the employer to the donor may be maintained during the 
time spent for the donation without being considered as a payment in so far as the duration of 
the  absence  does  not  exceed  the  time  necessary  for  the  displacement  between  the  working 
place  and  the  donation  place  and,  if  need  be,  to  the  return,  the  interview  and  the  medical 
examination, the blood collection and the rest period and snack deemed medically necessary. 

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2.4. 

Refreshments 

In  Latvia,  voluntary  donors  receive  a  lunch  allowance,  in  Slovenia  pre-  and  post-donation 
refreshments,  while  in  Hungary  they  are  entitled  to  calorie  and  fluid  replenishment 
refreshment, even if the donation does not yield a useable blood product. 

2.5. 

Acknowledgements 

An important aspect of voluntary unpaid blood donation is recognition of the contribution of 
individuals  who  are  willing  to  provide  blood.  This  recognition  ranges  from  small  tokens  in 
Austria for whole blood donations, to pins, pencils, tea-cups, towels, T-shirts, mugs, postcards 
and  back-packs  in  Lithuania  and  Poland,  to  certificates  and  medals  awarded  to  individuals 
who have reached certain plateaus of donations. In the Czech Republic these take the form of 
bronze, silver and gold medals, in Greece, certificates and a brass badge, and in Luxembourg 
a  special  State  Order.  Annual  donor  awards  ceremonies,  often  attended  by  the  press,  local 
governments and politicians, are held in many Member States including Greece and Ireland. 
In Poland, voluntary donors who have given at least 5 (female) or 6 litres (male) of blood are 
awarded the title ‘Honoured Voluntary Blood Donor’ and given a badge. 

2.6. 

Conclusion 

Although the principle of voluntary and unpaid donation is recognised by the Member States, 
the concrete interpretation of this principle differs across Member States. The amount of the 
expense allowances or the duration of a leave from work for example differs.  

3. 

PROMOTION OF VOLUNTARY UNPAID BLOOD DONATION  

The  number  of  activities  undertaken  throughout  the  European  Union  to  promote  voluntary 
unpaid donations is important. They range from the production of publications such as guides 
and  practical  materials,  or  advertising  to  specific  target  groups,  to  student  awareness 
programs.  

3.1. 

Information campaigns 

Lithuania  has  distributed  leaflets,  posters,  etc  advertising  voluntary  blood  donations  while 
Spain  issued  a  special  postage  stamp.  The  Czech  Republic,  Spain,  Cyprus,  Greece  and 
Slovenia  reported  that  their  Health  Ministries  have  provided  support  for  awareness  and 
education  campaigns,  advertising  the  organization  of  events  promoting  voluntary  blood 
donation,  the  dissemination  of  information  for  the  public  and  donors  on  blood  donation 
through leaflets, posters etc.  

In Poland, the Red Cross has published posters and flyers promoting voluntary blood donation 
and  explaining  its  role  in  society.  Documentation  is  sent  to  schools,  hospitals  and  local 
government  offices,  distributed  in  health  centres  and  during  blood  collection  campaigns. 
Radio  and  television  programmes,  concerts  for  blood  donors,  performances  by  musical 
ensembles are also held. 

In  Germany,  the  Advertising  of  Medicines  Act  was  amended  so  that  it  is  no  longer 
permissible  to  publicise  the  payment  of  a  monetary  consideration  or  expense  allowance  in 
connection with the donation of blood or plasma. This has led to blood and plasma donation 
services reconsidering their approach to promoting donations. 

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In Latvia, donations are encouraged by the National Blood Donors’ Centre which organise a 
range of information campaigns. Doctors also encourage people to give blood in cases where 
a relative has needed a blood transfusion. 

In Italy, the first campaigns started in the 1990s and took place during the summer months in 
order to overcome seasonal chronic shortage. Since then, national plans have been adopted to 
promote donation and national self-sufficiency. 

In  2004,  the  Minister  of  Health  of  the  Republic  of  Lithuania  approved  the  Programme  on 
Promotion of Voluntary Unpaid Blood Donations. In addition to a seminar on its principles, a 
concert was held, and advertisements were carried in the mass-media. 

The issue of blood donation in Malta is stressed by the National Blood Transfusion Service 
through its participation in a number of television and radio programmes, and through articles 
in the local press.  

In  Spain,  about  60  associations  throughout  the  Autonomous  Communities  are  involved  in 
promotion activities (talks, posters/leaflets, citations, preparation of collection centres, care of 
donors, conferences). 

In  Hungary,  numerous  projects,  recruitment  drives  and  advertising  campaigns  to  promote 
blood donation have been held, with a strong emphasis on its social value. 

Various  surveys  have  been  carried  out  in  Spain,  Ireland,  Malta  and  the  United  Kingdom  to 
determine  issues  such  as  attitudes  to  voluntary  unpaid  donation,  barriers  to  donation,  the 
impact of advertising campaigns, accessibility of donation sessions, causes of the shortage of 
blood and strategies for addressing this situation. 

The  national  blood  service  in  Ireland  recruited  a  marketing  executive  to  promote  corporate 
relationships, and to organise presentations for community groups, business organisations and 
student  groups.  An  agency  has  also  been  contracted  to  conduct  the  Irish  blood  donation 
advertising  campaign.  The  use  of  marketing  techniques,  including  paid  advertising,  direct 
marketing  and  public  relations,  have  been  used  in  the  United  Kingdom  and  are  thought  to 
have provided a combination of direct response and increased brand awareness. 

In  Italy,  an  internet  campaign  was  conducted  in  2002  on  portals  specially  created  to  draw 
attention to activities of the blood associations. Ireland’s blood transfusion service redesigned 
its web site in September 2003 to offer donors with email alerts, clinic search facilities and 
clinic calendars, as well as a source of related information. In Scotland, the web site can be 
used  for  on  line  donor  registration,  donor  information,  session  information  and  medical 
queries.  Text  messaging  has  also  been  piloted  in  Ireland  to  remind  donors  when  a  donation 
clinic was in their area. 

3.2. 

Special days  

World Blood Donor Day has proven to be an opportunity for many Member States to generate 
publicity promoting blood donation. Greece, Spain, Slovenia, Poland all reported events that 
had been carried out to raise awareness among the media and the public at large of the role 
played by voluntary blood donors.  

In  Italy  Ministerial  Decrees  proclaimed  ‘National  Blood  Donor  Days’  in  2002-2005,  with 
cultural  events  organised.  In  Poland,  ‘Open  Door  Days’  are  organised at  which  doctors  and 

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laboratory heads talk about donor eligibility, and the methods used to collect, test and process 
blood. The ‘Blood for Life Week’ in Ireland also aims to increase awareness and involves a 
series of week long events. 

3.3. 

Student awareness 

Student  awareness  programs  have  been  pursued  in  the  United  Kingdom,  with  Scotland 
designing  an  extensive  school  and  university  recruitment  programme.  Ireland  produced  an 
educational  video  and  Latvia  provided  explanations  on  the  processing  of  blood  and  donor 
requirements  to  institutions  of  higher  education  through  visits  by  representatives  of  the 
National Blood Donors’ Centre and Association. In Poland, information campaigns have been 
organised  in  schools  and  colleges  to  provide  information  on  blood  collection,  testing  and 
preparation. A national competition entitled ‘Young blood saves lives’ was targeted at college 
adults and resulted in the representatives of the colleges whose students had given the most 
blood  receiving  awards.  In  Slovenia,  the  Red  Cross  has  organised  numerous  talks  for 
secondary school pupils. 

3.4. 

Conclusion 

Different  initiatives  exist  to  promote  the  principle  of  voluntary  and  unpaid  donations,  using 
techniques  as  diverse  as  marketing  actions,  student  programs  and  e-initiatives.  Some  of  the 
actions  are  related  to  the  promotion  of  donation,  others  are  more  specifically  related  to  the 
promotion  of  unpaid  donation.  There  is  a  need  to  share  experiences  and  to  determine  best 
practices.  

4. 

COMMISSION ACTION 

The  Commission  will  continue  to  encourage  Member  States  to  promote  voluntary  unpaid 
donations.  In  doing  so,  the  Commission  will  follow  an  integrated  approach,  including 
different strategies to address blood shortages and promote self-sufficiency. The Commission 
suggests undertaking the following actions in its efforts to promote self-sufficiency in human 
blood or human plasma through voluntary unpaid donations.  

A  European  wide  study  under  the  Community  Health  programme  should  be  carried  out  in 
order to determine best practices for promoting voluntary and unpaid donations,  taking into 
account existing study material for example on citizens attitudes towards blood donation. This 
study  should  be  geared  towards  developing  a  methodology  and  basic  set  of  principles  for 
awareness campaigns and be based upon an impact analysis of marketing initiatives, student 
programs and e-initiatives for donor recruitment and retention.  

The  discussion  on  self-sufficiency  in  the  Community  should  be  continued  and  should 
complement the promotion of voluntary unpaid donations with a reflection on the optimal use 
of blood, the other determinant of self-sufficiency.  

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