Proposal to require citizens to donate blood once a year

In the draft Law on Blood and Stem Cells recently sent to the Ministry of Justice for review, the Ministry of Health proposed to stipulate that blood donation is a mandatory obligation of citizens to be performed once a year, but excludes some cases where blood donation is not possible or stipulates that blood donation is voluntary combined with increased spending on blood donation activities.

Before donating blood, doctors will conduct a clinical health check and take blood samples for testing. Photo: Chu Thanh

The report assessing the impact of the draft Law on Blood and Stem Cells for the upcoming meeting organized by the Ministry of Justice stated that blood and blood products are special medicines, which can only be taken from humans, and although scientists have conducted many research projects to find blood substitutes, there have been no results so far. Therefore, human blood is still the main source of materials for emergency and treatment of patients in the immediate future.

According to theoretical calculations by the World Health Organization (WHO), in developing countries, based on the population of each country, about 2% of the population needs to donate blood each year. To solve the blood shortage and ensure blood transfusion safety, governments of countries have proposed the promulgation of the Blood Donation Law or other laws related to the issue of voluntary blood donation without payment such as: Blood Transfusion Law, Law on Prohibition of Blood Trading, etc. After the Blood Donation Law was promulgated by the National Assembly of countries, the shortage of blood for emergency and treatment has been basically resolved.

Therefore, in the draft Law on Blood and Stem Cells, the Ministry of Health proposed two solutions regarding citizens' obligations related to blood donation.

Solution 1,Regulations on blood donation are mandatory for citizens to perform once a year but exclude some cases where blood donation is not possible;

Solution 2, regulating blood donation as voluntary combined with increased spending on blood donation activities.

According to the Ministry of Health, blood donation is performed based on the weight of the blood donor: People weighing from 42 kg to under 45 kg are allowed to donate no more than 250 ml of whole blood at a time; people weighing 45 kg or more are allowed to donate no more than 09 ml/kg of body weight and no more than 500 ml at a time.

The Ministry of Health affirmed that both solutions do not have an impact on increasing State spending, but only increase spending for the Health Insurance Fund with an average increase of about 500 billion/year.

With a population of about 90 million people, if the first policy is applied, about 46 million people will have to donate blood each year (excluding 30.3 million citizens under 18 years old and about 14.2 million people with diseases that prevent them from donating blood).

The regulation that blood donation is a citizen's obligation has the positive side of helping to ensure a sufficient and stable blood supply. If this policy is implemented, it will cost about 4,180 billion VND annually, of which: The health insurance fund will have to increase spending by about 400 billion/year, employers will have to spend about 3,200 billion VND to pay salaries for the time that employees use to donate blood and employees themselves will have to spend about 580 billion VND for travel to donate blood.

If blood donation is considered voluntary and in the ideal condition of 18.2 million people donating blood voluntarily in a year, it will cost about 2,000 billion VND annually, of which: The health insurance fund will have to increase spending by about 524 billion VND/year, employers will have to spend about 1,250 billion VND to pay salaries for the time that employees use to donate blood and employees themselves will have to spend over 217 billion VND for travel to donate blood.

According to research by the agency proposing the bill, none of the countries that have enacted a Blood Law stipulates that blood donation is a mandatory obligation for citizens, including China.

China's Blood Donation Law stipulates: "State agencies, departments, the military, social organizations, enterprises, units, residential committees and village committees must mobilize and organize their cadres and people to donate blood if they are of the appropriate age." Accordingly, cadres, civil servants and public employees working in the state system must be responsible for donating blood and this blood source is stored and used to serve the medical examination and treatment of the entire population, but there is no mandatory obligation to donate blood.

In addition, if using solution 1, there will be a large amount of unnecessary excess blood, about 28 million. Using solution 1 also doubles the cost to society compared to using solution 2.

From the above analysis, the Ministry of Health believes that solution 2 should be chosen to be both practical and in line with international law, as well as to avoid unnecessary costs for the State and society. In addition, because the content of the policies is determined to be related to the rights and obligations of citizens, according to the provisions of the 2013 Constitution, the authority to issue policies belongs to the National Assembly.

The Ministry of Health said that the blood donation rate (including whole blood and blood components) per population in 2015 was 1.27%, an increase of 13.5% compared to the blood donation/population rate in 2014. This is a noteworthy figure because based on Decision No. 1208/2012 of the Prime Minister approving the National Target Program on Health for the period 2012 - 2015, it is stipulated: "By 2015, the rate of voluntary blood donation of the population will reach 1.3%, by 2020 the rate of voluntary blood donation of the population will reach 2%".

Up to now, there are many medical facilities nationwide participating in receiving blood donations with a very diverse scale, currently there are 60 facilities receiving blood donations. Considering the actual operation over the past years, each blood transfusion facility can only begin to assume the role of a regional blood transfusion center when the blood collection reaches over 50,000 units/year - receiving at least 150 units of blood per day.

According to Dantri