A key aspect of ensuring a safe blood supply is the screening and counseling of donors to eliminate HIV-infected people from donating blood. Although testing of blood is essential to avoid transmission of the HIV infection, it is absent or inadequate in many low income countries.

The World Health Organization has outlined a series of recommendations so that countries can maintain a safe and constant blood supply. The proposed steps can prevent transfusion-transmissible infections (TTI) which include HIV-1 and HIV-2, hepatitis B, hepatitis C and syphilis passing from a blood donor to a recipient.

Among the recommendations are the following: to have a nationally coordinated blood transfusion service, to have voluntary unpaid donors, to test all donated blood, to use blood efficiently and appropriately, to ensure a safe transfusion practice and to have a quality system check throughout the blood transfusion process. These measures have made the risk of HIV transmission practically non-existent in countries that follow these recommendations.

In China, some cultural factors that inhibit the success of blood donation programs also need to be addressed. One such factor is the traditional belief that loss of blood is not only detrimental to a person's health but is also a disloyal act against a person's ancestors. These are concerns that health authorities should address to have an effective and safe blood donation system.

The author is an international public health consultant and has the book, AIDS: A Modern Epidemic, a publication of the Pan American Health Organization, to his credit.