In Focus
Lost in translation
Why Mexico must speak the global language of blood donation
In Mexico, as in many low and middle income countries (LMIC), the transition from replacement to voluntary non-remunerated blood donation (VNRBD) remains frustratingly slow.
This stagnation is not merely due to operational or financial limitations, it is rooted in a more fundamental conceptual error: we are not speaking the same language as the international community.
While global standards established by the World Health Organization and the International Society of Blood Transfusion define voluntary non-remunerated blood donation as the ethical and technical cornerstone of safe blood supply systems, Mexico persists in using the term “altruistic donation”.
At first glance, this may appear to be a benign linguistic variation. In reality, it represents a profound misalignment. “Altruism” appeals primarily to emotion, “voluntariness” defines a right and a standard, and “non-remuneration” ensures that this right is exercised within an ethical, transparent, and sustainable public health framework. One is moral rhetoric, the other is public health policy.
When a health system adopts the wrong terminology, it builds its entire structure (campaigns, laws, strategies, workflows, and indicators) on a flawed foundation. This is not a mere delay in progress, it is movement in the wrong direction. Using “altruistic” instead of “voluntary and non-remunerated” generates confusion among professionals, donors, and policymakers, and distances the country from evidence-based international cooperation.
Language matters because it shapes thought, policy, and outcomes. The nations that have successfully achieved 100% VNRBD did so by aligning terminology, legal frameworks, communication strategies, and quality management systems under a single conceptual umbrella. Without this alignment, Mexico risks perpetuating a model widely recognized as inefficient, dependent on family replacement donations and structurally unable to guarantee sufficiency, equity, or long-term safety in the blood supply. Beyond semantics, however, the deeper issue is the reluctance of health authorities to embrace international standards with genuine openness. Reforming a national blood system requires more than isolated technical improvements: it demands listening, learning, and acknowledging that other countries have already walked this path with success. Many of the obstacles Mexico faces today were once faced by nations that are now global references. Their progress did not arise spontaneously, but from the deliberate adoption of shared definitions, shared metrics, and shared values regarding the role of voluntary donors in public health.
For years, Mexican authorities have insisted on adapting global principles to local interpretations, often without recognizing that this “tropicalization” dilutes or distorts the core elements that make VNRBD effective. There is a persistent belief that Mexico’s context is exceptional or incompatible with international frameworks. Yet nothing in the country’s culture, socioeconomic profile, or history makes voluntary non-remunerated donation unachievable. What is missing is not donor willingness, but institutional coherence and conceptual alignment.
A modern blood system cannot flourish if its conceptual language is out of sync with global practice. The absence of VNRBD terminology is not neutral, it perpetuates contradictions that limit progress. How can Mexico evaluate its performance against global indicators if it does not use the same definitions? How can it participate meaningfully in international collaboration if its foundational concepts differ? How can policymakers commit to reform if the language guiding those reforms remains imprecise? Adopting the correct terminology is therefore a necessary first step, but it must be accompanied by a broader cultural and institutional shift. Authorities must be willing to hear uncomfortable truths: that replacement donation survives not because it is effective, but because it is administratively convenient, that “altruism” has become a rhetorical shield to avoid confronting the need for systemic change, and that the current model, despite decades of evidence, remains misaligned with modern standards of transfusion medicine.
Opening the door to international dialogue does not diminish national sovereignty, it strengthens public health. Embracing change should not be mistaken for admitting failure or assigning blame. Countries that transitioned successfully did so because their authorities understood that aligning with global norms is not imitation, but a forward-looking commitment to patient safety, donor dignity, and system sustainability. Mexico deserves a blood system grounded in these principles, not in outdated terminology or institutional inertia.
Those who transformed their systems to achieve 100% VNRBD did not reach their goals by chance. They built them through patience, evidence, and an unwavering belief in collective responsibility. Their experience reminds us that safe and sufficient blood supplies are not products of isolated heroism, but of collaboration, continuity, and trust between institutions and society.
Transforming this reality requires humility. It means acknowledging that our vision is limited when we stand alone, and asking for help not as a sign of weakness, but as proof of commitment. For this to translate into meaningful progress, health authorities must demonstrate sustained openness to learning from international experience.
This, in turn, requires asking the questions that can help change an adverse reality, and, just as importantly, developing the capacity to absorb the answers: How has donor psychology been studied to promote VNRBD more effectively? How were weaknesses in donation systems identified and addressed? How were supportive public policies designed and implemented? How were efforts coordinated between public and private sectors? How were logistical barriers for donors and transfusion services overcome? How were initiatives funded? How were diverse cultural contexts navigated? And how were healthcare professionals trained to recruit and retain donors?
These are not rhetorical questions. They are essential tools for building a bridge between Mexico’s present and the world’s best practices.
True progress begins by speaking the same language as those who have already succeeded, and by learning from their experience. Adopting the term “voluntary non-remunerated blood donation” is not symbolic, it is strategic. It signals a commitment to international standards, ethical transparency, and scientific coherence, and invites Mexico to reimagine its blood system not as an exception, but as part of a shared global effort to guarantee safe and sufficient blood for all who need it.
Until Mexico makes this linguistic and conceptual correction, until it embraces openness, listens to evidence, and aligns itself with proven global frameworks, every effort to reform its transfusion system will remain, quite literally, lost in translation.
