From the Central Office
From the President
Over the last two years, I have had the opportunity to prepare talks introducing ideas around our shared challenges surrounding blood donors and the donation process. I have been privileged to present these in Oman, Australia, India and most recently in Mexico. Each time, I review recently published global data, local data and aim to customize the content to its region. And every time, my review reveals two donor-related factors.
Lin Fung ISBT President
The first is AGEING. In the world today, there are more people aged over 60 years than children aged under 5 years. Furthermore, the rate or pace of ageing is increasing, and this change is not limited to high-income countries, but is also happening in low and middle-income counties. To safeguard donor health, many blood services impose a maximum donation age, consequently as populations age this shrinks the pool of people eligible to donate. Based on careful assessments, some services have significantly increased (South Africa) or removed (Australia, Canada) upper age limits on repeat donors. In addition, there is growing evidence that wherever blood is available, older patients (>60 years) are the major or largest transfusion recipient group. Hence, population ageing may lead to shrinking the size of the donor pool, as well as an increase in the demand for blood. Therefore, it would be prudent to ANTICIPATE AGEING and to develop strategies to accommodate this inevitable change.
The second challenge is ANAEMIA. WHO has thresholds defining anaemia as Hb < 13 g/dL for adult males and < 12 g/dL for non-pregnant women (1). Most blood collection services have minimum gender based Hb criteria for donation, but these thresholds vary globally, and in some services the minimum Hb required is below the WHO anaemia threshold. In lower income countries, low donor weight is a more common trigger for donor deferral and in high income countries low Hb is the most common cause of deferrals (2). These factors are particularly significant in deferral of female donors.
As examples, in Africa only 23% of blood donors are female, and in the Eastern Mediterranean the female donor rate is even lower at 5% (3). Anaemia leads to poorer health, well-being and productivity so is a concern not only for blood services but also for public health authorities worldwide (4). Sadly, findings from the 2025 WHO global anaemia study estimates that for all WHO regions, most countries have shown no progress or are worsening in their efforts to reduce anaemia.
As all blood collection services assess for minimum Hb, we are in a unique position to identify anaemia in the community. This raises a number of questions: Can we do more to ADDRESS anaemia in our communities? Can we be more pro-active in PREVENTING anaemia? Can we work more closely with the public health systems to direct anaemic individuals to local health support? This aligns well with ISBT’s mission to advance transfusion medicine worldwide through knowledge, connection and advocacy (for our donors).
Therefore, in this issue of Transfusion Today, I encourage our readership to contemplate how can we can best ACKNOWLEDGE AGEING and ADDRESS ANAEMIA in our transfusion practice. Lin Fung, ISBT President
References
1. Nutritional anaemias: tools for effective prevention and control. Geneva: World Health Organization; 2017. https://www.who.int/publications/i/item/9789241513067
2. Global status report on blood safety and availability 2021. Geneva: World Health Organization https://www.who.int/publications/i/item/9789240051683
3. WHO Global Status Report on Blood Safety and Availability. 2025. Geneva: World Health Organization https://www.who.int/publications/i/item/9789240121546
4. Geneva WHO. WHO global anaemia estimates: key findings. 2025. Geneva: World Health Organization https://www.who.int/publications/i/item/9789240113930
