club25

World Health

Organization

Club 25... whereblood donorslove life!

IntroductionThe spread of HIV in the 1980’s caused blood services across

the world to seek new strategies to collect the safest blood possible.A variety of strategies have been implemented and in some casescostly and sophisticated advertising campaigns have resulted indismal failures, while others have had limited success. Countriesacross the world are continually evaluating their blood donorrecruitment and motivation strategies in the light of currentdemands for blood and blood products and in some cases areduction in available eligible donors: this being due to thestringent criteria in place to protect blood safety.

With this as a very brief backdrop to the challenges facingthose tasked with the collection of the safest blood possible it isfascinating to find that often the best solutions can also be thecheapest!

Introducing… “Club 25” where young blood donors indeed love life and are happyto share their time, their blood, their energy

and their ideas!

In 1989, Zimbabwe started targeting a previously untappedpool of low-risk donors and one such school-age blood donor atthe time suggested it might be a good idea if young people pledgedto give 25 blood donations by age of 25 years. Very soon many stu-dents started committing themselves to this idea and the forma-tion of the first “Pledge 25 Club” took place. Now around 70% ofblood collected in Zimbabwe is donated by school students andPledge 25 Club members.

The accompanying video and this leaflet provide an overviewof how this initiative is now having appeal to teenagers across theworld. It is interesting that the initiative has been particularly suc-

2 Club 25... where blood donors love life!

cessful in keeping young people protected from HIV and otherinfections because part of their pledge is that they will maintainhealthy life-styles in order to provide the safest blood. Indeed inZimbabwe the HIV infection rates among blood donors fell from4.45% in 1989 to 0.61% in 2001, in a country where infectionrate in the sexually active population was 33.7% at the time.

Elsewhere, such as in neighboring South Africa the results arejust as impressive: young people aged 16-25 years are providingabout 24% of the national blood supply. This video will introduceyou to various Club 25 programmes and examine their progress inthree different countries, South Africa, the Philippines andMalawi.

In preparation for World Blood Donor Day 14 June 2005,where we will again acknowledge the role of all voluntary blooddonors, it seems appropriate to introduce an approach to blooddonor motivation and HIV/AIDS education which may provideguidance to other organizations wishing to introduce similar pro-grammes. The philosophy behind the Club 25 Programmes is tobe open and honest with young people, providing clear guidelinesabout blood donation criteria and similarly facts about the bestHIV/AIDS protection based on the evidence available, and thenallowing young people to make their choices based on this evi-dence.

One very important consideration in setting up a Club 25 Programme

is that on no account is the Blood Serviceused as the place to find out if one is HIV positive. This would only be counter productive and attract

the wrong target population.

3Club 25... where blood donors love life!

In summary it appears that Club 25 Programmes are using anevidence based approach to stimulate youth to take responsibilityfor their own actions. This ultimately has an impact in the com-munity in which they live and so far the impact in maintainingblood supplies and in stopping the spread the HIV/AIDS is prov-ing to be significant, at least in some parts of the world.


1 Stoneburner and Low-Beer, Population-Level HIV Declines and Behavioral Risk Avoidancein Uganda, Science 2004 304: 714-718 Science Journal

Club/pledge 25…worldwide activities as at November 2004

Zimbabwe BotswanaZambia South AfricaIndia IndonesiaMalawi UgandaHaiti Philippines

Togo

Pilot programmes are also underway elsewhere and with YOUR help this list will be extended before

World Blood Donor Day 14 June 2005.Start now and establish a Club 25 programme in your country!

Overview with country examples:

Models of various kinds exist but generally they follow a simi-lar structure as per this very simple example:

Models of various kinds exist but generally they follow asimilar structure as per this very simple example:1. The Club elects a national and provincial administra-

tive committee to organize activities, for example aNational Youth Blood Donor Day.

2. Peer promoters are elected to assist the Blood Service inthe recruitment of voluntary, non-remunerated blooddonors from low-risk populations and in turn theBlood Service supervises and supports the Club.

Operationally the Club functions according to local needs butthe following example from South Africa helps to illustrate the roleof the Blood Service and the responsibilities of Club Members:

Adapting Pledge 25 Club to South Africa

The idea started in Zimbabwe. In the late 1990s, the bloodservice there revealed some interesting data and strategies in theoverall context of reducing the HIV rate and retaining youngdonors. The service had reduced the HIV rate among Zimbabweblood donors from about 21 per cent to 1.1 per cent includingnew donors (in a country where 20-26 per cent of people agedbetween 15-49 years were living with HIV/AIDS, and with ratesclimbing). They had identified young people as a low-risk group


but they had also observed they ceased donating after they leftschool. So the first Pledge 25 Club was established, for schoolleavers who pledged to donate 25 times in their lifetime.

As part of the pledge, the young people had to remain sero-negative in order to achieve their objective and within a short peri-od there was a significant increase in both club membership andblood donor retention among school leavers.

Some time afterwards the “club concept” was then introducedin South Africa under the title of Club 25, and in general it oper-ates as follows:

Approximate age of Club members: 18-25 yearsRecruitment for Club 25 is aimed at current donorswho are leaving school or who have left school andalready donated three or more units..Donors (21 years or younger) who are no longer atschool can also join the programme as long as they havepreviously given three units of blood.Club 25 members must ensure they lead a safe lifestylein order to remain safe blood donors and meet the cri-teria for donor eligibility.Club 25 members must commit to donate a minimumof two units per year with the aim of donating 20 unitsby the end of their twenty-fifth year (ie all donationsmust be made before they reach 26 years.

TeamworkIn South Africa Club 25 is very much a team exercise, involv-

ing various elements within the blood service. In involves thedonor staff in recruiting new members, the Corporate PublicRelations/Donor Marketing Department in special efforts toretain members as donors and to educate them to commit tohealthy lifestyles and a Club 25 newsletter to reinforce education


and to remind donors of their commitment. Finally, telerecruitersalso play a key role by contacting the young donors and remind-ing them about their first donation during the January-Marchperiod and again for subsequent donations later in the year.

The processAfter blood donors leave school they sign up as Club 25 mem-

bers and give their first donation as part of the club. They receivea bag from the Blood Banks of South Africa as token of theirappreciation for their support and commitment. On their 20thdonation, a Club 25 member receives a nationally recognised Club25 medal and there is also a quarterly Club 25 newsletter to keepall members informed about blood donation drives and activities.One of the primary functions of this newsletter is to remind thesedonors of their commitment and to continually provide them withinformation on risk behaviour: the focus is on the importance ofdonating blood regularly and living a safe lifestyle.

ResultsThe launching of Club 25, conducted on National Youth

Blood Donor Day, 4 December 1999, involved twenty branches ofSANBS and all centres reported that Club 25 was well received.Despite the cultural diversity of South Africa the National BloodService (SANBS) has been successful in creating a concept thatappeals to a target age group across all ethnic boundaries.

SANBS has had some years to develop the concept and watchthe programme grow. Latest statistics indicate that Club 25 is cer-tainly making an impact on the quality and quantity of the coun-try’s blood supply. Moreover, it is also clear that the Blood Centreis playing a significant role in educating young people about riskbehaviour and ensure they remain free of the HIV/AIDS scourgethat has taken hold of the continent.


Latest dataIn 4 years:

35,193 active donors on Club 25 donor panel.177,426 donations from Club 25 members.Increase in 18-25 year old donors on SANBS donorpanel from 6% to 15%.Decrease in HIV prevalence of Club 25 panel to0.04%: SANBS donor panel to 0.07%: South Africacountry 26 – 28%.

A similar model in the Philippines

“Pledge 25” has recently become a project of the PhilippineNational Red Cross (PNRC)-Red Cross Youth Department (RCY)in support of the drive on voluntary blood donation. It consists ofa group of young blood donors who pledge to regularly donateblood 3 to 4 times a year starting the age of 18 until they reach 25years old. After this period, they will be joining other blood donorgroups for their regular blood donations.

ObjectivesTo organize a youth group as a link with Red Cross totap the youth sector as regular donors of the PNRC.To create a group of young blood donor recruiters.To interface the youth program with the NBS.To promote the participation of women in voluntaryblood donation.To instill into both young and old alike, the value ofsaving others’ lives by voluntary blood donation.


RepresentationMembers mostly represent various youth groups, either gov-

ernment or non-government. But also accepted are young peoplewho do not belong to any youth organization. There are thou-sands of active members nationwide, and these young people arealso actively participating in other various worthwhile Red CrossYouth activities. Each member receives an attractive ID card aftertheir second donation, and a pin is given after the third donation.A regular Pledge 25 blood donor will receive a different design ofpin every year after the third donation.

ResultsPledge 25 memberships for year 1999, 2000, 2001, 2002:

Nationwide membershipYear Luzon Visayas Mindanao Total1999 1,038 353 960 2,3512000 1,249 624 555 2,4282001 815 913 271 1,9992002 1525 605 820 2,950January-June 2003 266 386 120 772Over – All total 4,893 2,881 2,726 10,500


HIV/AIDS prevention:it is your choice!

Based on current evidence available there are three broad cate-gories of risk concerning HIV/AIDS (No Risk, Low Risk andHigh Risk) and the chart opposite tries to identify these categoriesto enable young people especially make their choice in terms ofappropriate protection where sexual relationships are concerned.

Generally Club 25 Programmes include guidelines for youngpeople to ensure they remain eligible as blood donors by leadinghealthy life-styles and the Blood Service can play an important rolein providing HIV/AIDS education materials. In this way youngpeople themselves become “HIV/AIDS” peer educators and theirrole in the community is even more significant than “saving livesby blood donation”... they now also play a vital role in health pro-motion as well!

The Club 25 Programme, though only just beginning in somecases, appears to be a most economical model in terms of publichealth care. With young people playing such valuable roles in help-ing to secure a safe and adequate blood supply, and in creating aculture of healthy lifestyles among their peers, World Blood DonorDay, 14 June 2005 seems be a good opportunity for governments,policymakers and blood programmes to include them in their mes-sage of thanks to all blood donors.

Thank you to all Pledge/Club 25 members!


Further information,see World Blood Donor Day website

www.wbdd.org

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