In October 1997, UNAIDS released its position on Blood Safety and AIDS to serve him as a reference to countries in formulating policies and programs. Specifically, he urged to "educate, motivate, recruit and retain low-risk donors, and these donors defined as" those unpaid volunteers who donate their blood out of altruism, regularly. "

The same document also suggested that "It requires effective and sustained campaign to persuade a large number of people who give blood voluntarily and regularly for civic sense, that is, to motivate and recruit."

In September 2000, 189 countries adopted the Millennium Declaration, United Nations and pledge to eliminate gaps and inequalities, set itself the target eight development goals, the sixth goal calls explicitly to stop the spread of HIV. And the goals four and five set goals whose achievement will contribute to the extent that the National Blood Bank to ensure timely and safe blood for the population that needs it. These objectives are:

1. Reduce the mortality of children under 5 years.

2. Improve maternal health.

Nationally, in March of that year, the Dominican Government has defined a National Blood Policy, which was made explicit by the arrangement 5384. The policy calls for:

FIRST: Create mechanisms that ensure timely access and quality of safe blood and blood components to all citizens, based on the principles of equity, solidarity, universality, quality and efficiency.

SECOND: To promote voluntary blood donation through the Provincial and Municipal Health establishing specific programs for implementation of this Policy.

THIRD: The quality and safety of blood and its components, should this be screened before being transfused.

Fourth: To promote the rational use of blood and its components, creating all relevant laws, training of staff from health and guiding the community towards voluntary blood donation and / or secure components.

In 2001, the Dominican Congress enacted the General Health Law (Law 42-01) and established through Articles 107 and 108 that blood donation should be voluntary and prohibits commercial donation.

In 2004, Decree No. 349-04 approving the Regulations for the Qualification and Operation of Blood Banks and Transfusion Services and establishes the legal provisions for the donation of blood, as specified in Articles 38 and 39 blood banks only will be made on voluntary unpaid donors, and that there should be a plan to promote voluntary donation.

In September 2005, the Ministers of Health of all American countries gathered at the 46th PAHO Directing Council approved the Plan of Action for Transfusion Safety 2006-2010 and proposed a series of strategies and indicators to facilitate the implementation and monitoring plan. Between what we can say:

1. All countries have quality programs that include all the blood services.

2. 100% of allogeneic blood coming from voluntary donors.

In 2007, UNAIDS through its document Guidelines for Intensifying HIV Prevention suggests that it should promote safe blood donation.

Following the international and national guidelines, the National Blood Bank and other national and Dominican Red Cross have developed actions to increase voluntary blood donation and unpaid. These guidelines have not been entirely successful, since in our country's blood donation has declined significantly in recent years and the act of giving does not seem to provide motivation that drives people to assist blood banks.

According to the Report of the National Blood Bank (DNBS), Ministry of Public Health in 2009 were collected 85.169 units, which represents only 50% of the need for blood supply expected. To achieve the 171.251 collect blood units, which requires the country and meet the standard of 2% of the population, established by WHO, will require education and communication efforts to convey highly motivating messages and correct.

In this report, it is reported that only 20.770 (19.26%) were voluntary donors, altruistic and unpaid, and 61.015 (56.58%) were replacement donors. This report shows that the major proportion of blood collected from blood banks in our country comes from relatives and / or replacement. This blood is usually less safe, because often those who donate blood for the need and pressure to a relative or friend who needs it urgently can not disclose information about your health or lifestyle that they do as a person ineligible or disqualify suitable for donation.

1. Support well-organized and coordinated blood safety activities through a central partner (e.g., MOH, National Blood Transfusion Service NBTS, Red Cross or other entity) with legal authority to manage the national blood supply.

a. Strengthen capacity to test all donated blood for transfusion-transmissible infections in quality-assured laboratories

i. Equip the Blood Banks of 3 hospitals to become regional banks

ii. Participate in development of regional waste management plans

iii. Coordinate with laboratory and health care facilities in commodities procurement, equipment maintenance

b. Support the expansion of blood collection and transfusion services beyond urban areas. Equipping two mobile units for blood collection

2. Continue technical assistance to the Ministry of the armed forces in the process of strengthening of blood services

3. Assess need for blood by health centers

4. Continue financial and technical assistance to the DNBS for the design and implementation of a National IEC strategy in relation to the voluntary blood donation

5. Promote policies mandating the collection of blood only from voluntary, non-remunerated, low-risk blood donors. Support Red Cross in promoting the voluntary blood donation