The Champion Blood Donor Ceremony

14 Jun 2007

By Mr Khaw Boon Wan

Venue: VivoCity

Tribute to our blood donors

Tonight, we pay tribute to three special groups of people. Topping the list are our regular blood donors. With your acts of compassion, you save many lives, people who need blood as a result of cancers, blood disorders, accidents, complicated childbirth or surgeries. We cannot gather everyone here together, but our Champion Blood Donors here tonight can proudly represent all our regular blood donors.

Next on the list are two groups of individuals who work quietly behind the scenes to enable your gift of life to reach those in need in a safe and efficient manner. One group comes from the Singapore Red Cross and its many dedicated volunteers. You have done an excellent job in promoting voluntary and regular blood donations among Singaporeans. In the last six years since you became the national blood donor recruiter, our annual blood donations have grown one and a half times - from 66,000 to 95,000 units.

By your efforts, you ensure a steady stream of safe donors: donors who give voluntarily and freely, driven purely by altruism and the satisfaction of knowing that they have helped someone else. Safe donors are the foundation for a safe blood supply.

Safe blood Supply

Another group comes from our blood bank, which has been managing our blood supply for over 60 years. Through their dedication, our national blood service ranks among the best in the world.

This does not happen by accident. It requires a meticulous system of quality control and safety measures.

This is important. We have seen examples of terrible consequences when blood banks do not maintain high standards. In one country, a major HIV epidemic broke out in the 1990s because of badly-run commercial blood banks. Villagers sold their blood in unsanitary facilities. The use of unsterilised needles, coupled with lack of testing on the donated blood, led to tens of thousands of people contracting HIV while donating blood or receiving unsafe blood transfusion.

This incident reaffirms the case against paying blood donors as “bought” blood carries a high risk of transfusion-associated infections, for example HIV. Paid donors are often under pressure to conceal information that would have revealed their higher risk profile. That is why many countries that used to rely on paid donors are now moving towards systems based on voluntary and unpaid donors, to improve the safety of their blood supplies.

HIV problem

Our blood bank’s contribution in saving lives is well known. But less well acknowledged is its quiet work in preventing infectious diseases such as HIV from being unwittingly spread through contaminated blood transfusion. 

In Singapore, over 3,000 people have been diagnosed with HIV infection. We do not know how many others are out there with the virus and remain undiagnosed.  But we know that we cannot be complacent because our region has high rates of HIV infection.

Sources of transmission

There are four major sources of HIV transmission.

Poorly-run blood banks

The first is through poorly-run blood banking systems as we discussed just now. In Singapore, we have an excellent blood donation and transfusion service, so this is not a problem for us.

Sharing of needles

The second is through the sharing of needles by intravenous drug abusers. Thanks to our strict drug laws, this is not a big problem here. But it is a big problem in many countries in our region.

Mother-to-child transmission

The third source of transmission is from a HIV-infected mother to her child during pregnancy, delivery or breastfeeding. But this is preventable. If we detect a HIV infection in a pregnant mother early enough, we can treat the mother and give her advice about how to deliver and feed her baby safely. This can break the transmission from mother to child.

In 2003, the US CDC issued a recommendation that routine HIV testing and counselling be made a standard of care in antenatal clinics. In 2004, we got our doctors and antenatal clinics to support the US CDC recommendation. HIV testing is now part of the standard antenatal screening package in Singapore and has been very effective in reducing this source of HIV transmission. 

Today, practically all pregnant women in Singapore are screened for HIV, and we would like to thank the mothers and the doctors for supporting this measure. Last year, 13 pregnant women who were HIV-positive were detected. A similar number, 15, was detected the year before. They were promptly treated and counselled. As a result, we save more than a dozen babies each year from being born with HIV. Since implementing this measure, only one case of mother-to-child transmission has occurred, and that was because the mother refused her HIV test until very late in her pregnancy. 

Unprotected sex

The final mode of transmission of HIV, and the most challenging to control, is through unprotected sex. Having largely reduced the other sources, we must now focus on breaking this mode of transmission.

To do so, we need to identify previously undiagnosed HIV carriers, so that we can treat, care and support them in a timely manner and give them advice on practical measures to prevent HIV transmission to others. Studies show that HIV carriers do respond to such counselling and do reduce their high-risk behaviour. After all, nobody wants to deliberately infect his loved one. 

The challenge is in identifying this group of undiagnosed HIV carriers early. The public health problem is that HIV-infected persons can remain well for many years before they start showing symptoms. If they are careless in their behaviour, they can infect others without knowing it. 

Our case records contain many such stories. There is one middle-aged married man with two adult children. He has been married to his wife for over 30 years, but he also had unprotected sex with commercial sex workers. He was confirmed positive for HIV when he sought treatment in our hospital. We got his wife to be tested and found that she too was infected, presumably by her husband. Both are now under active treatment at CDC.

Such tragedies can be prevented if we can identify and counsel the carriers early. We are studying how other countries address this problem and whether there are good solutions out there which we can adopt.

Conclusion

Tonight, we salute our blood donors for their generosity and their community spirit. The recipients of your blood donations do not know who you are, but I have no doubt that they are deeply grateful to you. Your selfless acts of blood donation will inspire and encourage many others to do the same.

Thank you.