2. Introduction
The 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 cases
costly and sophisticated advertising campaigns have resulted in
dismal failures, while others have had limited success. Countries
across the world are continually evaluating their blood donor
recruitment and motivation strategies in the light of current
demands for blood and blood products and in some cases a
reduction in available eligible donors: this being due to the
stringent criteria in place to protect blood safety.
With this as a very brief backdrop to the challenges facing
those tasked with the collection of the safest blood possible it is
fascinating to find that often the best solutions can also be the
cheapest!
Introducing… “Club 25” where young
blood donors indeed love life and are happy
to share their time, their blood, their energy
and their ideas!
In 1989, Zimbabwe started targeting a previously untapped
pool of low-risk donors and one such school-age blood donor at
the time suggested it might be a good idea if young people pledged
to 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% of
blood collected in Zimbabwe is donated by school students and
Pledge 25 Club members.
The accompanying video and this leaflet provide an overview
of how this initiative is now having appeal to teenagers across the
world. It is interesting that the initiative has been particularly suc-
2 Club 25... where blood donors love life!
3. cessful in keeping young people protected from HIV and other
infections because part of their pledge is that they will maintain
healthy life-styles in order to provide the safest blood. Indeed in
Zimbabwe the HIV infection rates among blood donors fell from
4.45% in 1989 to 0.61% in 2001, in a country where infection
rate in the sexually active population was 33.7% at the time.
Elsewhere, such as in neighboring South Africa the results are
just as impressive: young people aged 16-25 years are providing
about 24% of the national blood supply. This video will introduce
you to various Club 25 programmes and examine their progress in
three different countries, South Africa, the Philippines and
Malawi.
In preparation for World Blood Donor Day 14 June 2005,
where we will again acknowledge the role of all voluntary blood
donors, it seems appropriate to introduce an approach to blood
donor motivation and HIV/AIDS education which may provide
guidance to other organizations wishing to introduce similar pro-
grammes. The philosophy behind the Club 25 Programmes is to
be open and honest with young people, providing clear guidelines
about blood donation criteria and similarly facts about the best
HIV/AIDS protection based on the evidence available, and then
allowing 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 Service
used as the place to find out if one
is HIV positive. This would only
be counter productive and attract
the wrong target population.
Club 25... where blood donors love life! 3
4. In summary it appears that Club 25 Programmes are using an
evidence based approach to stimulate youth to take responsibility
for their own actions. This ultimately has an impact in the com-
munity in which they live and so far the impact in maintaining
blood supplies and in stopping the spread the HIV/AIDS is prov-
ing to be significant, at least in some parts of the world.
Club/pledge 25…worldwide activities
as at November 2004
Zimbabwe Botswana
Zambia South Africa
India Indonesia
Malawi Uganda
Haiti 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!
1 Stoneburner and Low-Beer, Population-Level HIV Declines and Behavioral Risk Avoidance
in Uganda, Science 2004 304: 714-718 Science Journal
4 Club 25... where blood donors love life!
5. 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 a
similar structure as per this very simple example:
1. The Club elects a national and provincial administra-
tive committee to organize activities, for example a
National Youth Blood Donor Day.
2. Peer promoters are elected to assist the Blood Service in
the recruitment of voluntary, non-remunerated blood
donors from low-risk populations and in turn the
Blood Service supervises and supports the Club.
Operationally the Club functions according to local needs but
the following example from South Africa helps to illustrate the role
of 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 blood
service there revealed some interesting data and strategies in the
overall context of reducing the HIV rate and retaining young
donors. The service had reduced the HIV rate among Zimbabwe
blood donors from about 21 per cent to 1.1 per cent including
new donors (in a country where 20-26 per cent of people aged
between 15-49 years were living with HIV/AIDS, and with rates
climbing). They had identified young people as a low-risk group
Club 25... where blood donors love life! 5
6. but they had also observed they ceased donating after they left
school. So the first Pledge 25 Club was established, for school
leavers 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 and
blood donor retention among school leavers.
Some time afterwards the “club concept” was then introduced
in South Africa under the title of Club 25, and in general it oper-
ates as follows:
Approximate age of Club members: 18-25 years
Recruitment for Club 25 is aimed at current donors
who are leaving school or who have left school and
already donated three or more units..
Donors (21 years or younger) who are no longer at
school can also join the programme as long as they have
previously given three units of blood.
Club 25 members must ensure they lead a safe lifestyle
in order to remain safe blood donors and meet the cri-
teria for donor eligibility.
Club 25 members must commit to donate a minimum
of two units per year with the aim of donating 20 units
by the end of their twenty-fifth year (ie all donations
must be made before they reach 26 years.
Teamwork
In South Africa Club 25 is very much a team exercise, involv-
ing various elements within the blood service. In involves the
donor staff in recruiting new members, the Corporate Public
Relations/Donor Marketing Department in special efforts to
retain members as donors and to educate them to commit to
healthy lifestyles and a Club 25 newsletter to reinforce education
6 Club 25... where blood donors love life!
7. and to remind donors of their commitment. Finally, telerecruiters
also play a key role by contacting the young donors and remind-
ing them about their first donation during the January-March
period and again for subsequent donations later in the year.
The process
After blood donors leave school they sign up as Club 25 mem-
bers and give their first donation as part of the club. They receive
a bag from the Blood Banks of South Africa as token of their
appreciation for their support and commitment. On their 20th
donation, a Club 25 member receives a nationally recognised Club
25 medal and there is also a quarterly Club 25 newsletter to keep
all members informed about blood donation drives and activities.
One of the primary functions of this newsletter is to remind these
donors of their commitment and to continually provide them with
information on risk behaviour: the focus is on the importance of
donating blood regularly and living a safe lifestyle.
Results
The launching of Club 25, conducted on National Youth
Blood Donor Day, 4 December 1999, involved twenty branches of
SANBS and all centres reported that Club 25 was well received.
Despite the cultural diversity of South Africa the National Blood
Service (SANBS) has been successful in creating a concept that
appeals to a target age group across all ethnic boundaries.
SANBS has had some years to develop the concept and watch
the 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 Centre
is playing a significant role in educating young people about risk
behaviour and ensure they remain free of the HIV/AIDS scourge
that has taken hold of the continent.
Club 25... where blood donors love life! 7
8. Latest data
In 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 donor
panel from 6% to 15%.
Decrease in HIV prevalence of Club 25 panel to
0.04%: SANBS donor panel to 0.07%: South Africa
country 26 – 28%.
A similar model
in the Philippines
“Pledge 25” has recently become a project of the Philippine
National Red Cross (PNRC)-Red Cross Youth Department (RCY)
in support of the drive on voluntary blood donation. It consists of
a group of young blood donors who pledge to regularly donate
blood 3 to 4 times a year starting the age of 18 until they reach 25
years old. After this period, they will be joining other blood donor
groups for their regular blood donations.
Objectives
To organize a youth group as a link with Red Cross to
tap 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 voluntary
blood donation.
To instill into both young and old alike, the value of
saving others’ lives by voluntary blood donation.
8 Club 25... where blood donors love life!
9. Representation
Members mostly represent various youth groups, either gov-
ernment or non-government. But also accepted are young people
who do not belong to any youth organization. There are thou-
sands of active members nationwide, and these young people are
also actively participating in other various worthwhile Red Cross
Youth activities. Each member receives an attractive ID card after
their second donation, and a pin is given after the third donation.
A regular Pledge 25 blood donor will receive a different design of
pin every year after the third donation.
Results
Pledge 25 memberships
for year 1999, 2000, 2001, 2002:
Nationwide membership
Year Luzon Visayas Mindanao Total
1999 1,038 353 960 2,351
2000 1,249 624 555 2,428
2001 815 913 271 1,999
2002 1525 605 820 2,950
January-June 2003 266 386 120 772
Over – All total 4,893 2,881 2,726 10,500
Club 25... where blood donors love life! 9
10. 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 and
High Risk) and the chart opposite tries to identify these categories
to enable young people especially make their choice in terms of
appropriate protection where sexual relationships are concerned.
Generally Club 25 Programmes include guidelines for young
people to ensure they remain eligible as blood donors by leading
healthy life-styles and the Blood Service can play an important role
in providing HIV/AIDS education materials. In this way young
people themselves become “HIV/AIDS” peer educators and their
role in the community is even more significant than “saving lives
by blood donation”... they now also play a vital role in health pro-
motion as well!
The Club 25 Programme, though only just beginning in some
cases, appears to be a most economical model in terms of public
health care. With young people playing such valuable roles in help-
ing to secure a safe and adequate blood supply, and in creating a
culture of healthy lifestyles among their peers, World Blood Donor
Day, 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!
10 Club 25... where blood donors love life!