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products. Blood donors have a responsibility to self-defer if they are aware of having been exposed to any risk of an infection or a known health condition or treatment that could influence their suitability to donate blood. Blood donors also have the right to withdraw at any stage of the donation process. Patients have a right to be protected from avoidable adverse effects of transfusion. Thus, while anyone may offer to become a blood donor, no one has the right to donate blood (20,21). 2.2 NATIONAL GUIDELINES AND CRITERIA ON BLOOD DONOR SELECTION National guidelines on blood donor selection should be developed through a full consultative process. A mechanism such as a national expert advisory 24 group should be established with a remit to develop and periodically review the guidelines and criteria on blood donor selection, in consultation with key stakeholders including: n National policy makers n National blood programme managers n Senior BTS personnel n Experts in transfusion medicine and science, including clinical users of blood, microbiologists and social scientists n Representatives of the regulatory agency. National guidelines on blood donor selection should include the criteria for blood donor selection and their implementation in the BTS for assessing donor suitability. The formulation and implementation of donor selection criteria will protect the health of blood donors and the recipients of transfusion. It will also help to maintain and raise standards of donor management and care and minimize unnecessary donor deferrals. Guidelines on blood donor selection should be comprehensive, relevant to the local situation and simple to apply in practice. The BTS should consider the feasibility of their implementation in day-to-day routine settings, in both fixed and mobile blood collection sites. In developing national guidelines, a review of existing international guidelines, relevant literature and best practices would help to identify the medical and scientific principles underlying donor selection criteria. National guidelines should be based on evidence and risk assessment, taking into account national data on the epidemiology of medical conditions and transfusion-transmissible infections, and risk behaviours (22). It is also important to consider the nutritional and health status of the population and cultural practices. National guidelines and criteria on blood donor selection should comply with national legislative and regulatory requirements and should be reviewed regularly and updated in response to changes in epidemiology, advances in technology, the latest medical and scientific information and new evidence. Emerging infections and other situations that may influence donor and patient safety should be monitored and may necessitate the revision and modification of donor selection criteria. Donor acceptance and deferral criteria and blood screening procedures have to be balanced to provide optimal safety for both donors and recipients while at the same time ensuring an adequate supply of blood and blood products (23,24). National health authorities should assess whether, and to what extent, any criteria for donor selection could be relaxed in order to maintain adequate blood supplies in an emergency situation, such as pandemic influenza. However, any deviation from national guidelines and criteria on blood donor selection should be limited to a defined period in managing the emergency situation (25). Donor questionnaire A donor questionnaire is the key tool in donor selection for assessing donor health and safety and for reducing the risk of transmission of infection, in particular for infections for which no suitable screening tests are available. A standardized donor questionnaire incorporating selection criteria is now widely accepted as being necessary for uniformity and consistency in approach and for ease of implementation in assessing donor suitability. It ensures that the same information is collected systematically about each donor on each occasion of donation and forms the basis for a one-to-one confidential interview with a trained member of staff. The use of a donor questionnaire prompts donor selection 25 staff to ask important questions and carefully assess the donor’s health. By presenting all relevant information in a standard format, a donor questionnaire facilitates decisions on the acceptance or deferral of the donor. A standard questionnaire that elicits a prospective donor’s demographic, medical and risk history should be used throughout the country. The design and implementation of the donor questionnaire is the responsibility of the BTS. The questionnaire should be simple, unambiguous, culturally acceptable, easy to complete and available in local languages where appropriate. Donor selection staff should be trained to recognize donors having difficulty in

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