KARACHI (APP)- Pakistan will observe World Voluntary Blood Donation Day on Sunday with efforts to promote voluntary donation culture among the youth. Experts and Haematologists talking to APP here on Saturday said the day holds extreme relevance to Pakistan where no less than 20 percent of its annually required blood transfusion are met through donations by professionals, mainly comprising intravenous drug users. The registered need is estimated to be 1.5 million points, said Dr. Rafiq Khanani of Pakistan Society of Infection Control and Director, Dow Institute of Infectious Diseases. The senior hematologist said absence of voluntary blood donation culture has exposed the country to a serious situation as even the 80% blood donations by relatives of the concerned patients hold their respective risks. Large majority of the blood banks resort to Rapid Tests or ICT conducted through test kits of questionable quality, he said. There was said to be no standard quality for ICT or rapid test kits in the country nor any mandatory application of verbal screening. The scenario was attributed to varied inter-linked factors, most prominently being the lack of accountability, non implementation of rules and lack of voluntary blood donation itself. Dr. Ishaq Ali said donations made by relatives can safely be termed as Forced or Targeted Donation as people are compelled to go for it. It is only when they find no other option that they agree to donate for their dear ones, he said adding that banks too, in such conditions, have little option but to conduct Rapid Test to assess safety or quality of blood donated by them. Dr. Khanani observed that all blood banks must have sufficient quantity of screened blood stored in advance so as to protect recipients against risks of contracting blood borne diseases including HIV/AIDS, Hepatitis B and C etc. He said lacunae in proper screening of the donated blood, even by individuals otherwise believed to have non risk behaviours, has often led to serious threat to the recipients. We have to develop voluntary blood donation for public utility, said Dr. Khanani. He referred to a newer technique Nucleic Acid Test (NET) that could help detect any virus or infection even on the first attempt. This is but expensive as costs Rs 5,000 for screening of HIV, HBC and HCV in the donated blood, said the haematologist. Dr. Syed Naim said ICT is extremely cost effective, however, failure to maintain a standardisation of required kits has exposed people to difficulties. To a query, he said test kits for ICT were not only manufactured within the country but also imported from different parts of the world. It is absolutely on the discretion of the blood bank to use any quality of kit and charge the donor or the patients relatives accordingly, he said . The haematologists also regretted that inability of the blood bank personnel as well as concerned doctors to conduct a proper verbal screening, ascertaining the life pattern or behaviour of the donors, has also led to a serious problem. They warned that the donor, with sketchy behaviour or precarious behaviours may have contracted a blood infection and at the same time may be in the window period hindering all chances of their getting suspected under ICT or rapid test. Capacity to detect early infection in window period enhances the risk of the recipient too, warned the haematologists. To a question they said people as well as doctors including specialists need to understand that blood transfusion, particularly whole blood, is not necessarily required under all conditions. Gynaecologists and obstetricians were advised to prefer oral medication which are not only extremely cost effective but also safe. In certain conditions need of iron could be met through intravenous means too, said Dr. Rafiq Khanani. Haematologists mentioned that components of blood could be separated and stored for quite some time after necessary screening before being transfused.