A national Red Cross Society center in eastern China’s Jiangsu province has clarified that government employees who fail to donate blood will not be punished, despite a previous announcement that a “blood donation index” would be included in annual civil servant assessments.

Although such an index does exist, it is not part of individual employees’ annual reviews, said Zhou Min, deputy chief of staff for the Zhangjiagang City Red Cross branch. Under the current policy, the government encourages civil employees to donate blood by dividing them into groups, giving each group a quota, and appointing administrators to ensure that the quotas are met. 

Zhou told Sixth Tone’s sister publication, The Paper, that while he would like for employees’ blood-donation histories to be considered in civil servant assessments, most of the employee groups already meet or exceed their designated quotas, leaving no need for stricter enforcement. “Who will donate blood, and how to execute the donations, is up to the groups themselves to control,” Zhou said. 

China is experiencing a blood-donation shortage so severe that it’s been dubbed a “blood famine.” Some hospitals have even refused blood transfusions to patients unable to provide proof that they or one of their family members have donated blood in the past. 

Though the quota system has been around for decades, civil servants have felt increasingly pressured to give blood since the previous scheme — in which medical supplies of blood were commercially procured by state-run medical centers and even for-profit businesses — was abandoned. 

Under the previous system, unhygienic blood transfusions caused rates of blood-borne diseases to spike and contributed to the HIV/AIDS crisis of the 1990s. By 2005, 75,000 people living with AIDS in China had been infected through commercial blood and plasma donations and blood transfusions, UNAIDS reported, and even more hepatitis B and C infections had been spread through the same contaminated conditions. To reckon with the emerging crisis, the central government closed most state-run commercial donation centers in 1996 and outlawed commercial blood procurement in 1998.

The health crisis only served to strengthen the public’s misgivings about blood donation, which were already informed by cultural beliefs like the theory that giving blood will leave the donor chronically weak, as well as concerns over the privacy of medical records. 

Though blood donation in China is stipulated as voluntary, many regions imply the disciplinary enforcement of quotas for civil servants. For example, the Regulations of Shanghai Municipality on Blood Donation, adopted in 1998, warns that employee groups that don’t meet donation standards may be forced to compensate by paying a “blood-donation penalty fee.” 

(Header image: Jorge Dan Lopez/Reuters)