The Swiss Red Cross organisation Swiss Transfusion SRC presents a classic example for how the performance of public functions can be taken over by a non-profit organisation. The organisation’s evolution has been quite interesting, and in no way has it followed a straight path: established in 1939 as a sort of “army transfusion service”, it has long had a place as a respected civilian institution within the Red Cross family. Swiss Transfusion SRC now works to not only ensure the security of the country’s blood supply, but also on behalf of people suffering from life-threatening diseases.
We know the exact date on which the Swiss blood transfusion system originates: shortly after the outbreak of World War II, on 6 October 1939, the chief military doctor of the Swiss Army issues a directive calling for more hospitals to take up blood transfusion. He requests the Swiss Red Cross to recruit blood donors from the civilian population. This plan evolves into an army transfusion service, which, fortunately, is not deployed.
In late 1945, the American Red Cross gives the Swiss health authorities over 13,000 units of dried plasma, which is distributed to hospitals via the SRC. The SRC uses this gift as an opportunity to set up a civilian “peacetime blood transfusion service”. The Dutch blood transfusion organisation, set up by the resistance movement in occupied Netherlands in 1943, serves as a model.
The SRC then builds a Central Laboratory for the future Swiss Transfusion SRC and requires its sections to establish regional transfusion centers. These centers are required to promote donation and recruit donors, as well as produce and supply units of whole blood.
In the early days of the Central Laboratory’s activities, policy guidelines have to be set up. A strict adherence to the principle of non-remuneration of donation is deemed essential. Unpaid donors are made available to those hospitals which had begun paying money to donors. In this way, the principle of non-remuneration of donation is established nationwide within a few years.
In 1951, the legal basis for the Blood Transfusion Service’s activities is established through a federal resolution of June 1951, which identifies the “Blood Transfusion Service for civilian and military purposes” as among the most important functions of the SRC. The resolution makes the SRC the only national Red Cross society obliged to support an army’s health service in event of war.
Shirley Nolan establishes the world’s first registry of bone marrow donors in London. Her son Anthony is suffering from a rare immune disease and urgently needs a blood stem cell transplantation. An unrelated donor must be found, because none of Anthony’s relatives is a possible donor. Shirley Nolan’s dedication creates the impetus for the establishment of other registers throughout the world.
In 1988, the Swiss Bone Marrow Donor Registry is established by private individuals from the spheres of blood stem cell transplantation, Blood Transfusion SRC and medicine. That same year, the first bone marrow transplant with a foreign donor for a Swiss patient is performed.
As a result of the way it came into being – and reflecting the typical Swiss federalist structure – Swiss Transfusion SRC continues for decades to take the form of an association of more than a few smaller and extremely small hospital blood banks. In 1994, it still has 15 ordinary and 45 associated members. The majority of these transfusion centres collect less than 1000 units of donated blood per centre annually.
In the 90s, the transfusion centres separate themselves from the SRC sections and form regional groups. Most of the 13 regional blood transfusion services chose to take the legal form of a foundation.
Switzerland’s first unrelated bone marrow donation takes place in 1992. The same year, the Bone Marrow Donor Registry becomes a foundation.
Peripheral blood stem cells are donated in Switzerland for the first time in 1995 and the first transplantation of peripheral blood stem cells for a Swiss patient is performed.
The first transplantation with cord blood for a Swiss patient is performed in 1997.
SBSC celebrates the 10th anniversary of its establishment in 1998. Somewhat over 14,000 blood stem cell donors are registered in Switzerland at this time.
The Central Laboratory in Bern, that has evolved into a modern, international enterprise with around 670 employees, is put up for sale by SRC. Purchase negotiations are concluded with the Australian company CSL in the spring of 2000.
On 1 January 2000, Swiss Transfusion SRC is declared an autonomous association, with the 13 regional blood transfusion services and the Swiss Red Cross as its members. The federal resolution of 1951 continues to serve as the legal basis for its activities.
A 2005 reform strengthens the national umbrella organisation and Blood Transfusion SRC becomes a charitable public limited company. With a 50.5% share, the SRC has the requisite influence; the regional blood transfusion services own the remaining shares. Clearly redrafted cooperation agreements with the 13 blood transfusion services ensure uniform management.
The foundation changes its name to “Swiss Blood Stem Cells (SBSC)”, or “Stiftung Blut-Stammzellen”. There are around 10 million donors registered worldwide at this time; almost 20,000 of them are in Switzerland.
The first transplantation for a Swiss patient with cord blood from Switzerland is performed.
2011 The former Blood Transfusion SRC and Swiss Blood Stem Cells (SBSC) merge to form one organisation: Swiss Transfusion SRC. Since then, SBSC has continued its work under the motto “Together against leukaemia”. The two organisations had been collaborating closely for many years before the merger took place.
25 years of SBSC. Almost 50,000 people are registered as blood stem cell donors in Switzerland. Globally, the number is over 22.5 million. The 25th anniversary celebration is an opportunity for Swiss Transfusion SRC to increase awareness of blood stem cell donation using new marketing tools. The organisation is working towards its target of 100,000 registered donors in Switzerland by 2020.
More than once, Swiss Transfusion SRC has adapted itself organisationally and structurally to meet changing circumstances. Along the way, it has transformed itself from a purely charitable organisation firmly based on volunteerism into a professional service provider capable of fulfilling its great responsibilities in the areas of blood transfusion and blood stem cells.