Sunday, March 26, 2006

AABB Board of Directors: non-Americans need not apply?

The Jan.-Feb. 2005 issue of AABB News featured global initiatives and international membership. Being a Canadian who is interested in international transfusion medicine and loves foreign travel, I made a note to write a blog sometime on an aspect of international membership in the AABB.

This blog focuses on the possibility of a non-American being elected to the AABB's Board of Directors. Sorry about the provocative blog title but it's meant only as an attention grabber.

Further motivation for writing on this topic came from several sources:
  • 2005 AABB elections. For the first time that I can recall (having been an AABB member for 31 years), a Canadian, Graham Sher, CEO of Canadian Blood Services, ran for elected office in the AABB.
  • In 2005, Canadian Nancy Heddle of the McMaster University Transfusion Research Program was appointed as an associate editor of Transfusion.
  • In 2008 the AABB Annual Meeting will be held in Montréal, Québec, Canada, the first time it has ever been held outside the USA.
  • And currently the AABB has its call for nominations for the 2006-2007 Board of Directors on its website.

According to the Jan.-Feb. 2005 AABB News, the key statistics on individual membership were:

  • USA: 6926 (83.7%)
  • Canada: 444 (5.4%)
  • Japan: 77 (0.93%)
  • Australia: 74
  • Germany: 66
  • UK: 60
  • Brazil: 50
  • All other countries (n=59): each less than 50
  • GRAND TOTAL: 8279

As shown, 2 countries (USA and Canada) account for almost 90% of the membership and the other 64 countries account for 10%.

Which brings me to the 2005 elections to the AABB's Board of Directors. As a Canadian I was hoping for a fellow countryman to be elected as an At-Large-Director but it did not happen.

Part of the difficulty is simply the numbers. For example, 2 At-Large directors are elected each year. Consider the scenario of 2 American candidates and 1 non-American running for the 2 positions.

Of course, no one votes strictly along nationalistic lines, but consider this scenario. If only10% (692) of American AABB members voted and their votes were split evenly among the 2 American candidates, each would receive 346 votes. If a whopping 50% of Canadian members voted, and they all voted for the Canuck, he or she would receive 222 votes and lose, assuming that votes from other nations were evenly split among the 3 candidates. Under this set of assumptions, if significantly more than 10% of Americans voted, any foreign candidate would be hard pressed to become a Board member.

Another factor in getting elected is name recognition. Studies have shown that name recognition is a major contributor to success in local, regional, and national elections. Whereas most, if not all, Canadian AABB members would recognize the name of the CEO of CBS, my guess is that, while many American leaders of the AABB would, the vast majority of rank-and-file American members would not recognize any non-American, short of someone of the stature of Karl Landsteiner.

A third element is the AABB system of USA-based district directors, some of whom run for national office after gaining experience and name exposure at the regional level. This feeder system also makes it more difficult for foreigners to win elected office.

Interestingly, the current AABB Board shows Graham Sher as 1 of 2 appointed directors, who are appointed for 1-year terms for "relevant expertise".

The AABB is undoubtedly a global leader in transfusion medicine, but this does not translate into large foreign memberships. For example, Canada's membership in the AABB is more than 5 times that of any foreign country. Consider the populations of these countries and number of AABB members:

  • Japan: 128 million (77 members)
  • UK: 60 million (60 members)
  • Canada: 32 million (444 members)

Canada's proximity to the USA appears to be one factor in explaining the relatively large number of Canadian blood bankers who join the AABB and subsequently get perks such as reduced registration fees for annual meetings. Travel to meetings in American cities is less onerous for Canadians than for overseas members. There are other reasons why so many Canadians as opposed to other international blood bankers join the AABB, and this may be the subject of a subsequent blog.

Being a member of an organization is one thing. True equality comes only when people participate in running it. So, could a non-American, particularly a Canadian, ever be elected to the AABB Board? Anything is possible but it seems unlikely without such a candidate having high recognition among American members. As to how that could happen - your guess as good as mine.

Comments on this or any other blog are most welcome (see comments link below). Readers are reminded that the views expressed in this blog are mine alone.

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