Politics of diversity in the framing of blood donation: The in-and exclusion of racially minoritised blood donors on blood agency websites in Belgium and the United Kingdom

Blood donation is vital to the functioning of health systems, yet racially minoritised groups remain systematically underrepresented in donor populations. We advance an organisational perspective to reveal the organisational logics that govern who counts as a donor. Building on Healy's concept of blood collection regimes, which highlights the role of organisations in shaping donor profiles, this study compares the discursive strategies of the Red Cross in Belgium, specifically in Flanders (RCF) and the NHS Blood and Transplant (NHSBT) in the UK. Our frame analysis of official webpages from both organisations enables us to identify three dominant frames: the biomedical frame (emphasising safety, risk, and exclusion through negative reciprocity); the citizenship frame (linking donation to civic duty and solidarity via generalised reciprocity); the lifeworld frame (positioning donation as a relational, community-based act, aligned with positive reciprocity). Although present in both contexts, these frames operate differently in the two cases. RCF maintains a colourblind, universalist discourse that masks structural exclusions under the guise of neutrality, while NHSBT explicitly addresses Black communities through biomedical appeals linked to sickle cell disease. Both framings contribute to the construction of donor profiles that systematically exclude certain racially minoritised groups. More generally, we conclude that blood collection agencies do not merely manage supply; they also shape racialised belonging and visibility within national health systems. Reimagining blood donation in increasingly diverse societies requires more than targeted recruitment—it demands a fundamental reckoning with how safety and diversity are framed, and whose bodies are rendered necessary, risky, or expendable.