Editorial: Improving access to safe blood

Published in The Hindu on July 24, 2007

Even 11 years after the Supreme Court passed its landmark judgment to put an end to professional blood donation, the malaise continues to thrive in India.  If anything, the ban has only forced it to operate under the guise of replacement donation. Unlike voluntary donation that is purely altruistic in nature, replacement donation is born out of compulsion.  Forced by a majority of private hospitals and many private blood banks to find donors to meet the blood requirements of patients, relatives often turn to professional donors. It is a pity that the illegal practice continues though the national blood policy of 2001 in an attempt to root out the evil plaguing the system stated: “…Institutions who prescribe blood for transfusion shall be made responsible for procurement of blood for their patients through their affiliation with licensed blood centres…”  While the policy has underlined the need to gradually phase out replacement donation “in a time bound programme,” no sincere efforts have been made to translate the intent into reality.  Some  States claim a high percentage of voluntary donation but how much of it is genuine is not clear.  That professional donors go “scot-free even when detected ” and sincere efforts to compel hospitals to source blood directly from licensed blood banks have not be taken are disconcerting.

Paid donation in the garb of replacement donation will cease only when blood supply through voluntary donation matches demand.  Educating and motivating more people to donate blood and retaining such donors will be a sure way to stamp out paid donation.  With blood camps as one of the proven ways of augmenting availability, there is a pressing need to promote such camps. The youth being one of the most forthcoming segments of voluntary donors, more concerted efforts have to be taken to conduct regular blood camps in educational institutions. While increasing supply through a larger number of donors is important, there should be a more rational use of blood and blood components.  Renewed efforts will be required to change the current practice of using whole blood instead of components as blood separated into components can help meet the demand of a larger number of people in need.  Also, when separated into components, the shelf life of certain components is increased.  Initiating steps to increase availability without first having in place the necessary infrastructure to store the collected blood will be to put the cart before the horse.  In this context, a recent decision of Tamil Nadu to create more blood storage centres in areas with no blood banks is a welcome step to improve access to safe blood.