Why India has still a long way to go to ensure blood safety

Access to safe blood is regarded as one of the most important aspects of modern-day healthcare. Questions around access to safe blood have often surfaced especially in developing economies like India. While some states do have an adequate collection of blood, in many places, there is a shortage of safe blood and most importantly, the issue of the shortage of safe blood is still not highlighted in the media and social media. Access to safe blood should be considered one of the most important pillars of modern-day healthcare to reduce the huge disease burden in India.

There have been two recent cases reported in the last four months, first, one in Nagpur where four children, suffering from Thalassemia, became Human Immunodeficiency Virus (HIV) infection positive, allegedly after blood transfusion. The other one was in Hyderabad where a three-year-old thalassemic patient allegedly contracted HIV after receiving blood from the Indian Red Cross Society’s blood bank (IRCS). The boy underwent an HIV test a few days back and the results were positive. Such instances call for the immediate attention of the government and the advocacy groups to work together and ensure better blood screening and testing standards so that every patient gets safe blood and lives a healthy life. Medical experts from Maharashtra are actively looking to strengthen their blood safety regulations. In Maharashtra, the proposal regarding NAT testing is pending for about six months now.

Every year thousands of innocent people get HIV infected through unsafe blood transfusions. When our country has progressed so far and celebrates Amrut Mahotsav, and appropriate technologies like ID-NAT are easily available, it is nothing short of medical laxity that dreaded infections such as HIV and Hepatitis B/C are still transmitted due to unsafe blood transfusion practices.

Thalassemic kids are the most affected by such unsafe blood practices since their sustenance of life itself depends upon receiving blood transfusions frequently. An old survey done by us in 2006-07 (Delhi NCR) found that about 27 per cent of thalassemia kids were infected with HIV or with Hepatitis B or C due to unsafe blood transfusion. Isn’t this appalling? Who is responsible for such medical disasters? It is high time that our health authorities bring about radical reforms in the blood transfusion practices because blood saves lives, but unsafe blood can take lives! Universal and mandatory NAT adoption is the only option to ensure safety. In case NAT adoption is not viable for smaller blood banks, the same must be specifically displayed at such centres and Thalassemic kids must be given only NAT-tested safe blood from other advanced blood banks.

It would also make sense to issue star ratings to blood banks; the one that has the best technology and other safer practices to be given a higher star and the others a lower star; so that blood banks upgrade and strive towards obtaining the highest star rating. Such Star ratings are prominently displayed at each blood bank. Consumers can also take an informed decision when they accept blood from a lower star facility.

Nucleic Acid Amplification Testing is the most advanced screening platform for infectious diseases. Here, the window period is considerably shorter than on other conventional testing platforms. NAT also adds the benefit of resolving false reactive donations on serological methods which is very important for donor notification and counselling. Under the current framework, blood banks are free to implement any testing methods they choose. They may charge a processing fee based on the specialised tests or technologies they employ. Therefore, it is important to commission a study on best practices related to blood safety, supporting a blood bank or blood banks in a specific area with NAT testing for thalassaemic, and supporting technology for putting together dedicated pools of voluntary donors for thalassaemic.

It is estimated that 13.5 million units of blood are required annually in India. People who suffer from different blood disorders, and diseases such as Thalassemia, demand frequent blood transfusions and recurrent blood transfusions open the risk of contracting other infections as well. The need of the hour is to adopt better blood screening standards and reduce the burden of transfusion-transmitted infections (TTIs).

The author is general secretary at National Thalassemia Welfare Society & Federation of Indian Thalassemics. Views are personal.

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