On Blood Transfusion in India – Bloody mess

Source: This post on Blood Transfusion in India is based on the article “Bloody Mess- Patients infected via transfusion in UP hospital tells larger all-India story of poor regulation” published in The Times of India on 25th October 2023.

UPSC Syllabus: GS2- Governance- Issues relating to development and management of Social Sector/Services relating to Health.

News: In Kanpur, 14 thalassemia children received infected blood, causing HIV and hepatitis. India has many thalassemia cases. Blood transfusions are essential but risky. Blood management in India is poor. Stronger regulations are needed.

What is blood transfusion?

According to the American Red Cross Society, blood transfusion is generally the process of receiving blood or blood products intravenously. Transfusions are used for various medical conditions to replace lost components of the blood.

What is the system of blood transfusion in India?

The system of blood transfusion in India is structured and regulated to ensure the safety, quality, and availability of blood and blood components to those in need. Here’s an overview:

• NACO’s Role: The National AIDS Control Organization (NACO) has been pivotal since 1992 in ensuring the provision of safe blood across the country.
• Network of Blood Banks: India has a network of 1131 blood banks, spread across over 600 districts, primarily supported by NACO.
• National Blood Policy: Introduced by the Government of India in April 2002, this policy aims to guarantee easy access to adequate, safe, and high-quality blood.
• Regulatory Body: The National Blood Transfusion Council (NBTC), formed as per a Supreme Court mandate in 1996, serves as the apex policy-making body for issues related to blood and plasma.
• Modernization and Quality Control: NACO has undertaken numerous steps to modernize blood banks, ensuring that the country’s blood supply is safe.

Why is blood transfusion becoming important in India?

Thalassemia Prevalence: India has 1-1.5 lakh children with thalassemia. These patients require a lifelong regimen of blood transfusions.

Chronic Conditions: The country has a growing number of people with chronic diseases like cancer. For such patients, transfusions are integral to treatment.

Maternal Health: Studies indicate that 25% of maternal deaths result from haemorrhaging. A report by The National AIDS Control Organisation (NACO) highlighted that 70% of deaths from postpartum haemorrhage occur due to a lack of available blood.

Health Issues: High demand for blood is driven by preventable health problems, including complications from malnutrition, anaemia, and pregnancy-related issues.

What are the issues with blood management in India?

Shortage of Safe Blood: Blood is consistently a health emergency. High demand is driven by conditions like malnutrition, anaemia, and complications from pregnancy. However, supply often falls short.

System Mismanagement: Blood and its components are among India’s most mismanaged resources, with issues ranging from collection, safety, storage, to distribution.

Inadequate Regulation and Oversight: Despite having testing and screening regulations, there is minimal monitoring. This permits the operation of fraudulent blood banks with outdated testing facilities.

Illicit Blood Trade: A concerning grey market for blood exists, taking advantage of desperate families and patients.

What should be done?

Investigation and Accountability: India’s haemovigilance programme should thoroughly investigate incidents like the one in Kanpur to ensure accountability and prevent future occurrences.

Strengthen Regulations: Clearer and stricter regulations are essential. This includes rigorous testing and screening standards for blood and its components.

Enhanced Monitoring: Regular monitoring of blood banks, especially for their testing facilities, is crucial. This will help weed out spurious blood banks with outdated methods.

Empower NACO: NACO should be granted more authority. It should be able to mandate audits, set strict standards, and most importantly, penalize mismanaged blood banks and hospitals.

Collaborative Effort: State authorities must invest more resources and collaborate with agencies like NACO to streamline procedures and improve blood management.

Public Awareness: There’s a need for campaigns to educate the public about the importance of safe blood donation and the risks of the grey blood market.

Terminology used:

The National AIDS Control Organisation (NACO):

The National AIDS Control Organisation (NACO) was established in 1992.

It is the nodal organization for National AIDS response in the Ministry of Health and Family Welfare.

National AIDS Control Programme is a fully funded Central Sector Scheme implemented through State/ UT AIDS Control Societies (SACS) in States/Union Territories (UTs) and closely monitored through District AIDS prevention and control unit (DAPCU) in 188 high priority districts.

Questions to practice:

How can the integration of stricter regulations, public awareness campaigns, and enhanced monitoring mechanisms improve the safety and efficacy of blood management in India, especially in preventing tragedies like the one in Kanpur?