India must focus on improving accessibility and affordability of blood

This article is authored by Amar Patnaik, Member of Parliament, Biju Janata Dal, Rajya Sabha.

The G20 health track prioritises discussions on the prevention of emergencies like antimicrobial resistance (AMR), strengthening cooperation in the pharmaceutical sector, and digital health innovations. While all these issues are relevant, discussions should also focus on improving the availability, accessibility, and safety of blood and its products. Blood is essential for the modern healthcare ecosystem. Blood transfusion services (BTS) are critical to the success of most clinical specialties. The 230 million major operations, 331 million cancer-related procedures like chemotherapy, and 10 million pregnancy complications require blood transfusion.

blood donation (HT Photo)

Unfortunately, only 16% of the G20 member-States meet all the World Health Organization's (WHO) recommendations for a national quality blood transfusion system. Further, only about 39% of the global blood supply is donated in the poorest countries where, however, 82% of the world's population lives. The Health Working Group (HWG) of the G20 is an ideal forum to discuss the difficulties many developing countries face while trying to ensure a healthy and efficient ecosystem for the transfusion of blood.

As stated by the WHO, blood donation by 1% of the population is regarded as the minimum need to fulfill a nation’s requirements. In 2019, India required 1.3 crores of blood units, however data tabled in the Rajya Sabha reveals that only 1.27 crore of blood units could be collected. This shortfall would have aided recovery of multitudes of patients undergoing bone marrow transplant and suffering from trauma-related injuries.

In 2021, blood transfusion services supported by National AIDS Control Organisation in India collected a total of approximately 58 lakh blood units, a decrease of 15 million units from the previous year. Further, the blood shortage worsened during the pandemic due to lockdown associated restrictions and prioritization of mitigation of Covid-19 over other health issues. According to the India Red Cross Society, blood collection dropped 50%, compared to pre-lockdown. This presented an extreme risk to the over 200,000 estimated thalassemia patients that live in the Indian subcontinent whose lives depended on regular blood transfusion. In Hyderabad, over 3,000 thalassemia and sickle cell patients faced the risk of having an acute shortage of blood since not many people were coming forward to donate blood. In Kolkata, over 80% of blood supply in 108 blood banks comes from blood donation camps, which were not functioning during the pandemic. However, Odisha stood out. The Biju Janata Dal, even though a political party, continued to hold these blood donation camps, mostly amongst the leaders and workers of the party itself and kept on replenishing the depleting stock.

The menace of misinformation is one of the key reasons behind low collections of blood, year after year. Many people still hold on to beliefs that blood donation makes one weak or that frequent blood donation robs men of their manhood. Adolescents and young adults must be made aware of the benefits of non-remunerative voluntary blood donation (NRVBD) and the government must leverage them to spread the noble message of VRBD in society. While corporations and institutions should continue to organize regular blood donation camps, multi-lingual behavioural change and awareness campaigns can also be a part of their corporate social responsibility (CSR).

A major problem is the wastage of blood and blood components. From 2014-15 to 2016-17, the government reported that over 30 lakh units of blood were wasted. According to an RTI data, Mumbai wasted 1,600+ units of blood during the pandemic much of which was needed in more rural areas of Maharashtra. Many blood units are simply wasted due to the logistical challenge of transporting the blood. Innovative approaches can improve the affordability and accessibility of donated blood in India. The hub and spoke model of blood collection is one such approach. Under this model, blood is collected and processed in the hubs, which are high-volume blood banks, and distributed through spokes, which are smaller blood banks and blood storage centers.

Further, the hub and spoke model may be a boon for people inhabiting difficult geographies as they would not have to make arduous journeys to secure blood units for their kin. Another possible solution is that of providing mobile blood storage units. Due to the large population and vast geography of the country, accessing blood donation centers can be a challenge for many people. By bringing the donation centers to communities, mobile blood storage units can increase the availability of blood, particularly in rural areas where access to healthcare services may be limited. Additionally, mobile blood storage units can target areas with a higher likelihood of blood shortages or wastage, helping to ensure that blood is available when needed and reducing the chances of wastage due to expired blood.

Apart from the supply and demand constraints around blood, the country also needs an enabling legal framework. While the National Blood Policy was adopted in 2002, it is legally non-enforceable in the absence of supporting legislation. Further, as health is a state subject, the directives of the National Blood Transfusion Council (NBTC) – the apex body for blood policy formulation - are not enforceable on their state counterparts. Sound legislation that could empower the National Blood Policy and standardise the operations of blood banks across the country is urgently required.

This article is authored by Amar Patnaik, Member of Parliament, Biju Janata Dal, Rajya Sabha.