Need for legislative support to reverse India’s blood shortage

This article is authored by Fauzia Khan, Member of Parliament, Rajya Sabha, Nationalist Congress Party.

As a nation, India has been persistently grappling with a shortage of blood and its products. A vital fluid that sustains life, blood cannot be synthesised in laboratories; it can only be sourced from generous donors. On average, approximately 14.6 million units of blood are required annually, yet there remains a shortage of 1 million units. The situation exacerbated during the Covid-19 pandemic wherein doctors faced a daunting challenge as they were forced to make tough decisions, prioritising patients in critical need of blood transfusions, while others had to endure a waiting period until more supplies became available. The pandemic further emphasised the crucial importance of blood as an essential healthcare resource, and made its replenishment an indispensable necessity.

Blood Shortages: Blood shortages can occur at any time, particularly during holidays, natural disasters, or unforeseen events. By donating blood, you help prevent or alleviate shortages and ensure a stable blood supply for those in need. (Pixabay)

In the context of individuals who rely on lifelong blood transfusions due to certain diseases, the significance of each individual's contribution through generous donations of blood and plasma becomes even more profound. India has the second highest projected number of births affected by sickle cell anemia, a chronic single gene disorder causing a debilitating systemic syndrome. The Union Budget for 2023-2024 has announced an initiative to combat this disease. The mission aims to completely eliminate sickle cell anemia from the country by 2047. To support this effort, the National Rural Health Mission (NRHM) and the Indian Council of Medical Research (ICMR) have already been implementing various outreach and surveillance programmes to enhance disease management and control. Furthermore, in alignment with a national programme for screening and managing sickle cell anemia, the Union government has also committed to launching a national mission targeting thalassemia, another genetically inherited blood disorder.

Despite the existence of such programs to address blood-related disorders, the lack of sufficient legislative support hinders their implementation and leads to policy failures. This issue is exemplified by the National Blood Policy enacted in 20021, which has not yielded significant results. The current involvement of multiple authorities in the blood management system adversely affects its efficiency. While the National Blood Policy of 2002 emphasises improved coordination between national and state authorities, the practical implementation falls short. The National Blood Transfusion Council (NBTC) is tasked with formulating blood-related policies, but its directives are not legally binding on the State Blood Transfusion Councils (SBTCs) due to health care falling under state jurisdiction. This often results in fragmented management practices.

Furthermore, the blood management system faces limitations on both the demand and supply sides. On the demand side, the lack of non-remunerative voluntary blood donation (NRVBD) is influenced by misconceptions among the general population regarding the safety and viability of blood donation. Many individuals refrain from donating blood due to the mistaken belief that it weakens their immune system or reduces their overall blood volume. Similarly, some men choose not to donate blood due to concerns about masculinity. Additionally, false notions such as the transmission of blood-borne infections through donation further compound the problem. These myths not only perpetuate blood shortages but also spread unfounded fears. On the supply side, inadequate infrastructure, human resources, and processes contribute to poor blood collection. Critical deviations in diagnostic procedures, processing, storage, transportation, and delivery further compromise the quality and safety of the blood supply.

Efforts have been made to prioritise blood availability by implementing revised standards for blood banks and introducing policies to tackle blood-related disorders. However, there remains a pressing need for legislative measures and innovative solutions to further improve the situation. Innovative approaches that aim to enhance behavioural sensitivity among potential donors, particularly addressing misconceptions and concerns, can effectively boost the number of voluntary blood donors (on the demand side). Additionally, the implementation of novel methods for blood collection, preservation, and transportation, such as the hub and spoke model, can address the challenges faced on the supply side. This model involves centralised blood processing centres (hubs) that collect, process, and distribute blood to peripheral blood centres (spokes) located in various regions. Over a period of three years, from 2014-15 to 2016-17, over 5.5 lakh whole blood units were discarded. The hub and spoke approach can optimise blood collection, minimise wastage, and ensure a sustainable and reliable blood supply for those in need.

While blood and its components are not inherently scarce, their availability can be a significant challenge. Legislative interventions not only ensure the availability of safe and adequate blood supplies but also encourage public participation and raise awareness about the critical importance of blood donation. By combining legislative support, innovative strategies, and the adoption of efficient models, the challenge of blood shortage can be effectively addressed, leading to improved healthcare outcomes and a more robust blood management system.

This article is authored by Fauzia Khan, Member of Parliament, Rajya Sabha, Nationalist Congress Party.