World Blood Donor Day: Urgent need to increase availability of safe blood for use wherever, whenever
There’s rising need to reassess, advocate implementation of best technologies, practices related to safety, quality of blood transfusions across India, with view to preventing deaths by transfusion transmitted infections
In this ongoing crisis of COVID-19 that concerns all, another major crisis that cannot be overlooked is the lack of availability of safe blood for patients, which is a vital healthcare resource regularly used in treatment on various occasions. June 14, which is annually observed worldwide as World Blood Donor Day, it is pertinent to raise wider awareness on the urgent need to increase the availability of safe blood for use wherever and whenever it is needed to save life specially in a situation when blood banks across some cities in India are running dry due to the current pandemic.
While safe blood availability has been a concern in India, COVID-19 has further deepened the gaps in India’s blood donation and transfusion practices since voluntary blood donation is becoming rare and patients in some cases are even forced to move from safe blood transfusion practices like voluntary blood donation and a NAT tested blood regime to a regressive blood testing regime because of lockdown. There’s a rising need to reassess and advocate implementation of best technologies and practices related to safety and quality of blood transfusions across India, with a view to preventing deaths by transfusion transmitted infections (HCV, HIV, HBV, etc.). India needs to establish superiority of nucleic acid testing technology (NAT) method as a safe option for blood screening since it ensures 99.99 per cent blood safety.
The situation is even more difficult for those patient groups who are more susceptible to transfusion transmitted infections due to repeated blood transfusions and surely have a greater reason to be concerned with the quality of blood. The challenge of availability of safe blood in India remain un-noticed for past several years now. Focussed on the theme of ‘Safe blood saves lives’ this year, this World Blood Donor Day called for action from governments and concerned health authorities to provide adequate resources and put in place systems and infrastructures to increase the collection of blood from voluntary, non-remunerated blood donors; to provide quality donor care; to promote and implement appropriate clinical use of blood; and to set up systems for the oversight and surveillance on the whole chain of blood transfusion.
According to a report published by The Lancet, India has the world’s largest shortage of blood, with all states together battling a huge shortfall of 41 million units and demand outstripping supply by over 400 per cent. The demands are rising, mention the report. [1]
Prof Dr SK Sarin, Director, Institute of Liver & Biliary Sciences, Delhi said on the occasion, “We have to bring in the aspect of blood donation and health awareness for safe blood as a part of character-building exercise. There are sections who will get motivated by this and come forward to donate blood. An adequate supply of safe blood can only be assured through regular donations by voluntary unpaid blood donors if you regularly donate blood at the age of 18 that means you could be giving a chance to at least 120 people. In the post pandemic COVID-19 era, India needs to adopt better screening practices in prevention of disease propagation as it is one of the worst thalassemia affected countries in the world.”
Interestingly, an increase of 11.6 million blood donations from voluntary unpaid donors has been reported from 2008 to 2015. In total, 78 countries collect over 90 per cent of their blood supply from voluntary unpaid blood donors; however, 58 countries collect more than 50 per cent of their blood supply from family / replacement or paid donors according to WHO. [2]
According to Professor K Srinath Reddy, President, Public Health Foundation, India and a member of the ICMR COVID-19 taskforce, “Due to COVID-19, we are experiencing the largest ever lockdown in the world. Blood banks across India are facing shortages of blood components, with demand from patients with thalassemia, cancer, trauma and emergency interventions largely unmet in the current pandemic situation. It is essential to have at least one good blood bank in each district of India with good regulation and assured safety of blood transfusion. The oversight has to be provided by the State Blood Transfusion Council and the Food and Drug Administration. There is also a need to initiate the right dialogue with the involvement of multiple stakeholders to establish a robust policy environment for safe-blood transfusion, prioritising the patient’s safety uppermost and thereby preventing deaths from transfusion transmitted infections.”
“As a citizen of this country, a tax-payer and a legal professional, it is difficult for me to understand as to how can so many resources invested in thalassemia pre and post NHM be allowed to be sacrificed to a single bag of infected blood! It is equally difficult for me to understand as to how a patient of thalassemia getting transfusion in a government hospital in Bengaluru get NAT tested blood (several studies show how NAT along with conventional serological testing can reduce the residual risk while blood transfusion to a great extent and help to get safe blood to patients) and another one sitting in Jharkhand get whole blood. Situation with blood donation practices is the same. Are we one country?” Commented Anubha Taneja Mukherjee, Member, TPAG.
According to ICMR study [1] out of every 18 births is a thalassemia carrier in Delhi. In Delhi around 200 births of thalassaemia major takes place every year. All these patients require repeated & regular blood transfusion (Every two to four weeks) and iron chelation therapy for survival. The average cost per patient is Rs 50,000-Rs 2,00,000 per year which is bound to increase further with inflation. A thalassaemic child on an average requires 30 units of blood every year. All these thalassaemia major births can be completely prevented through awareness / sensitisation & timely screening. [3]
References:
[1] https://www.change.org/p/narendra-modi-majority-of-blood-banks-are-empty-donate-blood-asap-in-nearby-blood-bank-and-save-lives
[2] https://www.who.int/news-room/fact-sheets/detail/blood-safety-and-availability
[3] https://health.economictimes.indiatimes.com/news/policy/delhi-hospitals-to sensitise-staff-public-on-thalassaemia/47195187