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Improving access to safe blood

Even 11 years after the Supreme Court’s landmark judgment ruling out professional blood donation, the malaise continues to thrive in India. If anything, the judicial pronouncement has led to its taking on the new garb of replacement donation. Unlike voluntary donation that is purely altruistic in nature, replacement donation is born out of compulsion. Forced by many private hospitals and blood banks to find donors to meet the blood requirements of patients, relatives often turn to professional donors. It is a pity that the illegal practice continues, though the national blood policy of 2001 stated: “Institutions who prescribe blood for transfusion shall be made responsible for procurement of blood for their patients through their affiliation with licensed blood centres.” While the policy has underlined the need to phase out replacement donation within a set deadline, no sincere effort has been made to translate the intent into reality. Some States claim a high percentage of voluntary donation but how much of it is genuine is not clear. It is disconcerting that professional donors go scot-free even when detected and no significant initiative has been taken to compel hospitals to source blood directly from licensed blood banks.

Paid donation in the garb of replacement donation can be put an end to only when blood supply through voluntary donation matched the demand. Educating and motivating more people to donate blood and retaining such donors will be a sure way to stamp out paid donation. With blood camps as one of the effective ways of augmenting availability, there is a pressing need to promote such camps. The youth being one of the most forthcoming segments of the population in donating blood, more concerted efforts have to be made to conduct regular blood camps in educational institutions. While increasing supply through a larger number of donors is important, there should be a more rational use of blood and blood components. Vigorous efforts will be required to change the current practice of using whole blood instead of components. Blood separated into components can help meet the demand of a larger number of people in need. Also, when separated, the shelf life of certain blood components is increased. Initiating steps to increase availability without having in place the necessary infrastructure to store the collected blood will be to put the cart before the horse. In this context, a recent decision of the Tamil Nadu government to create more blood storage centres in areas with no blood banks is a welcome step towards improving access to safe blood.

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