Blood is a life saving product required for several millions of critical patients struggling for survival in public and private hospitals across the country. Ensuring its safety, quality and a fair price, therefore, becomes a key responsibility of any government by framing appropriate rules and regulations. In India, although there are certain rules to regulate the collection, storage and sale of blood, they are either not enforced or being blatantly violated. Take a recent revelation of National Aids Control Organisation (NACO). It says that in 2014 around 1,000 people contracted HIV in Maharashtra due to blood transfusion and on account of violation of blood donation guidelines during voluntary blood donation camps. Another report said that in the same year a state run hospital had to throw 717 units of whole blood due to lack of proper storage facility. The Drugs & Cosmetics Act stipulates that a blood bank should provide adequate arrangements for storage of whole human blood, blood components and products. The banks must also furnish to the licensing authority data on the stability of whole human blood, its components or blood products for fixing the date of expiry to be printed on the labels of such products. Many private and state run blood banks do not follow these rules despite periodic inspection by the officials from Maharashtra Food & Drug Administration.
The above two reports indicate the dilemma patients and their relatives may have to face during a medical emergency in a hospital. The challenge before them is how to get safe blood or blood products for their survival. Patients getting infected by HIV because of blood transfusion in the country is an extremely serious issue facing Indian healthcare system. Collection of infected blood usually happens at blood donation camps due to negligence while collecting and screening blood. And person who tests positive for HIV during a donation camp is seldom informed about his status or referred to an Integrated Counselling and Testing Centres (ICTC) although both are mandatory. HIV testing in most blood banks in the country is being done through ELISA test which has a basic shortcoming. If a person recently contracted HIV, ELISA test may not show it in the result. Yet, most blood banks have not adopted the advanced Nucleic Acid Amplification Testing (NAT) due to financial constraints. Currently, only a handful of leading private hospitals in Mumbai and other metros offer NAT-tested blood. And none of the Maharashtra government-run and BMC blood banks has this facility. This is a highly deplorable state of affairs for a country like India. The Union health ministry has to take note of this issue with due seriousness and see that all the blood banks and hospitals are adopting NAT without delay. There is also a need for encouraging the use of blood components and products in patients instead of whole blood.