By Dr Rajesh Gopal

Well-coordinated chains of mother banks and storage centres, supported by NGOs and altruistic donors, is the way to go

Blood security exists when all people have equitable and timely access to safe blood. Sufficiency, safety and suitability constitute the three pillars of blood security.

India does have a sound national blood policy, but the absence of a fully coordinated national blood service renders a patient hapless and helpless at critical moments.

Safety of blood was ushered in an effective manner after the landmark judgment from the Supreme Court of India on January 4, 1996, which led to banning of paid blood ‘donation’ by the professional blood sellers, effective January 1, 1998.

The office of the Drugs Controller General of India and the respective Food and Drugs Control Administration department of the states are expected to closely monitor blood donation services in the country in liaison with the National and State Blood Transfusion Councils. The National AIDS Control Organisation (NACO) and the State Blood Transfusion Councils have taken myriad steps to improve screening, processing and storage of blood for utilisation by end users. But there still is a severe shortage of accessible blood with varying levels of safety of the same throughout the nation.

There are more than 2,000 blood banks in the country. A significant number of these are partially regulated and even unregulated, with profiteering often being the main motive.

The available global evidence indicates that perhaps even with a significantly lesser number of the blood banks functioning efficiently with appropriate linkages, the dearth of accessible safe blood may easily be tided over.

We need to have more and properly trained lab technicians, fewer but more efficient blood banks, and district-level agencies that can handle all the processes necessary to make safe blood available to the needy.

A centralised database of ‘safe’ blood donors accessible to all, say through the Websites of the State Blood Transfusion Councils can make a big difference.

In most countries in the world, including many developing countries, blood services are run by the national, provincial or local self government or by organisations like the Red Cross and Red Crescent Societies.

The patients admitted to a hospital are thereby assured of the blood required for their treatment. This is in accordance with the classification of blood as a drug and the health care providers must, therefore, be in a position to ‘indent’ for safe blood just the way it is done for other drugs from the stores division of hospitals.

In our country, there is an absence of a centralised management of blood services, which results in lack of standardised practices and processes, poor quality standards, inadequacy of blood availability, and a near-complete neglect of those requiring regular transfusions due to chronic disorders.

We must plan to address the issue of blood security by setting up a centralised blood collection and processing system at the mother blood banks and storage centres, on a pilot basis.

A few mother blood banks supported by organisations of voluntary donors, but run by professionals, will have to be roped in.

Blood collected from voluntary blood donors will be processed using standardised and quality operating procedures at the mother blood banks. It will then be distributed to storage centres with maintenance of cold chain and stored according to standard operating procedures.

Participating hospitals will simply have to indent the required units of blood from the mother blood banks or storage centres. The existing blood banks in hospitals may function as storage and cross-matching centres. A modern health care system cannot function effectively without a blood service that assures blood security to all. Access to safe blood must be perceived as a right of the patient.

The author is Managing Director of Gujarat State AIDS Control Society and Gujarat State Council for Blood Transfusion

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Related October 2010