Voluntary blood donation stands as a noble act, capable of saving numerous lives and aiding in the management of various medical conditions. India faces a massive blood deficit, with an estimated requirement of 14.6 million units going unmet. This scarcity of voluntary blood donation creates immense pressure on blood banks, potentially impacting thorough screening procedures.

However, in the intricate web of India’s healthcare system lies a stark reminder of discrimination — a policy that prohibits transgender individuals, gay men, and female sex workers from donating blood.

Rooted in stigma from the HIV/AIDS epidemic and perpetuated under the guise of ‘scientific’ reasoning, this exclusionary practice continues to marginalise already vulnerable communities.

Since 2017, an official ban has been in place, reflecting an outdated mindset that links sexual orientation or gender identity to heightened risk of transfusion-transmitted infections (TTIs) like HIV. Despite challenges, activists like Santa Khurai from Manipur have bravely challenged this discriminatory policy in court.

The current policy framework fails to prescribe a standardised blood screening methodology and leaves it to the whims and fancies of about 3,000 blood banks to decide which methodology to deploy. Even more shocking is the fact that the National Blood Transfusion Council (NBTC), which lays down guidelines for blood transfusions lacks teeth and the regulator — Central Drugs Standard Control Organisation (CDSCO) — that actually has the power to regulate blood transfusion services lacks the expertise to do so!

In this background, to tighten donor selection criteria by excluding transgender persons, gay men, and sex workers instead of strengthening the regulatory framework perpetuates systemic failures rather than addressing them.

India must look at global role models — the US, Canada, Israel, and France have revised their blood donation policies to embrace inclusivity while maintaining rigorous screening protocols. These nations recognize that progress lies in improving screening systems, not in discriminatory bans. Increased adoption of NAT and investing in modern equipment for blood collection, processing, storage, transportation and efficient logistics can minimise contamination risks and ensure blood safety.

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Ending the ban on blood donations by transgender individuals, gay men, and sex workers is not just a matter of policy; it’s a step towards a more equitable society. On the other end of this spectrum are patients of thalassemia, who need blood to survive.

However, because of shortage of voluntarily donated blood, these patients are often compelled to arrange replacement donations.

Further, on account of lack of mandate for standardized blood screening, these patients are prone to TTIs leading to mortality in many cases. Keeping the donor selection criteria untouched under such circumstances may be the easy choice for policy makers.

It is time to introspect whether keeping the voluntary blood donation ban on certain communities is helping blood safety or is serving as an excuse to avoid mending a broken regulatory framework.

Taneja Mukherjee is Member Secretary, Thalassemia Patients Advocacy Group, and Varsha, Programme Coordinator, Nazariya, a Queer Feminist Resource Group

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