Voluntary blood donation by 2020, still a gap to be bridged

India is focusing its efforts towards reaching the World Health Organization’s goal of 100 per cent self-sufficiency and voluntary blood donation by 2020. However, around 11 million blood donations are collected in India every year against the required 13.5 million for 1.35 billion population in the country (1 per cent), leaving a gap of nearly 2 million.

Reportedly 84 per cent of these blood donations are collected through voluntary non-remunerated donors. However, reports from across the country reveal the incorrect practice of considering near relatives as voluntary donors. And due to the lack of customer satisfaction and donor loyalty, repeat donations are also low (0-30 per cent). Blood should be waiting for the patient and not the patient for blood as at times it may be too late before a donor is found. Therefore, it is a community responsibility to keep blood banks full all the time.

Quality matters

Blood shortages are especially high during March-July, during exams and vacations, when the number of voluntary donors and blood donation camps falls. These days, new avenues like social media are being used to attract more voluntary donors. Recently some apps using GPS technology helped users connect with registered donors in their area.

At many hospitals, a replacement is asked for when the patient requires blood. Despite the ban, paid donors are accepted in the guise of relatives. Many donor organisers provide costly gifts during blood drives, attracting many who do not provide correct history. These organisers need to understand the requirement of quality besides quantity and should not restrict the pre-donation counselling.

Voluntary non-remunerated regular blood donors (VNRRBD), a perfect example of altruism in action, are the foundation of a safe blood supply because they are associated with low levels of transfusion-transmitted infection, including HIV and hepatitis viruses. The insistence is on voluntary blood donors as we get correct answers to questions regarding their medical and lifestyle history and the regular donors who donate every three months are safer as their blood is tested for HIV, Hepatitis B & C and malaria every three months.

Cost, expiry issues

There is a window period which spans between the infection and the test becoming positive. Blood donated during the window period is the main source of residual infections. There are ways of reducing the window period by use of more sensitive tests, like DNA/RNA based tests. These still do not bring the risk to zero level and may raise the cost of one unit of blood by almost ₹1,200.

And it is with such concerns that the cost of blood is discussed. Many feel that if we donate blood freely, why should a blood bank charge the patient? The blood bank recovers the processing cost, which includes the cost of blood collection bag, tests done, storage, transport and maintaining the blood bank operations. The National Blood Blood Transfusion Council has fixed charges for government and other NACO or National Aids Control Organisation-supported blood banks as well as private blood banks. However, thalassemia, sickle cell anemia, hemophilia and other patients below poverty line are provided free blood.

It becomes our duty to project the right messages through right channels in order to motivate and promote voluntary blood donation. Sometimes there are reports of excessive discards, which lead to questions like, “Why donate blood if it is being discarded?” But blood has an expiry date, and that needs to be understood. Mass campaigns can play a role in dispelling myths, fears and misconceptions about blood donations among the general public.

Improper collections and units tested positive for infections also need to be discarded. Besides, enthusiastic donor organisers get large camps organised on particular days and if all that blood is not used before expiry date, it needs to be discarded. Good inventory management practices can keep wasted and outdated products to a minimum. To avoid wastage, short-dated products could be transferred from one hospital to another. This has now been accepted by the regulatory authority in their new amendments.

Blood transfusion service is an essential component of healthcare. And access to safe and quality blood and blood products is its mandate. Millions of lives are saved through blood transfusions across the world. But without human donors there can be no blood, as till date there is no substitute available. So it is the responsibility of the community, we the people, to donate blood.

The writer is Chairperson of the Federation of Bombay Blood Banks. Views are personal

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