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Bad blood: India’s trouble with transfusions and HIV

HIV and other viruses can be transferred from person to person via blood transfusions - a phenomena that is of significant concern in India
HIV and other viruses can be transferred from person to person via blood transfusions – a phenomena that is of significant concern in India

Damning figures publicised at the beginning of December have laid bare the extent of India’s problem with HIV transmission through faulty blood transfusions – believed to have caused 14,474 cases over the last seven years.

The information was obtained by IndiaSpend through a series of right to information (RTI) requests. It was published as their cover story on December 1 – the same day Health Minister JP Nadda declared that India would end the HIV/AIDS epidemic by 2030.

To put the statistics into perspective, IndiaSpend said that one in every hundred Indian HIV patients could have been infected via a faulty blood transfusion. This is virtually unheard of elsewhere.

The risk of contracting HIV through blood transfusions in India made headlines in the global and domestic press earlier this year. An RTI request by activist Chetan Kothari revealed that, between October 2014 and March 2016, 2,234 people were administered HIV infected blood which resulted in contamination.

IndiaSpend‘s findings included an uptick in such cases over the past year – 1,559 cases in 2015-16, compared to 1,424 in 2014-15.

Kothari took the government to task over the revelation, stating that “no action is taken against erring hospitals and blood banks.” He blamed “budget cuts” for “slackening on raising AIDS awareness.” Earlier this year, the Times of India reported that the National AIDS Control Organisation (NACO) had seen its budget cut by 20 percent, from Rs 1,700 crore in 2014 to Rs 1,300 crore in 2016.

The government has yet to order an inquiry into the problem, with some feeling that this public health crisis has not been given the acknowledgement it merits.

In August 2016, Anupriya Patel, the Minister of State for the Ministry of Health and Family Welfare, was asked

whether the Government is aware that a large number of persons across the country have been infected with Human Immunodeficiency Virus (HIV) while getting blood transfusions…?

Her response was

No, however the Government is aware of the limitations of available testing methods while screening of blood units for HIV in Blood Banks as a result of which possibility of HIV transmission during blood transfusion cannot be completely ruled out.

When asked “whether the transfusion of contaminated blood and lack in proper screening of blood by National AIDS Control Organisation (NACO) has resulted in increase of HIV patients”, Patel’s response was a simple “no.”

As a percentage of total HIV infections, faulty blood transfusions are admittedly miniscule – constituting between 0.1 and 1.7 percent. As pointed out by Naresh Goyal, NACO’s Director General, “20 years ago, nearly 8-10 per cent of total HIV infections were coming to transfusions.”

That being said, percentage points will be of little comfort to the thousands who have been infected with HIV this way. This is a prevalent problem in the developing world, but one that more economically developed countries such as Canada, the United Kingdom and the United States have managed to virtually eradicate in the past few years. That being said, some newly industrialised countries such as South Africa have made substantial progress in reducing the transmission of HIV and other infectious diseases via donated blood in the past few years. The South African National Blood Service announced in 2011 that it had “virtually eliminated the risk” since it introduced the individual donor testing-nucleic acid testing (IDT-NAT) system .  South Africa’s HIV prevalence is about 80 times higher than India’s, according to the CIA World Factbook

Dr. Goyal is correct when he says that “it is now legally mandatory for every blood bank to screen the units before giving it to a patient” – but what of the hospitals, private and public, which lack the facilities to put these measures into place?

Kothari pointed out that “even in a big city like Mumbai, only three private hospitals have HIV testing facilities. Even the largest government hospitals do not have the technology to screen blood for HIV.”

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