“Blood transfusion saves lives and improves health,” writes the World Health Organization (WHO) of blood donation, “but many patients requiring transfusion do not have timely access to safe blood. Providing safe and adequate blood should be an integral part of every country’s national health care policy and infrastructure.”
To this end, the WHO recommends that blood ought to be donated by between one and three percent of a country’s population to satisfy the country’s needs. Yet many countries are far off meeting even the one percent mark – and India is one of them, with an approximate fifteen percent deficit compared to the WHO recommendation as per the latest figures. Yesterday marked National Blood Donor Day in India – an opportunity to assess what holds the country back in blood donations and what can be done to improve the situation.
With a population of 1.3 billion, to meet the one percent target issued by the WHO India would need donations of thirteen million units of blood. In the 2016-17 period, there was a shortage of 1.9 million units of blood collected compared to the thirteen million unit target. The shortfall was actually worse than the preceding 2015-16 period, when the deficit stood at nine percent compared to a twelve million unit target. India was short then of 1.1 million units of blood.
According to IndiaSpend, the donated blood shortage in 2016-17 “could have aided more than 320,000 heart surgeries or 49,000 organ transplants.” The equivalent of sixty tankers, the shortfall of donated units of blood translates to negative health effects for numerous Indians.
As previously noted by Health Issues India, “the demand for an adequate supply of blood…encompasses a number of diseases and conditions. Many going through chemotherapy may require blood donations. Sickle cell disease – particularly prevalent among tribal populations in rural India – may also cause a patient to require regular blood donations. A lack of available blood may even contribute to a high maternal mortality rate due to blood transfusions often being used to compensate for blood lost during the birth.”
Controversies in India surrounding blood donation tend to centre around lax safety practices which lead to contaminated blood being transfused, exposing recipients to infectious conditions such as HIV and hepatitis. This issue is clearly worthy of attention and must be addressed. However, the country’s shortage of blood donors is a scandal in and of itself – especially given the size of its eligible donor population which numbers at over 512 million.
To be clear, not all states in India have a deficit of blood. In fact, some have a surplus. In 2016, sixteen states and union territories had shortages of donated blood compared to eighteen which collected excess donated blood. However, a number of the states which collect the most blood also waste the most. Maharashtra, for example, was among the best-performing states on blood donation with more than a 35 percent surplus. However, Maharashtra was also one of the states which wasted the most blood. Despite the country’s significant shortage of donated blood, Health Issues India reported in 2017 that India had wasted 2.8 million in the preceding five years.
To amend this situation, efficient distribution networks, achieving regularity with blood donation intervals as opposed to have blood donated en masse, and ensuring communication between blood banks, donation camps, and hospitals to avoid wastage.
Encouragement for potential donors to give blood is also needed. The WHO identifies “a need for recruiting more voluntary donors in addition to retaining those who have already donated” at the global level, adding that “retention of suitable blood donors should be a high priority for every country.” This is important to guarantee the “safety of the blood supply [which] is dependent on collecting blood from voluntary unpaid donors from low-risk populations, screening donated blood for transmissible infections and avoiding unnecessary transfusions.”
Writing in The Economic Times, Suryaprabha Sadasivan, healthcare practice lead and vice president of research and public policy consulting firm Chase India, says “voluntary blood donation programmes only succeed when people are well-aware of the benefits of it and are motivated by altruism and the desire to help others in need as a sense of moral duty or social responsibility.”
The need, she says, is to move away from “the concept of blood donation [being] demand-led wherein, even the most well-educated people perceive that blood donation is an emergency service which is to be done when asked or when there is a need.” Combating misconceptions of blood donation, such as that “it reduces blood in your body, thereby making you weak or that it is a painful and long process or that it could lead to contraction of infections,” is also key.
“[The] World Health Assembly resolution WHA63.12 urges all Member States to develop national blood systems based on voluntary unpaid donations and to work towards the goal of self-sufficiency,” notes the WHO. The need of the hour for India is to move towards such a system, to effect a positive difference in the lives of patients grappling with a plethora of health challenges and to encourage the population to take the lead and donate blood, to realise the vision of a healthy India and health for all.