The Hindu : Opinion / Editorials : Gifting blood throughout lifetime

Online edition of India's National Newspaper
Thursday, Jun 02, 2005

Opinion

Opinion - Editorials

Gifting blood throughout lifetime

That the supply of blood trails far behind demand is something patients needing surgery come to realise at the time of their admission to hospital anywhere in India. They and their families are required to come up with replacement units for blood transfused. This leads many of them to approach touts to bring in paid donors. The setting up of councils for blood transfusion at the national and State levels on the orders of the Supreme Court has not eliminated the severe shortage. In accordance with the apex court order, all paid donations were officially stopped in 1998. However, progressive judicial intervention has failed to persuade policymakers to reform the system at any significant level — to ensure that the demand is met more or less exclusively from altruistic, unpaid donors. According to the Drug Controller of India, only about half of the seven million units of blood required annually come from the blood banks. There is a thriving underground trade: the National AIDS Control Organization has calculated that 5.75 million blood bags were sold in 2003, compared with the three million units reportedly collected through the banking system. Can there be any doubt that India is a long way from escaping from dependence on blood commerce?

A steady supply of safe blood from donors who have nothing but humanism as motivation forms the bedrock of transfusion medicine today. The philosophy of giving to society without expecting a personal benefit in return was powerfully articulated by the social policy thinker, Richard M. Titmuss, in his path-breaking book, The Gift Relationship. Many countries have translated his vision of a world invigorated by altruism into efficient and secure blood banking systems. The United States, which uses 15 million units of voluntarily donated blood a year, abandoned policies that facilitated a market in blood after it was revealed that there is a higher risk of HIV, hepatitis, and other infections from paid donors. The United Kingdom serves patients through a dedicated national blood service. In all such altruistic projects, young and healthy individuals constitute the frontline donor group.

Several countries are meeting the demand by motivating young people to become lifelong donors. The World Health Organisation has identified the "Pledge 25" programme in Zimbabwe — under which school leavers pledge to donate blood 25 times before they are 25 years old — as a good model for all countries. Sadly, India's effort to replicate the Pledge 25 concept, lacking strong policy support, remains ineffectual. The reforms undertaken so far have spawned a disparate group of licensed agencies lacking the efficiency of a well-knit system managed by health professionals. India desperately needs a national blood service that can integrate all existing institutions, expand and network, and build credibility in the eyes of donors. Promoting altruism on a large scale is the only way.

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