In 2009, the only thing that kept Subash from going on to live past his fifth year was money. The five-year-old was diagnosed with Acute Lymphoblastic Leukemia and his only hope was an unrelated stem cell transplant – a transplant that would cost his parents, who had already spent lakhs, over Rs. 1 crore. That burden snuffed out the hope.
Children like Subash can now access matched cord blood units for about Rs. 2 lakh.
The Tamil Nadu government has recognised cord blood banking in the State, arguably the first State to do so, by agreeing to provide a grant of Rs. 9 crore to a public cord blood bank established by Jeevan Blood Bank and Research Centre. Stem cells will now be available to the poor free of cost, while the cost of transplantation is covered under the Chief Minister’s Comprehensive Health Insurance Scheme.
It is appropriate to begin the story with Subash, because the struggle to find him an affordable match is what led to the establishment of the public cord blood bank. “That is how we started. Today, with the recognition from the government, we have come to the fulfilment of a long-awaited boost for public cord blood banking,” says P. Srinivasan, chairman, Jeevan Blood Bank.
The grant, according to a recent government order, is to enable Jeevan Blood Bank to “collect, process, test, type and store 3,000 cord blood donations over three years to ensure access - to cure patients with blood cancers and Thalassemia, living in Tamil Nadu.”
At any given time there are several hundred patients admitted to various hospitals in the State with these conditions.
Umbilical cord blood, discarded after childbirth, is one of the richest sources of blood-forming stem cells and is being used across the world for the treatment of blood cancers, Thalassemia, and blood disorders, explains Dr. Srinivasan.
Human Leucocyte Antigen (HLA) matching of the donor and the recipient is critical to the success of transplant of stem cells. Globally, HLA matching is dependent on the ethnicity of the patient and donor. In the absence of an Indian inventory, the chances of Indian finding a match is less than 10per cent across the world. Even if a patient is lucky enough to find a match, it will cost him or her close to Rs. 20 lakh to import the same, he adds.
An initial allotment of Rs. 3 crore will be sanctioned to Jeevan for processing 1,000 cord blood units, and the remaining Rs. 6 crore will be released in two equal instalments.
J.Radhakrishnan, health secretary, explains how the scheme will benefit people in the State: “Jeevan is required to release 75 per cent of the units free of cost to patients referred by government hospitals.” All employees of the State government and their dependants, and all patients covered under the Chief Minister’s Comprehensive Health Insurance Scheme can benefit from this scheme.
“Clearly, this country needs more public cord blood banks. About 50 cord blood transplants have been performed in the country so far. This is the first government initiative in India that promotes public cord blood banks, and makes stem cell units affordable. More lives will be certainly be saved,” says Revathi Raj, paediatric haemato-oncologist, Apollo Hospitals.
Jeevan can release 25 per cent of the units on a commercial basis to all patients with an annual income between Rs. 5 lakh and Rs. 10 lakh. Residents of Tamil Nadu with this income criteria will be charged Rs. 50,000 for the units.Those with an income of over Rs. 10 lakh or non residents of the State can access the units at Rs. 2 lakh. The units will be released on a first-come-first-served basis, and the readiness of a patient for transplantation will be the main consideration. All factors being equal, priority will be given to those eligible for free units.
