India Ban on "Professional" Blood Donors Leads to Acute Shortage

by Ranjit Dev Raj

Sita Devi said she thought it was no good complaining because that would simply bring on additional expense and harassment. "In the end nobody would be punished." She was probably right.

Last year, at the Lok Nayak Jai Prakash Narain Hospital, another major government facility, Ram Kumar, a home guard was forced to donate blood twice within 10 days after his pregnant wife Mamta developed complications in February.

Ram Kumar lodged a formal complaint with the Delhi state government stating that blood bank authorities at the hospital simply ignored him when he pointed out that he had had blood withdrawn just 10 days earlier.

Sita Devi and Ram Kumar typify the plight of thousands of patients and their relatives who desperately look for donors in emergencies because of acute blood shortages brought on by a India Supreme Court ban on professional blood donors.

The ban, effective since January 1998, failed to stop the trade in blood. "All it did was to drive the trade underground and raise the price of blood beyond the means of ordinary people," says Dr Iqbal Malik, an activist.

Once again nothing happened. With no alternate arrangement in place yet, to ensure regular supplies of blood, the government is forced to ignore the many illegalities that dangerously flourish around blood banks here and elsewhere in India.

The failure of the government to boost voluntary donation of blood has also spawned a new business in imported blood components for those who can afford it -- though even here there is no guarantee.

Last year, Austrian authorities cracked down on a racket in that country in which HIV-infected blood was imported from Africa, processed and allegedly re-exported to India by a company identified as Albovina.

The Indian government quickly denied import of contaminated blood from Austria but admitted that imports from Albovina of 'tested' human blood albumin had indeed taken place through the Indian firm, Panacea Biotech.

Currently, India, despite its vast human resources based on a billion-strong population, is estimated to import around $200 million worth of blood components and the market is expected to expand even further as shortages grow.

At a conference held in Bombay last November, it was estimated that India could buy more than $75 million worth of blood components annually.

Says Purushottaman Mulloli a human rights activist: "It is strange that the government considers professional blood donation unethical but sees nothing wrong in importing blood components -- in the end both are commercial deals."

According to Mulloli, the Supreme Court ban on professional donors has proved convenient for transnational corporations dealing with costly processed blood components to replace a well- developed and cheap system based on professional blood donors.

What prompted the court to impose its ban was the idea that professional blood donors come from the dregs of society and therefore their blood was likely to be anaemic or infected with HIV, Hepatitis B or other dangerous pathogens.

In making its judgement, the court acknowledged relying on a study conducted by a firm of chartered accountants.

However, a study conducted by the Delhi state government showed that blood collected from professional donors before the ban became operative, showed significantly lower seropositivity for HIV than blood donated by voluntary donors.

"Unemployed or poor people are not necessarily more unhealthy than the well-to-do. Nor do they indulge more in high-risk behavior," says Dr V.B. Lal who runs Delhi's largest private blood bank.

Making a living by blood donation may be frowned upon, but at least it it was a systemwhere patients were assured a steady supply of blood at affordable rates, Dr Lal said.

Meanwhile, the government has itself been investing in blood component separation equipment imported from Germany and bought with funds made available by the World Bank to the National AIDS Control Organization.

According to Union Health Minister Dalit Ezhilmalai, the government has so far spent $62 million on importing such equipment for 40 different centers across India.

But reports say most of the high-capacity equipment is lying idle for lack of steady power supplies to run the high cooling needed for the equipment to function in and for storage of blood products.

Even if the machines are working they ultimately depend on voluntarily donated human blood as a source of basic raw material -- and that is something the government has done nothing about.