Safe blood is essential for robust health systems
This article is authored by Chetan Makam, senior vice-president and general manager, Global Blood Solutions, Terumo Blood and Cell Technologies.
Covid-19 has eroded years of progress on many development goals, so much so that the United Nations has called for an urgent rescue effort for the Sustainable Development Goals (SDGs). As policymakers try to accelerate post-Covid-19 recovery, improving the resilience of health systems should remain one of the priorities. This becomes more important as crisis multipliers like the climate crisis will test the resilience of our health systems in the future.
Timely access to safe blood and its products is the foundation of modern health systems. Designated by the World Health Organization (WHO) as an essential medicine, it is a life-saving measure in cases of trauma, and complications of pregnancy and for the management of diseases like cancer, thalassemia, and sickle cell anemia among many others. In line with this reasoning, over the years, Indian policymakers have tried to improve the efficiency of the blood ecosystem. The recent update of the National Standards for Blood Centres and Blood Transfusion Services would help bring uniformity to the operations of blood banks across the country. Further, the government’s impetus on the management of blood disorders like thalassemia and sickle cell anemia in mission mode form is laudatory. However, given the regional variations in the availability of blood in India, there needs to be a greater thrust on improving access to blood and its products. There are still many districts without a blood bank in India.
As per the data tabled in the Indian parliament in February 2023, there are almost 4,000 licensed blood banks in the country. While it might feel counter-intuitive, opening more blood banks might not be the most optimum way of increasing the accessibility of blood. The Indian situation can benefit by deploying the hub and spoke model of blood collection.
This model involves a centralised transfusion system, where smaller blood banks, and spokes, are connected to larger blood banks, and hubs. Due to the centralisation of blood collection and distribution, blood banks are informed about the status of the availability of blood and its products in real-time. This reduces the wastage of blood and improves safety as the hub is equipped with storage and processing facilities, and a capacitated manpower. Between 2014-15 and 2016-17, over 30 lakh blood units and blood products were wasted due to reasons like detection of infections and expiry due to not being used in time and deterioration during storage.
Improving the accessibility of blood is also critical for the management of several blood-related disorders like sickle cell anemia (SCA). In India, the prevalence of the disease among tribal populations varies between 5% and 40% of the total population. These communities often reside in low-resource geographies with limited access to adequate blood supply. The adoption of the hub and spoke model of blood collection states like Madhya Pradesh, Chhattisgarh, and Odisha which have a heavy burden of SCA is important for the elimination of SCA by 2047, as outlined in the Union Budget 2022-23.
Another important barrier that infringes on the accessibility of blood in India is the widespread belief in myths and misinformation. Many blood banks in district hospitals across the country struggle to collect adequate blood units. People refrain from regular and voluntary blood donation (VBD) because they believe that blood donation would harm their immunity, or it can affect their health. Around landmark days like National Voluntary Blood Donation Day and World Blood Donor Day, the government rolls out informatory campaigns to weed out this misinformation. The leading industry players of the Indian blood ecosystem must also play their part by partnering with state health departments to bring about a shift in the attitude of people towards VBD. Multi-lingual comic books, informatory brochures, workshops in schools and colleges, and videos on social media by regional influencers can be some of the tools to ensure that the need for regular VBD percolates through the community.
The pandemic stretched our health systems. Moving forward, we should be mindful that the preparation of health systems for future emergencies is underpinned by a robust blood ecosystem. A thrust on innovation and behavioural change is the need of the hour to mitigate some of the perennial issues of the Indian blood ecosystem. Our policymakers have started to lay down the blueprint for India@100 where the fruits of development reach every citizen by 2047. Against this objective, and as pointed out by the President of India, recently, it is equally important that the citizens, especially the youth, play their role in busting the myths and misinformation associated with VBD.
This article is authored by Chetan Makam, senior vice-president and general manager, Global Blood Solutions, Terumo Blood and Cell Technologies.