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The Blood Management System Needs a Fresh Infusion

Context:

Drawing lessons from the global disparities in public health highlighted by the COVID-19 pandemic experiences, policymakers worldwide have appropriately emphasized the necessity of enhancing the global health framework. While strategies like increased health funding, expanded utilization of digital health solutions, and improved accessibility to medical countermeasures are crucial, it is essential to prioritize access to blood and its derivatives in building a resilient global health architecture.

Relevance:

GS2- GS2- Governance- Issues relating to development and management of Social Sector/Services relating to Health.

Mains Question:

Prioritising access to blood and its products remains fundamental to building a resilient global health architecture. Evaluating the blood management system of India, suggest a way forward strategy to effectively ensure a better management of the blood in India’s health framework. (15 Marks, 250 Words).

Blood Transfusion:

As per the American Red Cross Society, blood transfusion generally involves the intravenous reception of blood or blood products. This procedure is employed for various medical conditions to replenish lost components of the blood.

Significance of Blood and its Derivatives in maintaining Patient Health:

Blood and its various derivatives play a pivotal role in numerous medical situations, including scheduled surgeries, emergency procedures, and the treatment of conditions such as cancer, thalassemia, and postpartum haemorrhage (PPH). This emphasizes their irreplaceable significance in maintaining patient health across a range of healthcare needs.

The Issue of Blood Shortage:

  • The issue of blood shortage has been highlighted in a recent report from the World Health Organization (WHO), shedding light on global disparities in blood collection.
  • Despite comprising 14% of the global population, countries in the WHO African region collected only 5% of global donations.
  • Similar patterns were observed in low-income and lower-middle-income nations, where they received 2% and 24% of worldwide contributions, respectively, despite representing only 8% and 40% of the global population.

Blood Management in India:

Blood Transfusion System In India

The blood transfusion system in India is well-structured and regulated to ensure the safety, quality, and accessibility of blood and its components for those in need. Here is an overview:

Role of NACO: The National AIDS Control Organization (NACO) has played a pivotal role since 1992 in ensuring the provision of safe blood throughout the country

Network of Blood Banks: India boasts a network of 1131 blood banks, spread across over 600 districts, primarily supported by NACO.

National Blood Policy: Introduced by the Government of India in April 2002, this policy aims to ensure easy access to sufficient, safe, and high-quality blood.

Regulatory Body: The National Blood Transfusion Council (NBTC), established as per a Supreme Court mandate in 1996, acts as the apex policy-making body for matters related to blood and plasma.

Modernization and Quality Control: NACO has implemented various measures to modernize blood banks, ensuring the safety of the country’s blood supply.

Evaluation of the Blood Management System in India:

  • Even though India has made improvements in its blood management system, the country continues to face a persistent shortage of blood units, affecting critical healthcare services.
  • According to WHO’s self-sufficiency standards, India collected approximately 1.27 crore blood units in 2019-20 but experienced a shortage of over six lakh units.
  • Addressing these shortages promptly is crucial as they can significantly impact the functioning of the healthcare system and contribute significantly to saving lives.
  • For instance, a study by Savitribai Phule Pune University revealed that an accident victim may require up to 50 units of blood, and in 2019-20, the shortage jeopardized the lives of approximately 12,000 accident victims. Additionally, this deficit could affect around 1,00,000 heart surgeries and roughly 30,000 bone marrow transplants.
  • According to data presented in Parliament, a surplus of 30 lakh blood units and related products was discarded over three years, from 2014-15 to 2016-17.
  • Primary reasons included expiration from non-use, degradation during storage, and the presence of infections such as human immunodeficiency virus (HIV) and syphilis.

The Hub and Spoke Model in Access to Blood:

  • The hub and spoke model features a central metro blood bank serving as the focal point for all blood testing and separation of components.
  • The processed blood and its components are then distributed to smaller blood banks and blood storage centers, known as spokes.
  • Addressing disparities in access to safe and sustainable blood can be achieved through the establishment of strong public-private partnerships (PPP).
  • Collaborations involving key industry players have significant potential to introduce innovative models for blood collection and distribution, effectively tackling existing challenges.
  • One such innovative approach is the hub and spoke model, where high-volume blood banks serve as hubs for smaller blood centers.
  • This model is particularly relevant in resource-constrained settings, such as Low- and Middle-Income Countries (LMIC), as it can bridge critical gaps in blood availability and distribution, thereby improving accessibility and availability of blood and its products.
  • Additionally, given the short shelf life of blood and its products, the hub and spoke model facilitates optimal utilization by smaller blood centers.
  • This innovative approach streamlines distribution, ensuring that these essential resources reach their maximum potential while minimizing losses due to expiration.
  • Implementing a hub and spoke model can not only address issues of blood discards and wastage but also enhance accessibility to safe blood and its products in community health centers and smaller sub-district hospitals, especially in geographically challenging terrains.

Way Forward:

  • Another factor contributing to the disparities within the blood management system is the perpetuation of myths and misinformation related to voluntary blood donation.
  • Many individuals still abstain from voluntarily donating blood due to concerns about infections, potential harm to their immunity, or the misconception that the process is time-consuming. Targeted awareness initiatives can dispel these misconceptions.
  • While the government and its agencies have made efforts to enhance awareness through regular campaigns, the private sector can collaborate closely with the government to initiate dedicated awareness campaigns at the grassroots level.
  • These campaigns can harness the influence of social media and utilize innovative tools like multilingual comics to emphasize the importance and benefits of regular and voluntary blood donation.
  • Employing such creative strategies can effectively engage diverse audiences and cultivate a culture of informed and voluntary blood donation.

Conclusion:

As we move beyond the COVID-19 pandemic and align the global developmental roadmap for an equitable and sustainable future, the health paradigm must be adequately prepared. Given the central role of blood and its products in modern medicine, political leaders and policymakers must continue taking measures to strengthen the blood management ecosystem. Concurrently, proactive involvement from the industry and the active participation of citizens should be integral aspects of this coordinated effort.


March 2024
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