Mumbai: India fell short of 1.9 million units of blood in 2016-17--equivalent to 60 tankers--that could have aided more than 320,000 heart surgeries or 49,000 organ transplants, according to official data.

This is an increase from a shortage of 1.1 million units or 35 tankers in 2015-16, when India had fallen 9% short of its 12 million target, as IndiaSpend had reported on September 3, 2016.

India collected 11.1 million units of blood in 2016-17, meeting 85% of its 13 million units target based on World Health Organization (WHO) norms, according to a recent reply by Anupriya Patel, junior minister for health, to a parliamentary question.

The World Blood Donor Day is celebrated on June 14 every year. About 112 million blood donations are collected worldwide every year, 50% of which are donated in low- and middle-income countries where around 80% of the world's population lives, according to the WHO.

The WHO recommends that the blood requirement of 1% of a country’s population be used as a ballpark estimate of its blood needs. By this measure, India was short of 1.9 million units of blood, data presented to the Lok Sabha (lower house of parliament) on March 23, 2018, show.

This would be equivalent to 60 tankers, considering one unit of blood as 350 milliliters (ml) and one standard tanker-truck to contain 11,000 liters.

Blood Requirements
Units Of Blood Required For Could Aid
Heart Surgery - 6 units 3,27,187 Heart Surgeries
Organ Transplant - 40 units 49,078 Transplants
Automobile Accident - 50 units 39,262 Accidents
Bone Marrow Transplant - 20 units 98,156 Transplants

Source: University of Pune

Regional variations

Chandigarh collected 74,408 more units of blood than it needed as per the WHO norm in 2016-17, government data show, while Bihar collected 985,015 units less than its requirement.

Delhi exceeded its target by 193% and Dadra and Nagar Haveli, 142%.

Bihar, on the other hand, reported a shortage of 84%, the worst in the country, followed by Uttar Pradesh, India’s most populous state, with a 61% shortage.

“Chandigarh is entirely a unique area in terms of voluntary blood donation,” said Yudhbir Singh Khyalia, national president, Indian Society of Blood Transfusion & Immunohaematology, a non-profit that aims to improve the state of blood banking in the country and encourage people for voluntary blood donation. “The unique feature is promotion of voluntary blood donation through educational institutions,” he said, adding that Chandigarh has for decades led the country’s blood donation movement thanks to adequate infrastructure and numerous donor clubs in educational institutions.

In Bihar and Uttar Pradesh, in contrast, none of the governments have taken concrete steps, Khyalia said, noting that there needs to be a formal structured movement to improve the state of voluntary blood donation.

Source: Lok Sabha
Note: Values below 100% mean shortage of blood based on World Health Organization recommendation.

Maharashtra collected over 1.4 million units of blood, the most in the country in absolute terms, 20% more than it needed. It was followed by West Bengal (1 million units) and Karnataka (960,049 units).

Many states remain short of blood, particularly in the summer months when educational institutes--a major source of blood donation--close for vacations or examinations. “Right now there is shortage of blood, in May-June, everywhere we have shortage, in every city of the country,” Vinay Shetty, vice president of Think Foundation, a Mumbai-based NGO that conducts blood donation drives, told IndiaSpend.

Blood banks

At present, India has 2,903 blood banks spread all across the country, of which 1,043 are public and 1,860 private, including those run by charitable trusts. Maharashtra has 328, the most, followed by Uttar Pradesh (294) and Tamil Nadu (291).

On the other hand, 74 districts across 17 states do not have a single blood bank. Assam has 12 such districts, followed by Arunachal Pradesh and Telangana, each with 10.

The government has planned to set up blood banks in 68 districts of the country to provide services in the rural hinterland, the reply to parliament said.

Chandigarh, which reported the highest blood collection as per requirement, has only four blood banks. On the other hand, Uttar Pradesh, with the second highest number of blood banks in the country, was 61% short of its requirements.

“There are certain cities which are very alive in organising blood donation camps, ensuring availability of blood in advance and not forcing the patients to look for donors," Shetty said, citing the case of Chandigarh. The new National Blood Policy and the National Blood Transfusion Council was formed as a result of efforts by a group of activists in Chandigarh, who went to court demanding regulation of blood donation, and the Supreme Court issued the requisite orders to the central government.

The Supreme Court also ruled that blood donation had to be voluntary, putting a ban on the practice of paying donors. Yet, in 2016-17, of the 11.1 million units of blood collected in India, 29% was not voluntary, according to the government’s Blood Transfusion Services 2016-17 data.

“There is no voluntary blood donation at all in most places. Even the medical practice believes that the responsibility of organising blood is that of the patient and not that of the hospital itself,” Shetty said, adding, “Voluntary blood donation happens in a very limited way and only in cities which are alive.”

Much wastage

As many as 1.18 million units of blood--nearly 38 tankers full--was discarded in 2016-17, according to a different Lok Sabha reply dated December 22, 2017.

The reasons attributed included “reactivity for infections like malaria, syphilis, HIV, Hepatitis B, Hepatitis C; expiry due to outdating, especially for platelets which have a short shelf life of only 5 days; deterioration during storage in the form of discoloration, haemolysis, bacterial contamination; not meeting quality parameters after collection and production; and non-completion of blood collection in requisite quantities due to donor reactions”.

(Mallapur is an analyst with IndiaSpend.)

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