Pre-and post-pandemic landscape of the blood transfusion sector in India

Priyanka Barman

(priyankagautam165@gmail.com) and Chethan M.

World Blood Donor Day 2024 marks a significant milestone as we celebrate 20 years of honouring the selfless individuals who give the gift of life through blood donation. This year’s theme, “20 Years of Celebrating Giving: Thank You Blood Donors,” acknowledges the profound impact donors have on the health and survival of countless patients worldwide. Over the past two decades, these unsung heroes have helped to ensure that hospitals and clinics are equipped to save lives, provide vital treatments, and support communities in times of need. Their generosity becomes even more poignant when considering the challenges faced during the COVID-19 pandemic, where blood supplies were critically low and the need for donations was more pressing than ever. Pre-COVID, blood donation drives were frequent and well-supported, with a steady flow of donors meeting the needs of patients. However, the pandemic brought unprecedented challenges, leading to a significant drop in donations due to lockdowns, social distancing measures, and fears of infection. Post-COVID, the world has seen a resilient resurgence in blood donations, with communities rallying together to overcome these obstacles and reestablish a stable blood supply. As we reflect on this journey, it’s clear that the spirit of giving has endured, adapting to new realities and continuing to save lives. In the words of an anonymous donor, “Giving blood is not just about donating; it’s about giving someone another chance at life.” This World Blood Donor Day, let us honour and thank all blood donors for their unwavering dedication and life-saving contributions.

The COVID-19 pandemic serves as a poignant reminder of the significant societal benefits associated with well-developed public health systems, as well as the distressing outcomes that arise when these capacities are permitted to deteriorate. The quantification of the toll of the pandemic in terms of human lives and suffering, the psychosocial ramifications, and the economic deceleration present compelling justifications for transforming experiences into practical lessons. This transformation aims not only to prevent future crises of a similar nature but also to enhance the entirety of population health and healthcare provision. The COVID-19 pandemic has served as a critical assessment for various facets of healthcare systems, particularly in terms of their overall preparedness. The effectiveness of public health surveillance systems and the adequacy of available infrastructure have been found to be inconsistent. The COVID-19 pandemic has had a significant impact on a total of 231 countries and territories, resulting in a staggering number of over 685 million confirmed cases globally. The initial instance of COVID-19 in India was detected in the state of Kerala on January 27, 2020. The implementation of nationwide lockdown measures has been adhered to by a majority of states in India. On the 25th of March 2020, a nationwide lockdown of 21 days was declared, which was subsequently extended until the 31st of May 2020 and implemented in four distinct phases.

The presence of a blood bank within a healthcare institution is of utmost importance, as it plays a crucial role in maintaining the efficient operation of the overall healthcare system. Blood transfusion therapy plays a crucial role in the treatment of diverse blood disorders such as thalassemia, sickle cell anaemia, and haemophilia. Additionally, it is employed in the management of conditions such as cancer, postpartum haemorrhage, and numerous surgical interventions. The significant advancements in blood banking witnessed in recent decades have resulted in a substantial surge in the need for blood components. As per the stipulations outlined in Section 2(b) of the Drugs and Cosmetics Act of 1940, blood is categorised as a ‘drug’. The aforementioned legislation and its accompanying regulations establish the legal structure for overseeing the operations of blood banks. According to the Ministry of Health and Family Welfare, 2022, the country is home to a total of 3840 licensed blood banks, collecting around 12 million units in a year. The majority of blood banks (77%) were found to be affiliated with hospitals, while a smaller proportion (22%) operated independently as stand-alone entities. Approximately 51% of the surveyed entities possessed a component separation facility, which effectively segregated 53% of the overall annual collection within the nation. Human blood is often regarded as the vital essence that sustains life. The sustenance in question is of utmost importance for the existence of the human species, with no viable alternatives available. Blood transfusion services play a crucial role within the framework of the national healthcare delivery system. According to estimates, there is a nationwide demand for around 14.6 million units of whole blood, equivalent to an average of 36.3 donations per 1,000 eligible individuals annually. They advised us to “stay safe at home,”  but we weren’t prepared for the full scope of the lockdown or how it would affect our daily lives in the long run. The nation’s blood donation camps had to be cancelled, and hospital staff members were the sole source of donors left, keeping independent blood banks at a distance. Further reducing the number of donations was tightening the donor selection criteria.

The complexity of the blood banking system arises from various factors, including the intricate interplay between supply and demand, the heterogeneity in blood types among the population, the perishable nature of blood, and the wide range of therapeutic uses for different blood components. The COVID-19 pandemic has introduced heightened intricacy to an already intricate system, resulting in a significant disparity between the supply and demand of blood and subsequently leading to periodic shortages in multiple regions of the country. In accordance with the guidelines set forth by the National Blood Transfusion Council (NBTC), blood transfusion centres in India are actively adapting their policies on donor recruitment, selection, and inventory management in response to the evolving nature of the epidemic. Notably, there was a substantial reduction, specifically during the month of April 2020, which coincided with the commencement of the lockdown measures, as compared to the preceding month of March 2020. India has historically encountered difficulties in ensuring a sufficient and secure blood supply to address the increasing demand.

The occurrence of blood shortages was prevalent in diverse regions of the nation, particularly in rural localities. Numerous non-governmental organisations (NGOs) and government-led programmes were actively engaged in efforts aimed at promoting and enhancing voluntary blood donation. But the pandemic precipitated heightened recognition regarding the significance of blood donation and its pivotal function in preserving human lives, hence fostering a greater inclination among individuals to engage in voluntary blood donation. The issuance of instructions by the Indian government aimed to ensure the secure collection and transfusion of blood amidst the ongoing pandemic. Additionally, individuals were urged to persist in their contributions of blood and plasma, as these resources are crucial for the treatment of COVID-19 patients. The primary findings derived from the pandemic in the pursuit of continuous transfusion service were that the effective management of the donor register, encompassing both the rare donor and platelet donor registries, should be maintained; the utilisation of social media as a potent communication channel for the purpose of educating and motivating donors can be taken as a strong weapon; as well as notifying the public about the lack of blood; the repeated emphasis on the judicious utilisation of blood components; and the implementation of alternative blood management approaches hold significant relevance. The use of timely coping techniques played a pivotal role in effectively addressing the challenges encountered at various blood transfusion services as a result of the COVID-19 epidemic. The pandemic has functioned as an instructive force, albeit a stern one, by serving as a reminder of the fundamental aspects that have significance in our lives: our health, the individuals we hold dear, and the resilience exhibited by our societal groups.