Blood
is an essential component of the body which provides sustenance
to life. There can be no greater service to the humanity than to offer
one's blood to save the life of other fellow human beings. At
the same time blood, instead of saving life, can lead to death of the
person to whom the blood is given if the blood is contaminated. As a
result of developments in medical science it is possible to preserve
and store blood after it has been collected so that it can be
available in the case of need. There are blood banks which undertake100 the task of collecting, testing and storing
the whole blood and its components and make the same available when needed.120 In view of the dangers inherent
in supply of contaminated blood, it must be ensured that the blood that
is available with the blood banks for use is healthy and free from infection.
In
this petition filed by way of public interest litigation under
Article 32 of the Constitution, the petitioner has highlighted the serious deficiencies
and shortcomings in the matter of collection, storage and supply
of blood through the various blood centres operating in the country and
has prayed200 that an
appropriate writ order or direction be issued directing the Union of India and
the States and the Union Territories, which have been impleaded
as respondents in this petition, to ensure that proper positive and concrete
steps in a240 time-bound
programme are immediately initiated for obviating the malpractices
and inadequacies of the blood banks all over the country and to
place before this Court a specific programme of action aimed at
overcoming the deficiencies in the operation of blood banks. For the
purpose of regulating its collection, storage and supply, blood is treated
as a 'drug' under the300 Drugs
and Cosmetics Act, 1940. In the Drugs and Cosmetics Rules, 1945 made under
the Act, provisions regarding equipment and supplies required for a blood bank
were inserted vide Notification dated June 24, 1967. In the said part,
requirements regarding equipment, blood collection supplies, centre equipment
and emergency equipment for the blood donor room360 were prescribed. Similarly, provisions were made for
the laboratory, general suppliers, technical staff, accommodation for blood
bank, label for whole blood and colour scheme for label etc.
In
1990, M/s. A.F. Ferguson & Co. was entrusted by the Government400 of India, Ministry of Health with the
study of blood banking system in the country. The scope of the said
study was to assess the status of Government, Private, Commercial and Voluntary
blood banks; to recommend policy and procedure changes; and to prepare a scheme
for modernisation. The report submitted by the said consultancy firm to
the Government in July, 1990, highlights the deficiencies with regard to
the facilities of testing blood, licensing of blood banks and professional
donors and storage of blood. In the said report, it was stated that out
of the total number of500
1018 blood banks, as many as 616 are reported to be unlicensed. There
are only 201 licensed commercial blood banks. The supply of blood by licensed
commercial blood banks is only about 1/4th of the blood used in the hospitals of
the country. The report said that no medical check-up is done on the blood
sellers; their health status is not examined. The blood trade flourishes
with poor people like rickshaw pullers, drug addicts selling their
blood. Such blood sellers suffer from various infections and their haemoglobin
is lower than the prescribed level. It has been600 reported that there are many
persons who donate blood 5-6 times in a month. Poverty makes them do so first,
but later it is reported to become like an addiction, with the
blood donor enjoying the dizziness due to reduced supply.
It is
a mandatory requirement to conduct tests on blood which is to be administered
to a patient or to be issued to hospitals for transfusion. The blood so
issued has to be free from AIDS, viral hepatitis, malaria, venereal
diseases etc. It is reported that mandatory tests which are required to be done
are rarely conducted. The report700
also mentioned that most of the AIDS surveillance centres are not functioning
efficiently and upto 85 per cent of720
blood collected in the country is not screened for AIDS. Under an action
plan to screen blood for AIDS, 37 blood testing centres were to be set up in 29
cities, but only 11 testing centres were functioning by July, 1990, and
training of technicians for these centres was lagging. The report
said that the blood banks presently thrive on bleeding 4000 to 5000 regular
professional donors in 18 to 20 cities. The professional blood800 donors, which include many women, are
reported to be victims of ill health, low haemoglobin levels and many
infections, and are bled at frequent intervals by the commercial blood banks. Storage
facilities in the blood banks are far from satisfactory. 840
The
blood banks have necessarily to possess facilities like refrigerators exclusively
for storage of blood with a specified range of temperature, for ensuring safety
of blood. In the existing blood banks, many items of equipment remain unattended
for years, electricity failures are frequent, and generators are a
rarity. This applies not only to commercial blood banks but even to some900 of the government hospitals. Many
items of the basic equipment needed for blood banks are not available and a
good part of them do not have even adequate storage facilities. As per
the report, many of the blood banks are located in unhygienic
environment and they collect and store blood in very dirty conditions. In
some places, strong middlemen operate960 for the blood banks by arranging for donors. The
middlemen dictate the charges to be paid and take a heavy commission, and
selection of donors disregards the level of health.
In the
report, it was also mentioned that a large1000 part of the professional donors are alcoholics
or drug abusers, have indiscriminate sexual habits and are a high-risk
group for Hepatitis B and AIDS and are unfit to donate blood. Trained personnel
are generally not available in the blood banks. Most of the blood banks lack
trained personnel at the helm; they have no donor organisers to bring
voluntary donors; and many of them are manned by technical staff who do not
have requisite qualification of a diploma in Medical1080 Laboratory Technology. At present, there
is not even a course to provide postgraduate specialisation
in the field of blood donation1100
and transfusion as in developed countries. The Drug Control departments, which
are expected to ensure the appropriate functioning of the blood banks, do not have
specified trained personnel. In the storage of blood, the basic and essential
requirements of clean environment, shelf life of blood etc. are ignored. Nexus
is reported to be existing between the attending doctor of the patient and the
commercial blood bank, with the former directing the patients to the latter,
and the latter giving a percentage of the sale to the former.1187
