NEW DELHI: Expressing shock over the transmission of HIV to six thalassemia children in Jharkhand through blood transfusion, a public health advocacy group has said the incident highlights a systemic failure and administrative collapse in the country’s blood banking system.
The People’s Health Organisation (India) — which works on HIV intervention and public health issues — said such incidents continue to occur due to “serious policy paralysis and intellectual bankruptcy.” The group urged the central government to impose a strict ban on the trade of blood and organs and to make it a severely punishable crime.
Speaking to this paper, Dr. Ishwar Gilada, Secretary General of PHO, said, “Jharkhand is not an isolated example. Across the country, there is total policy paralysis regarding the adoption of the latest techniques, tests, and equipment to prevent HIV infection, particularly in blood transmission.”
Expressing his dismay, the Mumbai-based global HIV expert noted that it was ironic the incident occurred at a government hospital blood bank that had been operating without a valid license since 2023.
“Importantly, the blood bank was using a substandard screening method,” said Dr. Gilada, who is also President Emeritus of the AIDS Society of India. Following the incident, the state government launched an investigation and suspended several officials, amid nationwide outrage.
Dr. Gilada suggested that the government should make universal blood safety standards and appropriate equipment a prerequisite for establishing or operating blood banks. He also called for:
Clear guidelines for blood banks, hospitals, and doctors on blood and organ safety,
Making cadaver transplants more feasible and realistic,
Periodic review of blood testing guidelines, and
Rehabilitation programs for professional blood sellers to discourage the sale of blood and organs.
“Blood safety has contributed significantly to HIV prevention in India,” he said. “Transmission through blood has fallen from 10% before 1998 to less than 1% now. However, the commercialisation of blood banks remains a serious concern.”
Highlighting that the Jharkhand HIV cases should serve as a turning point for blood banking reform in India, Dr. Gilada, a Governing Council Member of the International AIDS Society, said, “Protecting people from HIV transmission through blood and preventing mother-to-child transmission requires a firm policy and a robust system in place.”
He added that such “bloody” incidents are a blot on India’s blood-banking services, which are meant to be life-saving.
Appealing to doctors, hospitals, and blood banks, he urged them to use only screened blood — preferably in components such as plasma, platelets, or red cells rather than whole blood — to avoid commercialisation and to uphold the highest medical ethics.
He also recommended the use of advanced and sensitive testing methods such as the Nucleic Acid Amplification Test (NAAT) or Polymerase Chain Reaction (PCR).
This is the safest method with a 7-10 days of window period. Though relatively expensive and need special equipment, pool-testing can help reduce testing costs by up to 70–80%.
He also suggested that the blood banks should be mandated to publicize the donor deferral through posters, video and electronic messaging in the waiting areas in addition to self declaration forms, so those in window periods of any transfusion transmitted infections can self-eliminate from the blood donations.
He also recommended the use of advanced and sensitive testing methods such as the Nucleic Acid Amplification Test (NAAT) or Polymerase Chain Reaction (PCR), which can help reduce testing costs by up to 70–80%.
Dr. Gilada encouraged people to voluntarily donate blood on personal occasions such as birthdays and anniversaries, to opt for autologous transfusion (using one’s own blood) during planned surgeries, to question unnecessary prescriptions for blood transfusion, and never to buy blood or organs for their own safety.
Professional blood donors or blood sellers currently supply an estimated 30% of the country’s blood, while the remaining 70% comes from voluntary and replacement donors.
“Blood sellers are vulnerable to sexually transmitted infections (STIs) as they often visit sex workers and abuse alcohol and recreational drugs. They pose a major threat to blood safety and tend to donate frequently under different names at multiple blood banks. Many are also potential organ sellers — kidneys, eyes, skin, etc.,” he added.
Dr. Gilada further noted that the PHO had exposed major kidney trade networks between India, the Middle East, and Europe involving certain medical establishments.
The NGO has been championing the fight against the commercialisation of blood and has pursued legal action for blood safety since 1989. In 1998, following a Supreme Court directive mandating blood safety, the National AIDS Control Organisation (NACO) began a large-scale clean-up of blood banks by providing trained staff, testing kits, and equipment.
India’s first HIV-positive blood donor was detected in July 1987, Dr. Gilada added.
