The COVID-19 pandemic magnified the inequities in public health across the globe. Learning from experiences, policymakers across the world have rightly endorsed the need to improve the global health architecture as a tool to catalyse economic growth and secure the future of the planet. Greater health financing through international collaborations, deepening the adoption of digital health solutions, and increasing access to medical countermeasures are some of the aspects that are key to reducing the global disparity in health and strengthening the global health architecture. However, amidst these crucial strategies, prioritising access to blood and its products remains fundamental to building a resilient global health architecture.
Blood and its various products play a crucial role in a number of medical scenarios, which includes scheduled surgeries, emergency procedures, as well as in the treatment of conditions such as cancer, thalassemia, and postpartum haemorrhage (PPH). This underscores their irreplaceable significance in upholding patient health across a spectrum of health-care needs.
The issue of blood shortage
A recent report by the World Health Organization (WHO) has brought attention to the global disparities in blood collection. For example, despite having 14% of the global population, countries in the WHO African region could only collect 5% of the global donations. Comparable patterns emerged in low-income and lower-middle-income nations, where these countries received 2% and 24% of the worldwide contributions, respectively, even though their populations account for only 8% and 40% of the global population, respectively.
Similarly, while India has improved its blood management ecosystem, the country still faces a perennial shortage of blood units, impacting critical health-care services. Calibrating according to WHO’s standards for self-sufficiency, India collected around 1.27 crore blood units and faced a shortage of over six lakh units in 2019-20. Such shortages can have serious implications on the functioning of the health-care system and if addressed promptly, can significantly contribute to saving lives. For example, according to a study by Savitribai Phule Pune University, an automobile accident victim needs up to 50 units of blood. In 2019-20, the shortage was significant enough to put approximately 12,000 accident victims’ lives at risk. Moreover, this deficit could impact 1,00,000 heart surgeries and approximately 30,000 bone marrow transplants.
Advantages of a hub and spoke model
Inequities in access to safe and sustainable blood can be mitigated through the establishment of robust public-private partnerships (PPP). Collaborations between leading industry players hold immense potential in introducing innovative models for blood collection and distribution, effectively addressing numerous existing challenges. The hub and spoke model is one such innovative method where high-volume blood banks act as a hub for smaller blood centres. This model can be particularly relevant for resource-constrained settings in Low- and Middle-Income Countries (LMIC) as it can address critical gaps in blood availability and distribution, thereby enhancing the accessibility and availability of blood and its products.
Further, as the shelf life of blood and its products is short, a hub and spoke model would help in optimising their utilisation by the smaller blood centres. This innovative approach streamlines distribution, ensuring that these vital resources reach their maximum potential while reducing losses from expiration.
According to the data points tabled in Parliament, over the course of three years, from 2014-15 to 2016-17, a surplus of 30 lakh blood units and related products were discarded. The primary reasons were expiration from not being used, degradation during storage and the presence of infections such as human immunodeficiency virus (HIV) and syphilis. Moreover, the implementation of a hub and spoke model can also improve the accessibility to safe blood and its products in community health centres and smaller sub-district hospitals, especially in geographically challenging topographies.
Dispel the myths around blood donation
Another aspect of the blood management system that perpetuates the inequities associated with it is the propagation of myths and misinformation around voluntary blood donation. Many people still refrain from donating blood voluntarily because of the fear of infections, damaging their immunity, or simply because they assume it to be a time-consuming process. These misconceptions can be dispelled through targeted awareness initiatives.
While the government and its agencies have tried to improve awareness through regular campaigns, the private sector can work closely with the government to launch dedicated awareness campaigns aimed at the grassroots. Such campaigns can leverage the power of social media and deploy innovative tools such as multi-lingual comics to reiterate the need and benefits of regular and voluntary blood donation. These creative strategies can be effective in engaging diverse audiences and fostering a culture of informed and voluntary blood donation.
As we leave the COVID-19 pandemic behind us and align the global developmental road map for an equitable and sustainable future, the health paradigm must be prepared accordingly. Along with other modifications in the health paradigm, since blood and its products are central to modern medicine, political leaders and the policymakers must continue to take steps to strengthen the blood management ecosystem. Simultaneously, proactive engagement from industry and active participation of the citizenry should also be pivotal aspects of this concerted effort.
Chetan Makam is Senior Vice President and General Manager, Global Blood Solutions at Terumo Blood and Cell Technologies
