The pandemic has underscored the importance of robust health care systems for social and economic wellbeing. Learnings from this pandemic should be actualised to address the existing barriers to prepare our health systems for future contingencies.
Access to a safe and sustainable blood supply is one of the key elements that enable the functioning of a robust health care system. Blood and blood components are indispensable for elective and emergency surgeries, cancer patients, thalassemia and for post-partum haemorrhage (PPH) to name a few chronic needs.
India has faced a perennial mismatch between the demand and supply of blood. Calibrating as per the World Health Organisation's (WHO) guidelines for self-sufficiency in blood, India was short of 1.1 million units in 2018-19. With India's high burden of blood disorders like thalassemia and sickle cell disease, and the seasonal demand surge as seen with dengue this year, a sustainable blood ecosystem is a basic need for a healthy population.
Apart from its requirement for a robust health care system, the lack of access to safe and sustainable blood supply also hinders sustainable development goals. Blood supply barriers affect health and adversely impact education, employment and other determinants of citizens’ wellbeing. Consequently, on an aggregate scale, constrictions in the supply of blood affect the realisation of health-related developmental agendas and other policies that deal with poverty alleviation, gender equality and social inequalities.
Inadequate infrastructure, low voluntary blood donation rate, a small donor base and a lack of alignment towards voluntary blood donation create a vicious circle that plagues various states' blood ecosystems; Meghalaya is no different. The acknowledgment and resolution of these barriers can potentially catalyse positive development outcomes for the states.
In India, the governmental response to Covid-19 has been efficiently supported by robust public-private partnerships. Building on past experiences, there is a need to continue strengthening public-private partnerships in health care beyond the pandemic. Effective collaborations between the government and the private sector can improve accessibility, affordability and efficiency of health systems. Particularly increased penetration of the private sector into the blood ecosystem of states can help alleviate some of the barriers.
A major challenge for public-private partnerships to address in this domain would be catalysing a behavioural change towards voluntary blood donation. Sustained awareness campaigns regarding the various facets of blood donation should be a priority. At times, driven by bias or just due to lack of information, people fall prey to popular myths like blood donation causes weakness, donating blood is painful, or an individual can donate blood just once in their lifetime. Additionally, more people need to be aware that regular blood donation may be beneficial to themselves. However, the most prominent reason for voluntarily donating blood should be that one unit of donated blood can save up to three lives. There is no greater feeling than knowing that one has given the possible gift of life.
The synergy of the technical expertise of the private sector with administrative support from the government would allow the deployment of multiple strategic pillars for steering people towards increased voluntary blood donation. Dissemination of multilingual sensitisation resources through community health workers could be an efficient way to mobilise grassroots awareness. Further, the private sector's expertise could be leveraged to optimise existing databases of blood banks. While converting replacement donors into repeat voluntary donors is pivotal, the thrust should also be to cultivate community champions to drive behavioural change. In that vein, targeted youth outreach to schools and colleges would also ensure that the upcoming generations are aligned to the philanthropic cause of blood donation.
India's increasing trauma and surgical needs coupled with high prevalence of blood disorders and communicable diseases and high incidence of maternal mortality mean that an effective and well-functioning blood system is the need of the hour. Improving blood adequacy, safety and availability would aid the efforts of states like Meghalaya to curtail MMR, HIV and syphilis along with easing the lives of people who require regular or emergency blood transfusion services.
An underdeveloped blood ecosystem is a limitation for health and development aspirations. Encouraged by the pandemic, public-private partnerships can work complementarily to strengthen the various facets of our health care systems. However, the effective mitigation of many of the perennial issues of our blood ecosystem needs to be simultaneous from the collective action of government, private entities and the citizenry. While such collaborations are a perfect avenue for the government and private entities to leverage each other's strengths, we encourage citizens to also be the agents of change by dispelling myths and embracing the altruistic motive behind blood donation.
Sampath Kumar, IAS, is principal secretary, Health & Family Welfare Department, Government of Meghalaya. Chetan Makam is managing director, Terumo Penpol Pvt. Ltd.
Disclaimer: The government of Meghalaya has collaborated with Terumo Penpol Pvt. Ltd. to bolster the blood ecosystem of the state to counter the blood scarcity in the state, which was highlighted during the Covid-19 pandemic and subsequent lockdowns.
The opinions expressed in this article are those of the author's and do not purport to reflect the opinions or views of THE WEEK.
