The World Health Organisation (WHO) data reveals that globally 118.5 million blood donations are collected annually, whereas in Pakistan, the estimated number is around 3 million blood donations, collected from approximately 600-700 blood collection centres.
However, Pakistan’s blood transfusion safety system (BTS) is still really in shambles. Most of the population depends on self-arrangement or non-government organisations for blood donations and collection. Most of the NGOs are unlicensed and not acquainted with the accepted safety standards -- because they are mostly working on humanitarian principles.
The large and medium-sized hospitals have established their blood banks to cater to their needs, but these blood banks lack modern facilities for collection, testing, distribution, storage and transfusion.
Although Pakistan is a signatory of the UN Regulations No. WHA 28.72 (1975) and WHA 58.13 (2005) urging member states to develop nationally coordinated blood transfusion services, up till the first decade of 2000, Pakistan’s BTS was running without any legal framework. In 2008, National AIDS Control Program initiated some reforms to the blood safety system with the technical and financial support of the renowned German Agency of International Cooperation (GIZ) and German Development Bank KfW. In continuance of these reforms, the federal government of Pakistan drafted the first ever National Policy and Strategic Framework 2008-2012. Thereafter, some positive changes were visible in the country’s blood safety system.
As per the constitution, health is a provincial subject, but the role of the centre in the health sector remains relevant as a resolution under article 144 of the constitution was passed by the provincial assemblies to allow the parliament to make and regulate laws in the health sector, like the Drug Regulatory Authority Pakistan (DRAP) Act 2012.
Since health is now a provincial subject, all provincial governments should implement transfusion and safety laws strictly, so that the illegal collection and sale of blood can be checked, which is a major source of spreading infectious diseases, like HIV and Hepatitis.
However, later all the provinces promulgated their legislations on the subject of blood transfusion safety, and established authorities to regulate the legislations – such as, the KP Blood Transfusion Safety Authority Act, 2016, Punjab Blood Transfusion Safety Authority Act, 2016 and the Sindh Safe Blood Transfusion Act, 2017. Balochistan enacted its blood transfusion law way back in 2004.
In the Covid-19 pandemic, the illegal sale and donation of blood was discussed at length, and people were seeking help for blood on social media and were sharing stories of health recoveries when the DRAP and the Ministry of Health only allowed plasma for clinical trials. Even organisations were collecting blood illegally. No blood bank or centre is permitted to accept blood from paid donors. Blood transfusion safety and human organs and issue transplantation laws of all provinces have penalty of clauses against the contraventions of laws, and culprits can be sent behind bars for years and fined as well.
Since health is now a provincial subject, all provincial governments should implement transfusion and safety laws strictly, so that the illegal collection and sale of blood can be checked, which is a major source of spreading infectious diseases, like HIV and Hepatitis.
According to recent news reports, there was a shortage of blood bags in Pakistan. In such a scenario, the government should arrange and facilitate local manufacturing of blood bags.
The government must take strict action against illegal collection and sale of blood, and increase awareness on safety protocols in blood donation – for one donation can save up to three lives.