The Tribune, Chandigarh, India

Blood banks in India: an alarming scenario
by Dr J.G. Jolly

Enforcement of the national blood policy, directives of the Supreme Court for ensuring the safety of blood, licensing of blood banks for quality by the Drug Control Authority, guidelines by the Central and state health authorities for mandatory requirements have hardly made any impact on the prevailing practices to ensure the availability of the desired quality of blood and blood products. The practice of trading and commercialisation continues in most parts of the country.

Transfusion services in most of the developed countries have made tremendous progress. However, the scenario in the South-East Asian countries in general and India in particular in dismal. Reports of international agencies suggest that this programme has received considerable impetus during the last two decades because of the technological advances and the availability of trained manpower.

While the advancement in medicine has necessitated the increasing requirement of blood and blood products, its safety has attained immense significance because of the problem of AIDS and other transmissible infections. Elimination of high risk donors and the exclusive dependence on voluntary sources for ensuring safe blood have thus become all the more important.

Non-availability of quality blood in adequate quantity is a recurring problem. The factors responsible for this shortage require an in-depth study to understand the exact nature of the problem and evolve a strategy for appropriate solution. An analysis of the factors responsible for this sorry state of affairs and planning a course of action for removing the impediments by initiating steps to achieve the highest possible standards of transfusion services are essential.

In order to evaluate the current situation of the blood programme in the country, the nature of the organisational set-up and its operational strategies has been studied in detail.

Blood transfusion services are being operated by different agencies: governmental, semi-governmental, voluntary and commercial establishments. There is no organised or uniform pattern of service. The nature and standard of services differ not only from state to state, and region to region but also at different places in the same town.

For a population of 1000 million and a bed strength of ever 0.90 million in all the states and Union Territories, there is a meagre availability of 4.0 million units of blood annually as against the modest requirement of 7.5 million units, thereby leaving a gap of 3.5 million units. The manner in which this gap is to be covered can be anybody's guess.

But one thing is certain that such a situation results in a variety of malpractices. In spite of all the claims by the official and non-official agencies, the professional blood sellers continue to dominate the scene. While a few states have made some progress in developing the programme, others continue to have deplorable services. Notable among these are the North-Eastern states, Assam, Orissa, Bihar and UP.

Out of the 4 million units of blood collected from all over the country, about 50% is consumed in 15 large metropolitan cities. Most of these cities have 300-500 nursing homes and private hospitals depending mostly on blood shops. Even some of the government hospitals draw their supplies from the same source. It is distressing to note that over 50% of the medical colleges do not have actively functioning, self-sustaining blood centres and invariably depend on commercial blood centres, 90% of these institutions continue the practice of using whole blood and have not cared to develop a blood component programme.

There has been a lot of talk about having a voluntary blood programme in the country during the recent years. But the fact is that whereas there has been improvement in some parts of the country, in other areas there has been a corresponding increase of commercial establishments to cater to the increasing requirements of a large number of nursing homes and private institutions that have come up during the last two decades.

An analysis of the existing blood centres and the nature of their activities, the area of operation, management and statistical data relating to collection, the pattern of operation, donor screening, the availability of resources for providing blood components, facilities for blood donation camps and the type of services provided to large government hospitals, including medical colleges, demonstrate that the majority of these continue to operate in a highly unsatisfactory manner.

The current scenario thus projects the need for utilising all the available resources for the reorganisation of the programme to make available safe blood for all sections of society throughout the country.

There is need for an active involvement of the national Red Cross for coordinating the activities of all the NGOs engaged in a donor motivation drive and the establishment of regional transfusion centres and mobile blood collection units to augment blood supplies. Financial support for setting up these centres should be provided by the Government of India.

It is time for revamping all the existing blood centres in government and public sector institutions to ensure efficient screening procedures for transmissible infections, technological standardisation, quality control and a good manufacturing practice. There should be provision for blood component preparation and mobile blood units at all big centres.

It remains to be seen if even after the judgment of the Supreme Court, asking the authorities to take effective steps to carry out its directions, any tangible result emerges. The situation is alarming, to say the least. Desperate remedies are the need of the hour.

The writer is Emeritus Professor, Transfusion Medicine, PGI, Chandigarh

Scientists suppress appetite gene

SYDNEY: In what may help in the treatment of obesity in humans, Australian researchers have successfully blocked a gene believed to be a major regulator of hunger in rats, causing the animals to eat less and lose weight.

Using DNA to block a gene in the brain, called FIT, researchers from biotech company AGT Biosciences and Deakin University in Melbourne found that in four days, the rats were eating 40 per cent less food and had lost 5 to 8 per cent in body weight.

According to James Campbell, Director of Business Development at AGT, this showed that FIT was a key regulator of appetite and could provide a way to control obesity in people.

"This is a very strong lead in the search for a therapeutic treatment for obesity," The Age quoted Dr Campbell as telling the International Diabetes Federation Conference in Paris recently. He said that a predisposition to obesity was unlikely to be caused by a single gene, "but FIT may lead to a treatment that will work for some people."

Regular exercise and a healthy diet were the most effective methods of weight control, but some people had genes that made them more likely to be obese given the right environmental trigger, said Campbell.

If the research continues as hoped, a drug blocking FIT could be available in five to seven years.

Meanwhile, Tim Gill, Chief Executive of the Australasian Society for the Study of Obesity, said the research was important in developing a drug that might help a particular group of obese people control their weight. — ANI

New scanner detects prostrate cancer

WASHINGTON: Herald-ing a breakthrough in the scanning of body images, experts at UC Davis have devised a PET (positron emission tomography) scanner which can trap minute details, thanks to its sensitivity and is being used in the detection of prostrate cancer.

PET scanners have become quite popular in medical imaging, along with X-rays, CAT scans and magnetic resonance imaging to detect ailments. These products help dispel information about metabolic activity in body tissues and can be engaged to scan minute details often missed out by ordinary scanners, a report in the journal Physics in Medicine and Biology said.

"We think it's the highest resolution scanner in existence. We can see things we couldn't see before," Simon Cherry, Professor of Biomedical Engineering at UC Davis, leading the research group said.

The current machine, christened MicroPET II, can resolve a volume of about one cubic millimeter, or one microliter and works by detecting short-lived radioactive tracers that emit positrons, or anti-electrons. Those tracers can be attached to other molecules that are targeted to particular cells.

Considered eco-and-animal friendly, PET scanners allow researchers to use fewer animals in experimental studies. Researchers can use an experimental drug to treat cancer in mice and see if the tumours are retreating. Without the help of PET scanners, it becomes cumbersome to detect small lumps of cancer cells in experimental animals. — ANI