Beyond blood safety
Discarded infected blood units prove screening works, but
also expose urgent gaps in disease prevention — surveillance, testing, and
infection control — that public health can’t afford to ignore
ST file photo
A report published in this paper revealed that 47,375 blood
units collected in Sindh during 2025 had to be discarded after screening
detected transfusion-transmissible infections (TTIs), including hepatitis B,
hepatitis C, HIV, syphilis and malaria. The figures showed that 5.7 per cent of
screened donations — roughly one in every 20 units — were found unsafe for
transfusion.
There is reassurance in the fact that screening systems are
identifying infected blood before it reaches patients. Yet the findings also
expose a deeper public-health challenge. Every discarded unit represents an
individual carrying an infection, often without knowing it. Blood banks,
therefore, are not merely repositories of blood; they also provide a valuable
glimpse into the prevalence of infectious diseases in the wider community.
The persistence of these infection rates should be a matter of
concern. Hepatitis C remains the most frequently detected infection among
donors, followed by hepatitis B and syphilis, while HIV-positive donations,
though fewer, continue to appear in screening records. These are not simply
blood-bank statistics; they are indicators of ongoing transmission and
undiagnosed disease.
The report also highlighted Sindh's continuing dependence on
replacement donors. Only about 15 per cent of donations came from voluntary
donors, while the overwhelming majority were arranged through family members or
replacement donors. This model has long been regarded as less desirable than
one built on regular voluntary, non-remunerated donations. Individuals donating
under social or family pressure may be less willing to disclose potential
health risks, while repeat voluntary donors generally constitute a safer and
more reliable donor pool. Expanding voluntary blood donation is, therefore, not
merely a matter of increasing supplies; it is also a crucial component of improving
blood safety.
Courtesy: PMA
More importantly, the figures compel a broader assessment of
disease-control efforts. The continued prevalence of hepatitis B, hepatitis C
and HIV among apparently healthy blood donors suggests that large numbers of
infections remain undiagnosed in the community. This raises legitimate
questions about the reach and effectiveness of public awareness campaigns,
screening initiatives, vaccination programmes and infection-control measures.
Blood banks are detecting infections at the final checkpoint before
transfusion; ideally, public-health systems should identify and prevent many of
these infections much earlier.
Blood safety cannot be separated from wider public-health
realities. Unsafe injections, poor infection-control practices, unregulated
procedures and delayed diagnosis all contribute to the pool of infections that
eventually appear in blood donor statistics. While blood banks prevent infected
blood from reaching patients, they cannot by themselves address the causes that
produce these infections.
The thousands of infected blood units discarded each year are
evidence that screening safeguards are functioning. Yet they also point to a
more uncomfortable reality: the burden of preventable infectious diseases
remains far too high. The challenge before policymakers is not simply to keep
unsafe blood out of hospitals, but to reduce the number of infected individuals
entering the donor pool in the first place. This requires health authorities to
critically review the effectiveness of existing disease-control programmes,
strengthen surveillance and testing, improve infection-control practices and
expand access to treatment. A sustained commitment to voluntary blood donation
must form part of that effort. Until measurable progress is achieved, blood
bank statistics will continue to serve as a reminder of unfinished business in
public health.
(Originally published in the weekly Social Track, Karachi)
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