All donated blood is tested for HIV, other infections, making prohibition unnecessary
The Centre defended the ban in Supreme Court, arguing that the window between when a person is exposed to an infection and when a test can detect said infection in the body varies vastly. Photo: iStock The prohibition on transgender people, gay men and sex workers from donating blood in India is the remnant of stigmatisation during the acquired immunodeficiency syndrome or AIDS epidemic in the last century.
Today, the stigma is disguised as the ‘scientific’ grounds that these groups are at a higher risk for human immunodeficiency virus (HIV) and other transfusion-transmitted infections (OTTI).
Santa Khurai, a Manipuri Nupi Manbi activist, filed a petition in the Supreme Court of India in March 2021, which challenged blood donation guidelines.
Khurai argued the norms violate Articles 14 and 15 of the Constitution, which guarantee the right to equality and prohibit discrimination based on religion, race, caste, sex or place of birth, respectively.
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The Union Ministry of Health and Family Welfare defended the framework in place and said every effort has to be made to ensure that the recipient is shielded from an unfortunate result, especially since the consequences can be irreversible.
The central government response read:
The entire objective of a safe blood transfusion system (BTS) is to ensure the health and safety of the recipient of the donated blood...Thus, even on the balance of the individual rights of the blood donor versus the right of the recipient, the right of the recipient to receive a safe blood transfusion far outweighs the right of an individual to donate blood.
The integrity of the BTS is paramount from a public health perspective and constitutional courts should defer to the judgment of domain experts, the Centre further told the Supreme Court.
However, the exclusion of transgender people, gay men and sex workers from donating blood because they are an ‘high-risk population’ for sexually transmitted diseases is symptomatic of a systemic failure.
All donated blood is tested for a host of infections, including HIV and OTTIs, so the same mechanism should be applied to these select populations.
However, the Centre argued that the window between when a person is exposed to an infection and when a test can detect said infection in the body varies vastly. The time-lapse is largely a function of the type of test used and the particular infection, both of which are highly variable.
Even the most sophisticated testing technologies available in India — the nucleic-acid testing (NAT) test — have an average residual window period of 10-30 days. Moreover, NAT tests are not readily available across geographies, with most blood blanks using other technologies, the health ministry said.
The LGBTQIA+ community should not be blamed for systemic failures in testing donated blood, said Rohin Bhatt — a queer rights activist and lawyer. “Should queer people be banned from donating blood when more than a thousand people get infected with HIV due to blood transfusions every year, even with the ban in place?”
India is not the first country to enforce such a ban, but it is among the few that have persisted with it decades after the AIDS epidemic.
Most recently, the United States lifted similar restrictions in 2015 when the Food and Drug Administration allowed men who have sex with men to donate blood as long as there has been no sexual contact in the last 12 months.
Domain experts and stakeholders had at the time lauded the move, stating that we must stop “reacting to HIV like it is the early 1980s” and pave the way for scientifically sound decisions.
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Canada took similar steps in April 2022 by allowing gay men to donate blood. The move was hailed as “a significant milestone toward a more inclusive blood donation system” by the country’s health department.
The practice is legal in a host of other nations including South Africa, Brazil, Chile, Mexico, the United Kingdom, Russia, Spain, Portugal, Italy and Bhutan. Other countries in India’s company which disallow such groups from donating blood are China, Malaysia, Thailand, Algeria, Botswana and Venezuela, among others.
Improving the screening system for blood donation instead of excluding certain groups by effectively labelling them ‘disease vectors’ is the scientific way forward.
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