A Savior for Millions: Integrating Aadhaar Card with Blood Group

Inclusion of an individual’s blood group on Aadhaar card would offer a centralized digital
database of potential supply of blood & its spatial distribution and reduce the asymmetric
information that exists in the market for blood
Suhail Ahmad Khoja & Misba Rafiq
Context
World Blood Donor Day is held on 14 th of June each year. The event was organised for the first
time in 2004, by four core international organizations: the World Health Organization, the
International Federation of Red Cross and Red Crescent Societies; the International Federation
of Blood Donor Organizations (IFBDO) and the International Society of Blood Transfusion (ISBT)
to raise awareness of the need for safe blood and blood products, and to thank blood donors
for their voluntary, life-saving gifts of blood. It is celebrated on the birthday anniversary of Karl
Landsteiner, an Austrian-born American biologist who was awarded the Nobel Prize in 1930 in
Physiology or Medicine for his discovery of the ABO blood group system in 1901. This
remarkable discovery increased the likelihood of survival for recipients of blood transfusion
that was earlier quite low. The slogan for 2023 World Blood Donor Day campaign, celebrated
on 14 June 2023, is “Give blood, give plasma, share life, share often.” It focuses on patients
requiring life-long transfusion support and underlines the role every single person can
play, by giving the valuable gift of blood or plasma. The host country for the global event
of World Blood Donor Day 2023 is Algeria through its National Blood Transfusion
Service.
Types of blood donors and Global scenario
Donating blood, “the gift of life” is one of the noblest activities performed worldwide
118.5 million times annually as per World Health Organization(2018), which in itself
exemplifies human empathy and altruism. There are three types of blood donors:
Voluntary unpaid donors, who are also the safest group of donors as the prevalence of
blood-borne infections is lowest among this group. The second category is family or
replacement and third one the paid donor. World Health Assembly resolution WHA63.12
urges all Member States to develop national blood systems based on voluntary unpaid
donations and to work towards the goal of self-sufficiency. Data reported to WHO shows
significant increases of voluntary unpaid blood donations in low- and middle-income
countries: An increase of 10.7 million blood donations from voluntary unpaid donors
from 2008 to 2018 has been reported by 119 countries. The highest increase of
voluntary unpaid blood donations is in the South-East Asia Region (127%) followed by
the Region of the Americas (81%) and Africa (81%).
An Impending crisis: Imbalance between demand and supply in India
In India, the annual estimated requirement of blood is 1.46 Cr units (estimated) but, the
total blood collection reported in the Yr. 2019-20 was 1.25 Cr units only as per a report
by Ministry of Health and Family Welfare (GOI). The report also highlighted a
heightened need for voluntary non-remunerated (not paid) blood donations, to bridge
the gap between the requirement and the availability, and to have ready a roaster of
interested donors. During 2021, a total of 4,12,432 accidents were reported by all States/UTs,
of which, 1,42,163 (34.5 %) were fatal accidents. The number of persons killed in road accidents
were 1,53,972 and caused injury to 3,84,448 persons, as per Ministry of Road Transport and
Highways report for 2021. Moreover, the report also highlighted the rising accident severity
(persons killed per thousand accidents) from 36 in 2020 to 37 in 2021. Consequently, such a
scenario calls for increasing the supply of blood at the hospitals to save as many lives as
possible. Recently, the Registrar General of India’s Sample Registration System (SRS) released
the latest special bulletin on Maternal Mortality (MMR) in India (2018-20), which highlights a
consistent decline in MMR in India. It also points out that MMR in India has declined by 6 points
from 103 in 2017-19 to 97 in 2018-20 (5.5% decline). However, the number varies across states
with Kerala having the lowest MMR at 19 while Assam having the highest MMR at 195. Despite
some ambitious & appreciable policy initiatives of the Govt of India, one of the most common
and preventable cause of maternal death is Postpartum Haemorrhage (PPH), i.e. excessive
bleeding after childbirth. PPH accounts for about 35% of all maternal deaths globally and about
30% of maternal deaths in India. Replacement of blood and blood products plays an important
role in managing PPH. So, access to timely delivery of care and to safe and adequate blood for
transfusion can be a game changer in the effort to eradicate maternal casualties. Moreover, the
number of cancer cases in the country is projected to go up from 14.6 lakh in 2022 to 15.7 lakh
in 2025, according to the Indian Council of Medical Research-National Cancer Registry
Programme (ICMR-NCRP), the government informed Parliament on March 14, 2023. It
necessitates an increased supply of blood required by cancer patients. By and large, demand for
blood is projected to surge in India in the upcoming years.
Way forward
The WHO estimates that blood donation by 1% of the population is generally the minimum to
meet a nation’s most basic need for blood. As per the data of 2016-17, India had a shortfall of
1.9 million units (or 15%) vis-à-vis the WHO norm. A major lacuna in the Indian Health system
is the lack of an adequate and reliable repository of data on potential blood supply in the
country. Moreover, the most educated people in India perceive blood donation to be an
emergency service, i.e. donate blood when asked. Generally, people do not know their blood
group, mostly the need for it lies during medical surgeries or blood donation. So a lot of time
elapses in assessing a patient’s blood group before blood transfusion. Similarly, if a person
meets an accident that causes blood loss, assessing blood group before due transfusion may
be too late to save his life. Aadhar has the potential to resolve these issues by offering a
centralized digital database that stores blood group information of individuals who have been
tested. This database can be accessed by healthcare facilities in real-time, enabling them to
quickly identify suitable blood donors for transfusion purposes. Such information would also
be accessible and known to an Individual. Ensuring proper data privacy and security measures
ought to be prioritized to protect the sensitive information. By implementing these strategies,
healthcare facilities can significantly reduce the time that elapses between assessing blood
groups and blood transfusion, leading to improved patient outcomes and enhanced healthcare
efficiency.
Aadhaar or Unique Identification number (UID) is a 12-digit individual identification number
issued by the Unique Identification Authority of India (UIDAI) on behalf of the Government of
India. It captures the biometric identity – 10 fingerprints, iris and photograph – of every
resident, and serves as a proof of identity and address anywhere in India. If the UIDAI updates
Aadhaar and includes the blood group of an individual on it, complemented with incentives for
individuals who donate blood voluntarily ,such as certificates of appreciation , priority access
to blood in case of need , or tax benefits , there are higher chances that the voluntary unpaid
blood donation in the country would pick up pace. A randomized control trial in this regard is
worth an attempt, because the gains would far outweigh the losses from such a policy lever.
Though other equally important issues need to be addressed. Strengthening Blood Donation
Infrastructure must be prioritized. Implementing any measure requires collaboration among
government agencies, healthcare professionals, NGOs, educational institutions, and the
general public. It's essential to continuously evaluate and monitor the effectiveness of these
strategies aimed at increasing blood donation to make necessary adjustments and ensure
sustainable improvement in blood donation rates.
Suhail Ah Khoja & Misba Rafiq

Post graduate students of Economics at University of Kashmir