Why India needs inclusive blood donation policies now
Every year, thousands of Indians in critical medical need depend on life-saving blood transfusions. Yet, even as blood shortages persist, the country continues to enforce exclusionary policies that bar entire groups—particularly individuals from LGBTQIA+ communities and sex workers—from donating blood. These outdated bans are not just unscientific; they are discriminatory, rooted in stigma rather than evidence. It's time India reform its blood donation laws to reflect both medical advancements and human rights.
India's blood donation guidelines, modeled after policies formed in the early days of the HIV/AIDS epidemic, impose blanket bans on certain populations. Men who have sex with men (MSM), trans persons, and sex workers are automatically disqualified, regardless of their individual sexual behavior, health status, or willingness to undergo testing. These guidelines paint entire communities with the same brush and are based on the assumption that persons from these communities indulge in unsafe sexual practices. Not only is this rooted in regressive moralistic codes, but it also takes the focus away from safe-sex, plurality of desire, and sexual health.
Another key issue is the sidelining of advances in screening technologies and global best practices that enable safe blood collection from all individuals—regardless of identity.
Modern blood banks use nucleic acid testing (NAT), which can detect HIV and other infections within days of exposure. NAT is revolutionising blood safety by detecting infections earlier than traditional serology-based tests. Unlike conventional methods, which may take weeks to detect infections, NAT identifies viral DNA or RNA within days of exposure, significantly reducing the risk of TTIs. For thalassemia patients, who undergo repeated transfusions, NAT can mean the difference between life-saving care and life-threatening complications.
Excluding people based on identity rather than scientific risk factors not only violates their fundamental right to equality but also deprives the health system of potential donors. It perpetuates the harmful myth that LGBTQIA+ individuals and sex workers are inherently dangerous, further entrenching social stigma and institutional discrimination.
India must urgently reform its blood donation guidelines in line with international scientific evidence and human rights norms. This begins by replacing identity-based deferrals with behavior-based screening protocols. All donors—regardless of sexual orientation, gender identity, or profession—should be assessed equally based on recent activities that may pose risk.
The path forward requires a coordinated, multi-stakeholder strategy:
India is at a crossroads. We can continue to let fear and misinformation dictate public health policy—or we can lead with science and compassion.
We need a comprehensive review of India's blood donor eligibility criteria. This review must include consultations with medical experts, human rights advocates, and affected communities.
India deserves a blood donation policy that reflects the values of equality, dignity, and modern science.
This article is authored by Anubha Taneja Mukherjee, member secretary, Thalassemia Patients Advocacy Group and Rituparna Borah, co-founder and executive director, Nazariya Queer Feminist Resource Group.
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