No change in blood donation rules for transpersons: Govt
The Union government has told the Supreme Court that there is no need to revise the existing blood transfusion policy prohibiting donation from transgender persons, men having sex with men (MSM) and women sex workers, underlining that these groups continue to present a statistically higher risk of HIV and other transfusion-transmitted infections.
'Allowing blood donations from individuals statistically linked with a higher prevalence of TTIs (transfusion-transmitted infections) would proportionately increase systemic risks and undermine the integrity and reliability of the national blood supply chain… No modification or relaxation of the guidelines is warranted at this time,' said an affidavit by the ministry of health and family welfare filed before a bench led by justice Surya Kant.
Maintaining that the deferment of individuals belonging to high-risk categories is both 'reasonable and essential', the affidavit added: 'These guidelines are firmly rooted in globally accepted scientific research, established public health principles, and robust epidemiological evidence. Any dilution or relaxation of these standards would pose a serious risk to the safety and integrity of the national blood supply.'
The affidavit was filed in response to the court's oral suggestion in May that the policy be reconsidered in light of medical advancements and evolving global practices. Acting on the court's direction, the Directorate General of Health Services set up an expert committee, which met on May 29 and concluded that no change was warranted in the 2017 Guidelines for Blood Donor Selection and Referral.
The expert panel highlighted that even the most advanced testing technologies cannot offer absolute assurance of detecting infections during the 'window period' when diseases like HIV remain undetectable. In such circumstances, exclusion of high-risk groups was described as a 'prudent, precautionary, and evidence-based measure' aligned with international standards.
'Notwithstanding the availability of modern testing technologies, no diagnostic test can offer a 100% guarantee of detecting all infections, particularly during the 'window period,' wherein certain infections may remain undetectable,' stated the affidavit, adding that due to such inherent limitations, the exclusion of high-risk categories continues to be a 'prudent, precautionary, and evidence-based measure'.
Pointing to epidemiology, the Centre said the challenged clauses rest on data, not stigma. 'Multiple international research studies have consistently highlighted a significantly high prevalence of HIV and other sexually transmitted infections among transgender persons, particularly transgender women… Accordingly, the deferment… is rooted in established epidemiological data and public health evidence, which reflect a higher incidence of TTIs, notably HIV, within such population groups,' it said.
The government also noted that while some Western countries have lifted restrictions on certain donor categories, many Asian neighbours, including Sri Lanka, Thailand, Indonesia, the Philippines, Malaysia, Singapore and China, continue to uphold similar bans. India, it said, must base its policies on its own epidemiological profile, health care infrastructure and diagnostic capacities.
Invoking constitutional obligations, the Centre framed the policy as a precaution the Constitution demands. 'The continued adherence to the precautionary principle in matters relating to blood safety is not only justified but also constitutionally mandated under the State's obligation to protect public health, as enshrined in Article 47 of the Constitution of India,' the affidavit asserted.
The affidavit comes after the Supreme Court, during a hearing on May 14, questioned the rationale of branding entire communities as 'risky' donors. The bench had asked: 'Are we going to brand all transgenders as risky and stigmatise them? You cannot say that all transgenders are indulging in sexual activity.' The court had observed that transgenders already face severe prejudice and warned against creating 'a segregated group' that would deepen stigma.
The petitions, including one filed by Manipur-based transgender activist Thangjam Santa Singh in 2021, have challenged some relevant clauses of the 2017 guidelines, arguing that they are unconstitutional as they discriminate on the basis of gender identity and sexual orientation. The plea asserts that the exclusions perpetuate stereotypes and violate the right to equality under Articles 14 and 15 of the Constitution.
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