Thalassaemia and Hepatitis
Vinay Shetty
Vice President
Think Foundation
What we can do?
28July-WorldHepatitisDay
A facebook page
What we can do?
28July-WorldHepatitisDay
Name : Xxxxx Yxxxxx
Age : 34 years
Status : Married
Children : 1 ...
Who is this ?
What we can do?
28July-WorldHepatitisDay
Xxxxx Yxxxxx
is
a
Thalassaemia
Major
What did he do right ?
What we can do?
28July-WorldHepatitisDay
Blood transfusion
Pre-transfusion Hb > 9.5 gms/dl
Iron che...
What did others do right ?
What we can do?
28July-WorldHepatitisDay
Transfusion Service
Ensured availability of blood
Nucl...
Hepatitis in Thalassaemia patients
What we can do?
28July-WorldHepatitisDay
Around 10 % of Thalassaemia Major patients
inf...
What we can do?
28July-WorldHepatitisDay
What should we do ?
For general well being
Maintain Hb
> 9.5 gms/dld
Maintain Se ...
What should we do ?
What we can do?
28July-WorldHepatitisDay
Ensure Safety of Blood
Collect blood from
voluntary donors
Em...
What should we do ?
What we can do?
28July-WorldHepatitisDay
For treatment
• Early detection
• Determination of type
• Res...
What we can do?
28July-WorldHepatitisDay
Grateful to
Children’s Liver Foundation
All amazing doctors who take
care of thal...
What we can do?
28July-WorldHepatitisDay
Thank You
Blood Banks therefore regulated
under Drugs Cosmetics Act, 1940 and
rules thereunder.
Human Blood covered under the
defini...
1989
Notification by Central Govt.
under Drugs Cosmetics Rules
for mandatory testing for HIV
Following Reports of AIDS
1990
Drugs rules amended, and Drugs
Controller General of India vested
with the power of Central Licence
Approving Authori...
1992
Public Interest Litigation
filed by Mr. H.D. Shourie
1996
Consequent to P.I.L., Supreme Court
of India gives directive to the Govt.
of India to:
• ban commercial/paid donors
•...
1996
Govt. of India directs Drugs
Controller General of India to
formulate comprehensive legislation
In line with Supreme ...
1996
Establishment of Committee headed
by Dr. Mukherjee to study
possibility of Red Cross running the
transfusion service
...
1996
Establishment of Committee to
formulate
National Blood Policy
In line with Supreme Court directives
1996
Formation of National Blood
Transfusion Council
Registered as a Society
In line with Supreme Court directives
1996 –
2nd July
Formation of Maharashtra State
Blood Transfusion Council
• Regd. Under Societies Registration
Act,
1860 on...
In line with Supreme Court directives
National Blood Policy published by
Govt. of India
2002
In line with Supreme Court directives
Action Plan formulated for
National Blood Policy
2003
National Blood Policy – Objective 1
To provide safe and adequate
quantity of blood, blood components
and blood products.
T...
National Blood Policy – Objective 2
To make available adequate
resources to develop and reorganize
the blood transfusion s...
National Blood Policy – Objective 8
To take adequate legislative and
educational steps to eliminate
profiteering in blood ...
As per National Blood Policy
Structure of Transfusion Service
N.B.T.C
.
S.B.T.C./U.T.B.T.C
.
Red Cross
Blood Centre
NGO
Bl...
As per National Blood Policy
Organizations supporting
Transfusion Service
NACO – National Aids Control Organization
to all...
As per National Blood Policy
Problems - Macro
NBTC, being a Council and not an
Authority, can only recommend.
Legislative ...
As per National Blood Policy
Problems – on the ground
The practice of replacement donor
continues
Hospitals refuse to take...
The solution
One single metropolitan blood bank catering
to the city, and maintaining independence
from hospitals for bloo...
100% Voluntary Blood Donation - Mumbai
By testing of blood alone can we ensure that
blood is safe?
Window Period is a seri...
100% Voluntary Blood Donation - Mumbai
How do we ensure that blood is safe ?
By
collecting
blood
from safe
donors
100% Voluntary Blood Donation - Mumbai
Who is a safe donor?
A
voluntary
donor is
safe donor
100% Voluntary Blood Donation - Mumbai
Who is a voluntary donor?
A person who
donates blood
without
knowing the
identity o...
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thalassemia and Hepatitis C

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thalassemia and Hepatitis C

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thalassemia and Hepatitis C

  1. 1. Thalassaemia and Hepatitis Vinay Shetty Vice President Think Foundation What we can do? 28July-WorldHepatitisDay
  2. 2. A facebook page What we can do? 28July-WorldHepatitisDay Name : Xxxxx Yxxxxx Age : 34 years Status : Married Children : 1 son (5 years old) Works at : XYZ Corp. Studied at : Xxxx Inst. Of Mgmt. Interests : Reading and cricket
  3. 3. Who is this ? What we can do? 28July-WorldHepatitisDay Xxxxx Yxxxxx is a Thalassaemia Major
  4. 4. What did he do right ? What we can do? 28July-WorldHepatitisDay Blood transfusion Pre-transfusion Hb > 9.5 gms/dl Iron chelation Serum Ferritin < 1000 ng/ml Periodic monitoring LFT, RFT, Thyroid, TTIs, Growth, DEXA, MRI
  5. 5. What did others do right ? What we can do? 28July-WorldHepatitisDay Transfusion Service Ensured availability of blood Nucleic Acid Amplification Testing Ensured supply of safe blood Health Care system Ensured availability of medicines Provided facilities for monitoring
  6. 6. Hepatitis in Thalassaemia patients What we can do? 28July-WorldHepatitisDay Around 10 % of Thalassaemia Major patients infected with Hepatitis C Infection due to transfused blood carrying the virus • Mandatory Hep C testing only after 2002 • Large Window period in current methods Risks higher for Thalassaemia Major due to being multiple-transfused
  7. 7. What we can do? 28July-WorldHepatitisDay What should we do ? For general well being Maintain Hb > 9.5 gms/dld Maintain Se Fe < 1000 ng/ml Check all parameters periodically • prepare patient management book and provide to all centres • work with the health department to provide iron chelators • work with sponsors to adopt patients for iron chelation • draw up a centre-wise systematic plan to follow protocol laid down by TIF
  8. 8. What should we do ? What we can do? 28July-WorldHepatitisDay Ensure Safety of Blood Collect blood from voluntary donors Employ better testing systems for TTIs For prevention • Organize blood donation camps • Advocacy for implementation of National Blood Policy • Advocacy with Health Ministry/ Drugs Controller/NBTC/Blood Banks for NAAT testing of collected blood
  9. 9. What should we do ? What we can do? 28July-WorldHepatitisDay For treatment • Early detection • Determination of type • Resources for treatment • Arrange for Serology tests every 6 months • Select patients for treatment – determine genotype and viral load • Interact with pharma cos. and health authorities for making treatment affordable • Ask health authorities to take responsibility for treatment • Raise resources through sponsors
  10. 10. What we can do? 28July-WorldHepatitisDay Grateful to Children’s Liver Foundation All amazing doctors who take care of thalassaemia patients Blood Banks Sponsors
  11. 11. What we can do? 28July-WorldHepatitisDay Thank You
  12. 12. Blood Banks therefore regulated under Drugs Cosmetics Act, 1940 and rules thereunder. Human Blood covered under the definition of “Drug”. 1940
  13. 13. 1989 Notification by Central Govt. under Drugs Cosmetics Rules for mandatory testing for HIV Following Reports of AIDS
  14. 14. 1990 Drugs rules amended, and Drugs Controller General of India vested with the power of Central Licence Approving Authority Following Fergusson Report
  15. 15. 1992 Public Interest Litigation filed by Mr. H.D. Shourie
  16. 16. 1996 Consequent to P.I.L., Supreme Court of India gives directive to the Govt. of India to: • ban commercial/paid donors • formulate comprehensive legislation on blood transfusion services. • form National and State Blood Transfusion Councils
  17. 17. 1996 Govt. of India directs Drugs Controller General of India to formulate comprehensive legislation In line with Supreme Court directives
  18. 18. 1996 Establishment of Committee headed by Dr. Mukherjee to study possibility of Red Cross running the transfusion service Existing Red Cross network found to be inadequate
  19. 19. 1996 Establishment of Committee to formulate National Blood Policy In line with Supreme Court directives
  20. 20. 1996 Formation of National Blood Transfusion Council Registered as a Society In line with Supreme Court directives
  21. 21. 1996 – 2nd July Formation of Maharashtra State Blood Transfusion Council • Regd. Under Societies Registration Act, 1860 on 22nd Jan., 1997 • Regd. Under Bombay Public Trusts Act, 1950 on 17th April, 1998 In line with Supreme Court directives
  22. 22. In line with Supreme Court directives National Blood Policy published by Govt. of India 2002
  23. 23. In line with Supreme Court directives Action Plan formulated for National Blood Policy 2003
  24. 24. National Blood Policy – Objective 1 To provide safe and adequate quantity of blood, blood components and blood products. The Policy Objective mentions : …..the practice of replacement shall be gradually phased out
  25. 25. National Blood Policy – Objective 2 To make available adequate resources to develop and reorganize the blood transfusion service in the country.
  26. 26. National Blood Policy – Objective 8 To take adequate legislative and educational steps to eliminate profiteering in blood banks. The Policy Objective mentions : …..as a deterrent to paid blood donors who operate under the guise of replacement donors, institutions who prescribe blood should be made responsible to organize blood for their patients
  27. 27. As per National Blood Policy Structure of Transfusion Service N.B.T.C . S.B.T.C./U.T.B.T.C . Red Cross Blood Centre NGO Blood Centre Govt. Blood Centre Satellite Blood Centre R.B.T.C. N.B.T.C. : National Blood Transfusion Council S.B.T.C. : State Blood Transfusion Council U.T.B.T.C. : Union Territory Blood Transfusion Council R.B.T.C. : Regional Blood Transfusion Centre
  28. 28. As per National Blood Policy Organizations supporting Transfusion Service NACO – National Aids Control Organization to allocating budget to NBTC DCGI - Drugs Controller General of India To establish and enforce standards for blood and blood products Ministry of Health & Family Welfare To lay guidelines on bio-safety for all Blood Centres
  29. 29. As per National Blood Policy Problems - Macro NBTC, being a Council and not an Authority, can only recommend. Legislative action to be taken for implementation of National Blood Policy
  30. 30. As per National Blood Policy Problems – on the ground The practice of replacement donor continues Hospitals refuse to take blood from a blood bank, and insist on donors being brought to the Hospital. Too many blood banks, each charging different processing charges
  31. 31. The solution One single metropolitan blood bank catering to the city, and maintaining independence from hospitals for blood banking operations Will think of the city’s requirement Uniformity of collection/processing Collection from voluntary donors Will ensure 100% components
  32. 32. 100% Voluntary Blood Donation - Mumbai By testing of blood alone can we ensure that blood is safe? Window Period is a serious threat No
  33. 33. 100% Voluntary Blood Donation - Mumbai How do we ensure that blood is safe ? By collecting blood from safe donors
  34. 34. 100% Voluntary Blood Donation - Mumbai Who is a safe donor? A voluntary donor is safe donor
  35. 35. 100% Voluntary Blood Donation - Mumbai Who is a voluntary donor? A person who donates blood without knowing the identity of the recipient

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