COMMON CAUSEversusUNION OF INDIA AND ORS.
- Citation
- 1996 INSC 20
- Decided
- 4 January 1996
- Disposal
- Disposed off
Holding
The Court directed the establishment of a National Council of Blood Transfusion and State Councils, empowered them to raise funds, mandated licensing of all blood banks within one year and the eradication of professional donors within two years, and ordered compliance reporting.
Summary
The Supreme Court entertained a public‑interest writ under Article 32 filed by Common Cause seeking remedial measures for the serious deficiencies in India’s blood‑banking system. A 1990 consultancy report highlighted widespread unlicensed banks, reliance on professional donors, inadequate testing, poor equipment and hygiene. The Court constituted a Committee, which, together with a Red‑Cross expert panel, recommended the creation of a National Council of Blood Transfusion and State Councils, both to be registered societies, to coordinate licensing, training, voluntary donor mobilisation, research and funding. The Court directed the Union and State governments to establish these bodies, empower them to raise funds, ensure all blood banks are licensed within a year, eliminate professional donors within two years, strengthen the Drugs and Cosmetics enforcement machinery, and consider a separate blood‑banking legislation. The Director General of Health Services was ordered to report on compliance. The petition was disposed with these directions.
Issues considered
- The extent of the Court’s power to issue directions for systemic health‑care reforms under Article 32.
- Whether the deficiencies in blood‑banking constitute a violation of the right to life under Article 21.
- The appropriate institutional framework for regulating blood collection, testing, storage and distribution.
- The need for a separate legislation versus reliance on the Drugs and Cosmetics Act, 1940.
- The mechanisms for ensuring licensing of all blood banks and elimination of professional donors.
Legislation cited
- Constitution of Indias. Article 21, s. Article 32
- Drugs and Cosmetics Act, 1940s. Part XII‑B, s. Section 122
- Drugs and Cosmetics Rules, 1945s. Part X‑B, s. Part XII‑B, s. Rule 122‑F to 122‑f
- Income Tax Act, 1961s. Section 35
- Societies Registration Act, 1860
Subjects
Judgment
COMMON CAUSE A
v.
UNION OF INDIA AND ORS.
4THJANUARY, 1996
[S.C. AGRAWAL AND G.B. PATTANAJK, JJ.] B
Constitution qf India--Article 32-PiL--Blood Banks-Serious defi-
ciencies and shortcomings in the lnatter o.f collection, storage, supply of blood
through various blood agencies operating in lndia--Com.tnittee appointed by
the Court-Report sub1nitted-Programme for preventing infectior~ and C
strengthening of blood banking system in the Country--Directions issued.
Drugs and Cosmetics Act, 1940 and Rules, 1945.
Part Xll-B-Blood Banks prescribed requirement regarding equ1jJ1nent,
blood collection, supplies and emergency equipment etc. D
A petition was filed by way of Public Interest Litigation under
Article 32 of the Constitution to ensure that proper and concrete steps in
a time bound programme are initiated to obviate the malpractices, mal-
functioning and inadequacies of the blood banks all over the country and
to place before the court specific programme of action aimed in order to E
over come the deficiencies in the operation of blood hanks. In the petition
resume was under to this report was submitted in 1990 hy Mis. A.F.
Ferguson & Co. a consultancy firm who had been entrusted by the
Government of India to study the blood banking system in the country. The
,. said report highlighted the deficiencies with regard to the facilities of F
testing blood, licensing of blood banks and professional donors and
storage of blood. During the pendency of the petition the petitioner
submitted a draft scheme and the Union of India also submitted a Scheme.
The Court thereupon constituted a Committee to suggest the necessary
steps for further strengthening the existing frame work about licensing and
operation of blood banks and obtaining blood donations. The said Com- G
mittee in coordination with Indian Red Cross Society submitted its final
report containing recommendations for revamping the system of blood
banks in the country in the form of plans for implementation on immediate
basis and for long term implementation. The Committee also took note of
the programme for preventing infection and strengthening of Blood Bank· H
89
90 SUPREME COCRT REPORTS [1996] l S.C.R.
A ing System in the country that is being implemented by the National Aids
Central Organisation .
Disposing of the Writ Petiltion in the light of the report of the
committee constituted by the court as well as the report of the committee
of Experts set up by the Indian Red Cross Society and the programme that
B is being implemented by the National Aids Control Organisation the Court
directed :
HELD : 1. The Union Government shall establish a National Council
of Blood Transfusion as a society registered under Societies Registration
Act. It would have representatives from the Directorate General of Health •
c services of the Government of India, the Drug controller of India, Ministry
of Finance and the Government of llndia, Indian Red Cross Society, Private
Blood Banks, including the Indian Association of the Blood Banks, major
medical health institution of the Country and non-governmental organisa-
lion active in the field of securing voluntary blood donations. The Addi-
D tional Secretary in the Ministry of Health could be the Preside0 t of the
National Couocil. [107-A-C]
~
2. The National Council shall have a Secretariat at Delhi under the
charge of a Director. The funds for the functioning of the National Couocil
shall be provided by the Governllllent of India but the National Council
E shall be empowered to raise funds from various other sources including
contributions from trade, industry and individuals. The Government of
India should find out ways and means to secure grant of 100% exemption
~
from income tax to the donor in respect of donation made to the National
Council or State Council. [107-D; 104-F-G] .,
F 3. There shall be State Council in each State/Union Territory which
shall be registered under the Societies Registration Act. It should be a repre-
sentative body having in it representation from Dfrectorate of Health Serv-
ices in the State, State Drug Control.ler, Department of Finance of the State
Government, Union Territory Administration important medical i.nstitution
G in the State/Union Territory, Indian Red Cross Society, Private ' blood banks,
Non-governmental organisation active in the field securing voluntary blood
donations. The Secretary of the Government in charge of the Department of
health could be the President of the State Council. [107-E-F]
4. The State council should have its headquarters at the premises of
H the premier medical institution or hospital in the state/union territory and
COMMON CAUSE v. U.0.1. 91
should function under the charge of a Director. [107-G]
..
5. The funds for the State Council shall be provided by the Union of
A
India as well as the State GovernmenUUnion Territory Administration. It
shall also be empowered to collect funds in the shape of contribution from
trade industry ar.d individuals. [107-H; 108-A]
B
6. The programmes and activities of the National Council and State
Councils shall regulate .the operation and requirements of effective
motivation campaign through utilisation of all media for stimulating
voluntary blood donation, launching programmes of blood donation in
educational institutions, among the labour, industry, and trade establish-
ments and organisations of various services including civic bodies training c
of personnel in relation to all operations of blood collection, storage, and
utilization, separation of blood groups proper labelling, proper storage
and transport, quality control and archiving system, cross matching of
blood between donors and recipients, separation and storage of compo-
nents of blood and all the basic essentials of the operations of blood D
bankings. [108-B-C]
7. The National Council shall undertake training programmes con-
nected with the operation of blood bank. [108-D]
8. The National Council shall establish institution for conducting
research in collection, procesSing, storage, distribution and transfusion of E
whole human blood and human blood components, manufacture of blood
products and other allied fields. The Council shall take steps for starting
special post graduate courses in blood collection in various medical
colleges and institutions in the country. [108-E]
F
9. The Union Government and the Government of the states and
union territories shall ensure that within a period of one year all blood
banks shall be licensed and if a blood hank is found ill equipped for being
licensed and remains unlicensed suitable legal action should be taken fol'"
such blood banks. [108-G-H]
G
10. The Union government and the Governments of the states and
union territories shall take steps to discourage the prevalent system of
professional donors. [109-A)
11. The existing machinery for the enforcement of the provisions of
the Act and the Rules should he strengthened and suitable action be taken H
92 SUPREME COURT REPORTS [1996] 1 S.C.R.
A in that l"gard on the basis of the scheme submitted by Drugs Controller
(I) to the union Government for upgradation of the Drugs Control organi-
sation in the Centre and the State. [109-B]
12. Necessary steps be taken to ensure that Drugs Inspectors duly
trained in blood banking operations are posted in adequate numbers so as
B to ensure periodical checking of the operations of the blood banks through-
out the country. (109-C]
13. The Union Government should consider the advisability of
enacting a separate legislation for regulating the collection, processing,
storage, distribution of blood and operation of the blood banks in the
c country. [109-D]
14. The Director General of Health Service in the Government of
India, Ministry of Health shall submit a report about the action taken
in pursuance of these directions and it will be open for them to seek
D clarification/modification of these directions or further directions in the
case. (109-E-F] ,., .
CIVILEXTR•.ORDINARY JURISDICTION: Writ Petition (C) No. 91
of 1992.
Under Article 32 of the Constitution of India.
E
H.D. Shourie, Petitioner-in-person, Dr. V. Gauri Shankar, S. Rajappa for
Indian Red Cross Society.
P.P. Rao and B.K. Pal for Indian Association of Blood Banks.
F Ms. Manjula Gupta for State of Arunachal Pradesh J.B. Das and Dilip
Sinha for State of West Bengal.
M.T. George for the State of Kerala.
Ranbir Yadav and G.K. Bansal for State of Punjab.
G
A.S. Narnbiar, G. Prakash, D.S. Mohra, Brijender Chahar, Ashok Mathur, .,
S.M. Jadhav, D.M. Nargolkar, S.N. Sikka, Guntur Prabahkar, Kirti Mishra, Anil
K. Jha, C.V. Subba Rao, K. R. Nambiar, Krishnamurthi Swami, Aruneshwar
Gupta, B. Krishna Prasad, A.S. Bhasme, Veerappa, Hemantika Wahi, R.B.
H Misra, R.S. Suri, L.K. Pandey and V.K. Verma for the Respondents.
COMMON CAUSE v. U.O.l. 93
The Judgment of the Court was delivered by A
S.C. AGRAWAL, J. Blood is an essential component of the body
which provides sustenance to life. There can be no greater service to the
humanity than to offer one's blood to save the life of other fellow human-
bcings. At the same time blood, instead of saving life, cannot lead to death
of the person to whom the blood is given if the blood is contaminated. As B
a result of developments in medical science it is possible to pre-serve and
store blood after it has been collected so that it can be available in the case
of need. There are blood banks which undertake the task of collecting, testing
and storage the whole blood and its components and make the same available
when needed, In view of the dangers inherent in supply of contaminated C
blood it must be ensured that the blood that is available with the blood banks
for use is healthy and free from infection.
In this petition filed by way of Public Interest Litigation under Article
32 of the Constitution the petitioner has high-lighted the serious deficiencies
and short-comings in the matter of collection, storage and supply of blood D
._,, through the various blood centres operating in the country and has prayed
that an appropriate writ order or direction be issued directing the Union of
India and the States and the Union Territories, who have all been impleaded
as respondents in this petition, to ensure that proper positive and concrete
steps in a time bound programme are immediately initiated for obviating the E
malpractices, malfunctioning and inadequacies of the blood banks all over
the country and to place before this Court a specific programme of action
aimed _at overcoming the deficiencies in the operation of blood banks.
For the purpose of regulating its collection, storage and supply, blood
is treated as a 'drug' under the Drugs and Cosmetics Act, 1940 (hereinafter F
referred to as 'the Act'). In the Drugs and Cosmetics Rules, 1945 (hereinafter
referred to as 'the Rule>') made under the Act, provisions regarding equip-
ment and supplies required for a blood bank were contained in Part XII-B,
which was inserted vide Notification dated June 24, 1967. In the said part,
requirements regarding Equipment, Blood collection supplies, Canter equip-
ment and Emergency equipment for the Blood Donor Room were prescribed.
G
Similarly provisions were made for the Laboratory, General suppliers, Tech-
nical staff, Accommodation for Blood Bank, Label for whole blood and
Colour scheme for Label etc.
In 1990, Mis. A.F. Ferguson & Co., a Management Consultancy Firm, H
94 SUPREME COURT REPORTS [1996] l S.C.R.
A was entrusted by the Government of India, Ministry of Health with the
study of blood banking system in the country. The scope of the said study
was to :
(i) assess the status of Government, Private, Commercial and Voluntary
blood banks ;
B
(ii) recommended policy and procedure changes; and
(iii) prepare a scheme for modernisation ;
The report submitted by the said consultancy firm to the Government
C in July, 1990, high-lights the deficiencies which regard to the facilities of
testing blood, licensing of blood banks and professional donors and storage .
of blood. In the said report it was stated :
(i) Out of the total number of 1018 blood banks as many as 616
are reported to be unlicensed. There are only 201 licensed commercial
D blood banks; the supply of blood by licensed commercial blood
.,
banks is only about I/4th of the blood used in the hospitals of the
country.
(ii) No medical check up is done on the blood sellers; thei.r health
status is not examined. The blood trade flourishes with poor people
E like unemployed, rickshaw pullers, drug addicts selling their blood.
Such blood sellers suffer from various infections and their
haemoglobin is lower than the prescribed· level. It has been reported
that there are many persons who donate blood 5-6 times in a month;
poverty makes them to do so first but later it is reported to become
F like an addiction, the blood seller enjoying the dizziness due to
reduced supply.
(iii) It is a mandatory requirement to conduct tests on blood which
is to be administered to a patient or to be issued to hospitals for
transfusion. The blood so issued has to be free from AIDS, viral
G hepatitis, malaria, veneral diseases etc. It is reported that mandatory
tests which are required to be done are rarely conducted. Most of the
AIDS surveillance centres are not functioning efficiently and upto
85 per cent of blood collected in the country is not screened for
AIDS. Under an action plan to screen blood for AIDS 37 blood
H testing centres were to be set up in 29 cities, but only 11 testing
COMMON CAUSE" U.O.l. [AGRAWAL, J.] 95
centres were functioning by July, 1990, and training of technicians A
for these centres was lagging.
(iv) The blood banks presently thrive on bleeding 4000 to 5000
regular professional donors in 18-20 cities. The professional blood
donors, which include many women, are reported to be victims of
ill health, low haemoglobin levels and many infections, and are bled B
at frequent intervals by the commercial blood banks.
(v) Storage facilities in the blood banks are far from satisfactory. The
blood banks hav.e necessarily to possess facilities like refrigerators
exclusively for storage of blood with a specified range of temperature
for ensuring safety of blood. In the existing blood banks many items
c
of equipment remain unattended for years, electricity failures are
frequent, generators are a rarity. This applies not only to commercial
blood banks but even to some of the government hospitals. Many
items of the basic equipment needed for blood banks are not
available and a good part of them do not have even adequate D
storage facilities.
(vi) Many of the blood banks are located in unhygenic environment
and they collect and store blood in very dirty conditions.
(vii) In some places strong middle men operate for the blood banks E
by arranging for donors. The middle men dictate the charges to be
paid and take a heavy commission; the selection of donors disregards
the level of health etc.
;.
(viii) A large part of the professional donors are alcoholics or drug
abusers, have indiscriminate sexual habits and are a high risk group F
for Hepatitis B and AIDS and are unfit to donate blood.
(ix) Trained personnel are generally not available in the blood
banks. Most of the blood banks lack trained post-graduates at the
helm; they have no donor organisers to bring voluntary donors; and
G
many of them are manned by technical staff who do not have
requisite qualification of a diploma in Medical Laboratory
Technology. At present there is not even a course to provide post-
graduate specialisation in the field of blood donation and transfusion
as in developed countries. The Drug Control departments, which are
expected to ensure the appropriate functioning of the blood banks, H
96 SUPREME COURT REPORTS [1996] l S.C.R.
A do not themselves have specified trained personnel.
(x) In the storage of blood the basic and essential requirements of
clean environment, shelf life of blood etc. are ignored, Nexus is
reported to b~ existing between the attending doctor of the patient
and the commercial blood bank, with the former directing the
B patients to the latter, and the latter giving a percentage of the sale
to the former.
According to the report of M/s. A.F. Ferguson & Co. out of the total
number of 1018 blood banks in the country, 203 are commercial blood banks
and the rest are controlled by the Central GOvern1nent, State Governments,
c Private Hospitals and voluntary organisations. The volume of the blood
collected by the commercial blood banks is 4. 7 lakhs units out of the total
of 19 .5 lakhs unit by all blood banks and that commercial blo_od banks are
collecting blood mostly from professional donors while the other blood
banks under the control of the State Governments, Central Government,
D Private organisations and voluntary org~nisations are.collecting blood mostly
from the relatives of the patients or from the voluntary donors.
In the counter affidavit filed by Dr. Lalgudi Vaidyanathan Kannan,
Deputy Drugs Controller, on behalf of the Union of India it is stated that af~er
the receipt of the report of Mis. Ferguson & Co., the Drugs controller, India,
E by his letter dated August 23, 1990 asked all the State Drug Controllers (who
are the licensing and enforcing authorities under the Act) to ensure that
inspections are carried out of all commercial blood banks and unlicensed
Government blood banks keeping in view the standards prescribed in the Act
and rules and a phased programme of inspection covering first the commer-
F cial/private blood banks and thereafter the Government blood banks was
suggested. It was also suggested that the private/commercial blood banks
should not be allowed to operate unless they fulfil all the requiremento
prescribed in the Rules and each unit of blood is tested for blood transmis-
sible diseases (Hepatitis, HIV, Syphilis etc.) and that unlicensed blood banks
are to be licensed only after ascertaining that they conform to the standards
G laid down under the Rules. It \Vas also suggested to the State Govern1nents
that the licences of blood banks who do not comply with the provisions of
the Rules should be cancelled and the State Drug Controllers were asked to
send the status reports of blood banks in their respective States. As per the
information forwarded by 23 State Governments/Union Territories, about 341
H blood banks are unlicensed and mn•t of them are run by Red Cross Societies
COMMON CAUSE v. U.0.1. [AGRAWAL, J.] . 97
; and Charitable institutions. In the said counter affidavit mention is also made A
<
of the steps that have been taken in the matter of testing of blood for AIDS,
storage facilities in blood banks, for upgradation and modernisation of
Govcnunent managed blood banks, and training of drugs inspectors and
blood bank technical personnel.
During the pendency of this writ petition, action has also been taken B
to revise the Rules governing the licensing and operation of the blood banks
and by the Drugs and Cosmetics (First Amendment) Rules, 1982 published
in the Gazette of India vide notification dated January 22, 1993. Part X-B has
been inserted in the Rules and Part XIl-B has been substituted. In part X-B
(Rules 122-F to 122-f) provisions have been made prescribing the require- c
ments for collection, storage. processing and distribution of whole human .
blood, human blood components by blood banks and manufacture of blood ·
pro<lu·cts and for grant and for renewal of licence for the operation of a blood
bank/processing of human blood for components/manufacture blood prod-
ucts. Under the said provisions licence can only be granted/renewed with the
approval of the Central Licence approving Authority viz. the Drugs Control-
ler of India. Part XII-B contains provisions relating to space equipment and
supplies required for a Blood Bank.
During the course of the hearing of this petition. the petitioner submit-
ted a draft scheme and a scheme was also submitted by the Union of India. E
In the affidavit filed by Dr. Shiv Lal, Addi. Director, National Aids Control
Organisation, alor.g with the scheme, it was stated that the Central Council
of Health, in which the State Health ministers are members, is the highest
Forum for Policy frame work and that the said Council has given guidelines
in respect of Blood Bank and Transfusion Service and its recommendations
are as under : F
"Blood being a vital input in the present day medicare services
the acute shortage of which is hampering the effectiveness of our
services the joint Conference reco1nmends that urgent steps should
be taken by the State/Union Territories Governments and the Central
Government. -
G
1. To build up adequate blood banking services al State/District
level including provision of trained/qualified man power. Necessary
action should be initiated in right earnest for achieving the objective
in view. H
98 SUPREME COURT REPORTS [1996] I S.C.R.
A 2. To educate and motivate people about blood donation on a
voluntary basis. '
3. To provide adequate encouragement to voluntary donors.
4. To enforce quality control of blood in all its facets of collection,
B distribution and storage."
. In the said affidavit it was also stated ·that although the World Health
Organisation has prescribed that nearly 40 lakhs units of blood is required
for the country, the collection is only 19.5 lakhs units at present and, •
therefore, it is not possible to ban professional donors at this st.age unless the
C donations of blood by way of voluntary donation are increased. Jn the said
affidavit it was further stated that most of the Government Blood Banks are
lacking in man power, training and laboratory facilities to test blood for
blood transmissible diseases and to augment this, the Central_ Government
has provided funds to various State Government during 1990-91 and· 1991-
D 92 to modernise the Government Blood Banks. According to the said .>
affidavit, the main objective for the modernisation of the Blood Banks have
bee~ provided into long term objectives and medium terms objectives as
under :
"I. Long tenn objectives :
E
(a) Make available high quality blood and blood components in
adequate quantity to all users.
(b) Ensure wide usage of blood components.
(c) Expand voluntary and replacement donor base, so as to phase
F
out professional blood donors.
II. Medium tenn o~jectives :
(a) To provide minimum possible facilities for blood collections,
storage and testing in all government Blood Banks.
G
(b) To make available the trained man-power in all government
. Blood banks.
(c) To ensure the awareness of clinicians and Blood Banks staff on
the advaniages of blood components.
H
COMMON CAUSE"· U.0.1. [AGRAWAL, J.] 99
(d) To ensure Lhe effective geographical coverage keeping in mind A
the different volumes of blood requirement in different cities.
(e) To increase public awareness about the risks in using blood from
co1nn1crcial Blood Banks and professional donors and the
harmlessness of blood donation."
B
On a perusal of the Draft scheme that was submitted by the petitioner
• .and the draft scheme submitted by the Union of India, it was felt that it would
facilitate matters if the question of necessary steps which may be required for
further strengthening the existing fra1ne-work about licensing of blood banks
and obtaining blood donations is <>Xamined by a Committee which would
place its suggestions before the Court for consideration. By order dated l lth
c
February, 1994 a Committee of the following persons was constituted to
exa1nine the matter and submit its report :
l. Additional Secretary. Ministry of Health holding the charge of
Director, National Aids Control Organisation as Chairman. D
2. Drugs Controller of India.
3. Mr. H.D. Shourie.
The said Committee felt that since Indian Red Cross Society is presently
involved to a considerable extent in blood banking operations and it has
E
branches, spread all over the country and it has capacity to further strengthen
itselffor looking after the various aspects of functioning of blood banks, it
> may be recognised as a nodal agency in the field of blood banking and blood
transfusion technology in the country. The Committee suggested that
detailed discussions to finalise assessment in this regard may be held with F
the Indian Red Cross Society. Having regard to the said suggestions by the
Committee constituted by the Court, the Indian Red Cross Society consti-
tuted a committee of experts to examine the matter and to prepare a draft
blue print. The said corrunittee of experts in this report dated April 15, 1995
has indicated the following fields in which measures are required to be taken:
G
"l. Building a powerful voluntary blood donation moven1ent to
augment supplies of safe qualit}'_l:lood and blood components.
2. Exercising economy by processing whole blood for blood
components.
H
100 SUPREME COURT REPORTS [1996] 1 S.C.R.
A 3. lrUroducing screening procedure to mini1nize the danger of trans-
missible diseases like AIDS, Hepatitis etc.
4. Standardize technological procedures for rigid enforcement of
quality control, and good manufacturing practices.
B '5. Providing technical services -for raising- the standard of Blood
centre operations and assistance for admini~trative, motivational and
technical problems encountered."
It has proposed an action plan.in three parts : Immedi3te Plan, short Term Plan •
and Long Term Plan, which are as follows :
c
"/m1nediate Plan
l. To establish an administrative unit at the national headquarters
under the charge of a prcjecl director.
2. To identify and strengthen a minimum of 2 Red Cross blood
D
centres for each state for augrnenting the existing blood prograrrunc.
Necessary inputs towards staff, equipment and consumables for the
developn1ent should be made available at once. Basic requirements
to procure accreditation from DC(!) should be eosured.
E 3. Donor recruitment and intensification of donor _motiva:ion drive
may be taken up on priority basis. Involvement of media may be
ensured through Information and Broadcasting Ministry.
4. A crash programme for short term training of medical officers,
technicians and medical social workers nurses of concerned centres
F may be undertaken. This distance learning programme prepared by
the WHO may be helpful in updating the knowledge of technologists
at the centres being strengthened.
5. In addition to the blood centre strengthening programme, steps
may be taken for planning and initiating action for the establishment
G of Regional blood centres at the following 16 metropolitan cities
with 2 million population having many large medical superspeciality
institutions.
I. Delhi 9. Bhopal
H 2. Luckanow 10. Ahmedabad
COMMON CAUSE v. U.0.1. [AGRAWAL, J.] 101
J. 3. Patna 11. Bombay A
4. Calcutta l2. Hyderabad
5. Ganhati 13. Bangalore
6. Cuttack 14. Trivandrum
7. Nagpur 15. Madras
8. Jaipur 16. Chandigarh B
Each centre will be expected to collect 150 to 200,000 units
annually. These will be screened processed and distributed as blood
components to local hospital based centres against service charges.
As the regional centres will Stipplement the blood supplies through
the existing systems it would help in weeding out the blood supply
c
from paid blood sellers. Therefore it is of paramount importance that
top priority is given for the establishment of these centres.
Short Term Plan :
D
I. C~ordination of the blood programme of large medico[ colleges
havmg more than 1000 beds and or collecting over 10,000 units.
2. Establishment of post graduate training centres at places where
facilities for fulfilling the norms of the Medical Council of India
exist. In the initjal stages Faculty support can he obtained from E
departments of pathology. At the following cities post graduate
training can be started
i I. Chandigarh 6. Bombay
2. Delhi 7. Hyderabad
F
3. Lucknow 8. Bangalore
4. Calcutta 9. Trivendrum
5. Jaipur 10. Madras
Training of paramedical workers can also be undertaken at these
cer.tres. G
-ti
3. Coordination of all other voluntary organisations working for the
promotion of the blood programme by the Red Cross society would
further help in achieving the target of donor. recruitment with greater
vigour and better evaluation.
H
I
,---{
102 SUPREME COURT REPORTS [1996] l.S.C.R.
A 4. A national workshop at the Red Cross headquarters may be
organised for officers of all centres being strengthened and the
representatives of regional centres to provide necessary guidance for
uniform and standardised policies and practices.
WllR Term Plan :
B
1. To upgrade all other blood centres.
2. Establishment and upgradation of blood centres in areas where it
does not exist.
3. Planning of more regional centres.
c
4. Establishing fractionation centres.
5. Establishment of therapeutic centres for blood related disorders.
6. Prograrrunes for indegenisation of equipped software and reagents.
D 7. Establishment of tissue typing facilities for Bone Marrow and
organ transplant." •
After considering the said report of the Committee of experts set up by the
Indian Red Cross Society, the Committee constituted by the Court submitted
its final report which was filed along with the affidavit of Shri Ashwani
E Kumar, Deputy Drugs Controller of India in the Directorate General of Health
Services dated October 26, I995. The Committee has made the following
recommendations and has suggested steps for revamping the system of blood
banks in the country in the form of plans for implementation on immediate
basis and for long term implementation. '
F FOR IMMEDIATE IMPLEMENTATION:
(i) A National Council on Blood Transfusion should be established.
It should consist of Director General of health services. Drug
Cohtroller of India, representative of Ministry of Finance, high-level
representatives of Indian Red c:ross Society and selected five major
G medical and health institutions of the country, and three eminent
citizens, presided over by the Additional Secretary of the Ministry
of Health who is incharge of operations of the programme of
National Aids Control Organisation. The Council should be provided
the basic secretariat under charge of a Director by the Ministry of
H Health and be located in suitable premises at Delhi for effective
COMMON CAUSE v. U.O.!. [AGRAWAL, J.] 103
functioning. A
It would be desirable to register the Council as a Society under
the Societies Registration Act for enabling it to have its own
identity and funds and also for enabling it to raise funds from
various sources including contributions fron1 trade, industry and
individuals. The basic require1nents of its functioning should be B
provided by the Ministry of. Health. The Council will be policy
formulating body in relation to all matters pertaining to operation
of blood banks.
(ii) The Ministry of Health, with the assistance of National Council,
will ensure the establishment of State Level councils, at suitable
c
centres preferably head-quartered at the premises of some outstanding
medical institutions or hospitals. The State Councils should have on
them representatives of important medical institutions of the State,
selected representatives of blood banks of repute, a representative of
Red Cross, and should include the State Director of Health Services D
as well as State Drug Controller operating under a designated
Director and presided over preferably by the State Government
Secretary incharge of health. A representative of the State Ministry
of finance should also preferably be on the Council. The size of
State Council should preferably be restricted to the maximum of E
about 11 members. The Director of Health Services should provide
the Committee the basic essentials of secretariat and funds for its
functioning. The State Councils, as in the case of National Council,
> should be registered as Society under the Societies Registration Act
for maintaining their identity and for purposes of collection of funds
in the shape of contributions from individual and corporate bodies. F
The State Councils should endeavour to operate on the basis of
policies formulated by the National Council, effectively imple-
menting the policies and programmes formulated ,by them.
(iii) Programmes and activities of the National Council and State
G
Councils should cover the entire range of services related l? operation
and requirements of blood banks including the launching of effective
motivation campaigns through utilisation of all media for stimulating
voluntary blood donations, launching programmes of blood donation
in educational institutions, among the labour, industry and trade,
establishments and organisations of various services including civic H
104 SUPREME COURT REPORTS [1996] ! S.C.R.
A bcdies. training of personnel in relation to all operatior.s of blood
collection., storage and utilisation transport, quality control an<l
archiv1ng systein, cruss-1natcb:ng of blood bel'Nccn donors and
recipi~nts, separation and storage of con1ponent of blood. and all the
basis essentials of the operations of blood banking.
B LONG TERM OBJECTIVES:
(i) The programme formulation at the national level and State levels .\
should take into account the requirements of laying down targets for
achievemen~ ii;cluding the establishment of appropriately designed
and equipped blood bar.ks. ensuring that all blood banks are
c licensed, 1naking satisfactory arrangements for collection and storage
of collected blood, fractionalisation of blood into the components,
Special emphasis 'A jll need to be laid in the programme on the
1
attainment of prescrib~d targets of organising camps for voluntary
collection of blood through motivatioPal campaigns and utilisation
D of the media. 1l1e State Ccuncils shall sebmit their progra\l)mes and )
targets to the Nationai Council and thereafter continue to submit •
quarterly reports to the Central Council about the tulfilment of the
targets relating to the programmes.
(ii) The National Council and State Councils should launch effective
E programmes and organise campaigns for collecting funds for
implementation of their programmes, suplementing the funds allotted
to them respectively by the Government of India and the State
Governme.nts. For the purpose of facilitating the collection of funds
for blood banking purposes the Government of India in the Ministry
F of Finance should, at the earliest, be approached by the Ministry of
Health to.secure special dispensation u/s 35 of the Income Tax Act,
making it possible to grant exemption of 100 per cent basis to the
donations given to registered and authorised National Council and
State Councils. The fulfilment of this objective should be specifically
reported by the Ministry of Health to the Hon'ble Supreme Court.
G The National Council and State Councils should also utilise
opportunities which may be available for securing financial sanction
and other support to their blood banking programmes from
International sources and other donor agencies.
H (iii) The Ministry of Health should follow up the recommendations
(
COMMON CAUSE v. U.0.1. [AGRAWAL, J.J 105
made by the Expert committee set up by the Indian Red Cross A
Society to start M.D. Course in blood transfusion technology, and
to also undertake the preparation of comprehensive programme for
training of personnel operating in relation to various aspects of
functioning of blood bar.ks, storage of blood, fractiona!isalion of
b!ood, and transfusion of blood.
B
(iv) The System of licensing of blood banks will oc strengthened
to ensure that all quality banks operating in the country are
'y
equipped with licenses within a period of aot n1ore thar. one year.
Whether any blood banks remain ill-equipped for being licensed,
and remain unlicensed aft.er the expiry of the period of one year, C
their operations shou~d be rendered i1npossible through suitabl~
action under appropriate legislation. It shall be a policy objective
of the Ministry of Health as well as the National Council and the
State Councils established on the basis of these recommendations
that the prevalent systen1 of professional donors is discouraged
D
.• through utilisation of all appropriate media, through withdrawal of
licenses where any such blood bank has been licensed, and by
launching prosecutions under the appropriate provisions of law. The
objective of total elimination of professional donors should be
achieved !n at period of not more than two years through utilisation
of all requisite measures. For attainment of objectives & programmes E
of the local organisations, the State Govt. will be approached for
providing the requisite Inspectorate for continuing inspection of
blood banks."
,
The Comn1ittee has taken note of the prograrnme for preventing
infection and strengthening of Blood Banking system in the country that is F
being implemented by the National Aids Control Organisation, which. is
annexed as Annexure - I to the report of the Committee.
The Indian Association of Blood Banks has been impleaded as a party
in these proceedings and an affidavit of Dr. V. B. Lal, President of the said
association, has been filed.
G
We have heard Shri H.D. Shourie, the petitioner in person. Shri A.S.
Nambiar, the learned Senior Counsel for the Union of India, Shri P.P Rao,
learned Senior Counsel for the Indian Association of Blood Banks Dr. V.
Gauri Shankar, learned Senior Counsel for the Indian Red Cross Society and If
106 SUPREME COURT REPORTS [1996] 1 S.C.R.
A the learned counsel appearing for the States. Keeping in view the report of
the Committee that has been constituted by this Court and the report of the
Corrunittee of Experts set up by the Indian Red Cross Society and the
programme that is being implemented by the National Aids Control Organi-
sation as well as the submissions of the learned counsel, \Ve are of the view
that suitable action should be taken by the Union Government as well as
B
the Governments of the States and the Union Territories Administration in
accordance with the plan .for Immediate implementation as well as the plan
for Long Term implementation suggested. by the Committee constituted by )
this Court.
C It is no doubt true that after the report of Mis. A.F. Ferguson & Co.
the Union Govern1nent has taken certain steps towards improving the state
of affairs regarding the blood banks in the country and the National Aids
Control organisation is also working in this field. But a lot more is required
to done as would be evident from the reports to the Committee constituted
by this Court and the Committee of Experts appointed by the Indian Red
D Cross Society. The Committee constituted by this Court has made concrete
suggestions in this regard. We are in agreen1ent with the recomme!1dations of
the said committee that the entire range of schemes related to operation and
requirements of blood banks including the launching of effective motivation
campaigns for stimulating voluntary blood donations, launching programmes
E of blood donations training of personnel in relation to all operations of blood
banking should be entrusted to an autonomous representative body at the
national level which may be called the National Council on Blood Transfu-
sion, as suggested by the Committee. The National Council would exercise
the functions entrusted to it in coordination with similar bodies established
at State level which may be called State Councils. In order that they may
F have their own individuality and funds and are able to raise funds from
various sources including of contributions from trade, industry and individu- ·
als the National Council and the State Councils should be constituted as
socielies registered under the Societies Registration Act. The National Coun-
cil and the State Councils should undertake the measures suggested by the
G Committee constituted by the Court as well as the Committee of expeits
appointed by the Indian Red Cross Society and while doing so they should
coordinate their activities with those of the National Aids Control Organi- •
sation and other agencies in this field. Keeping in view the potentialities of
the harm in the prevailing state of affairs and the need for speedy action in
H this regard, we consider it appropriate to give the following directions ;
COMMON CAUSE v. U.O.!. [AGRAWAL, J.] 107
l. The Union Governmenl shall take steps to establish forthwith a A
)
National Council of Blood Transfusion as a society registered under the
Societies Registration Act. It would be a representative body having in it
representation fro111 the Directorate General of Health Services of the Govern-
ment of India, the Drug Controller of India, Ministry of Finance in the
Government of India, Indian Red Cross Society, private blood banks includ-
B
ing the Indian Association of the Blood Banks, major medical and health
institutions of the country and non-Govf'..rnment prgaitisations active in the
field of securing voluntary blood donations. In order to ensure coordination
with the activities of the National Aids Control Organisation, the Additional
Secretary in the Ministry of Health, who is incharge of the operations of the
programme of National Aids, Control Organisation for strengthening the C
blood. banking system could be the President of the National Council.
2. The National Council shall have a secretariat at Delhi under the
charge of a Director.
3. The basic requirements of the funds for the functioning of the D.
National Council shall be provided by the Government of India but the
National Council shall be empowered to raise funds from various other
sources including contributions fro1n trade, industry and individuals.
4. In consultation with the National Council, the Stale Govenunents/
Union Territory administration shall establish a State Council in each State/ E
Union Territory which shall be registered as a society under the Societies
Registration Act. The State Council should be a representative body having
in it representation from Directorate of Health Services in the State, State
, Drug Controller, Department of Finance of· the State Government/Union
Territory Administration, important medical institutions in the State/Union F
Territory, Indian Red Cross Society, private blood banks, Non-Governmental
Organisations active in the field of securing voluntary blood donations. The
Secretary to the Government in charge of the Department of Health could be
the President of the State Council.
5. The State Council should have its headquarters at the premises of G
the premier medical institution or hospital in the State/Union Territory and
should function under the charge of a Director.
6. The funds for the State Council shall be provided by the Union of
India as well as the State Government/Union'. Territory Administration.~ Th.e
H
108 SUPREME COURT REPORTS [1996] 1 S.C.R.
A State Council shall also be empowered to collect funds in shape of contri-
butions from trade, industry and individuals.
7. The programmes and activities of the National Council and the State
Councils shall cover the entire range of services related to operation and
requirements of blood banks including the launching of effective motivation
B campaigns through utilisation of all media for stimulating voluntary blood
donations, launching progranunes of blood donation in educational institu-
tions, among the labour, industry and trade, establishments and organisations
of various services including civic bodies, training of personriel in relation
to all operations of blood collection. storage and utilisation, ~eparation of
C blood groups, proper labelling, prnper storage and transport, quality control
and archiving system, cross-matching of blood between donors and recipi-
ents, separation and storage of components of blood, and all the basic
essentials of the operations of blood banking.
8. The National Council shall undertake training programmes for
D training of technical personnel in various fields connected with the operation
of blood banks. ~ ;-
9. The National Council shall establish an institution for conducting
research in c91lection, processing, storage, distribution and transfusion of
whole human blood and human blood components, manufacture of blood
E products and other allied fields.
10. The National Council shall take steps for starting special post-
graduate courses in blood c.ollection, processing, storage and transfusion and
allied fields in various medical colleges and institutions in the country. •
F I l. In order to facilitate the collection of funds for the National
Council and the State Councils, the Government of India (Ministry of Health
and Ministry of Finance) should rind out ways and means to secure grant of
1OOo/o exemption from income tax to the donor in respect of donations made
to the National Council and the State Councils.
G
12. The Union Government and the Governments of the States and
Union Territories shoul_d ensure that wi_thin a period of not more than one
year all blood banks operating in the country are duly licensed and if a blood
bank is found ill equipped for being licensed, and remains unlicensed after
the expiry of the period of one year, its operations should be rendered
H impossible through suitable legal action.
COMMON CAUSE I'. U.0.1. [AGRAWAL, J.] 109
13. The Union Government and the Governments of the States and A
Union Te1ritories shall take steps to discourage the prevalent system of
professional donors so that the system of professional donors is completely
eliminated \Vithin a period of not moie than two years.
14. The existing machinery for the enforcement of the provisions of the
Act and the Rules shotild be strengthened and suitable action be taken in that R
regard on the basis of the Scheme submitted by the Drugs Controller (I) to
the Union Governn1ent for upgradation of the Drugs Control Organisation in
the Centre and the States (Annexure - II to the affidavit of Shri R.
Narayansawami, Assistant Drug Controller, dated September 16, 1994.)
15. Necessary steps be taken to ensure that Drugs Inspectors· duly
c
trained in blood banking operations are posted in adequate numbers so as to
ensure periodical checking of the operations of the blood banks throughout
the country.
16. The Union Government should consider the advisability of enact-· D
ing a separate legisl~tion for regulating the collection, processing, storage,
• distribution and transportation of blood and the operation of the blood banks
in the ,country.
17. The Director Qeneral of Health Services in the Government of India,
Ministry of Health shall submit a report by July 15, 1996 about the action E
taken in pursuance of these directions.
18. It will be open to the Director General of Health Services, Govern-
ment of India as well as the National Council to seek clarification/modifica-
tion of these directions or further directions in this rnatter.
F
. The writ" petition is dispo~ed with these directions. No order as to c9sts.
P.C. Petition disposed of.
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