1. NAT as part of routine tests ? I disagree ! Dr Anjali Arun Mysore

2. Intelligent use of blood Any transfusion has risks The safest blood is the one which is not transfused.

3. Reducing the Risk of Infection Donor history -deferral Donor examination Testing Diversion Leukoreduction Component inspection Post donation information Donor deferral registries Limit exposures Hemovigilance

5. What is the best test for HIV, HBV & HCV ? Undoubtedly Nucleic Acid Testing ( NAT)

6. Stakeholders Blood banks : Government/trust/private/corporate/stand alone/hospital based,etc Policy makers : health ministry,planners, economists, bureaucrats, Implementers: drug control dept Patients, blood donors

7. Aspects Technical Legal Logistic Financial

8. Limitations Fragmented blood bank system Repeat voluntary donor mass is less Variable volumes in each centre Infrastructure Health care cost burden: insurance / individual /government (BPL/co-operatives, TPA, CGHS, ESI,etc)

9. Blood banks: Government /trust / private / corporate / stand alone / hospital based Technical : pooled or single donor, which equipment, work load, TATs, Legal: not yet mandatory Logistic : convince management; recruit train and retain staff or out source,attitudes** Financial : rising cost of components, budgetary constraints

10. Policy makers Technical : centralized Vs decentralized Legal : StateVs Central Logistic : talent pool availability, training, location, Financial : Equitable distribution of funds, Priorities related to health care and prevention of

11. Implementers: drug control dept Technical : knowledge pool, training Legal : present framework Logistic : training their staff, numbers Financial : rules regarding charges for components.

12. Patients, blood donors Technical : want and should get the best Legal : right if made mandatory Logistic……… Financial : market rates for components ?

13. Best case scenario NAT is legally mandatory Blood banking is cohesive Training is done Logistics is arranged Funding is arranged We are all doing NAT for every unit collected

14. outcome Window period reduced not eliminated Cost will rise Other measures needed

17. Blood Safety is a journey, ……………………………. Thank You ! Declaration : Conflict of interest : none