‘Right To Safe Blood’: Supreme Court Seeks Cost, Access Details On Mandatory NAT Testing In Govt Hospitals

The Court was hearing a Public Interest Litigation (PIL) that seeks nationwide mandatory implementation of NAT in all blood banks to prevent Transfusion Transmitted Infections (TTIs) such as HIV and hepatitis.

The bench of Chief Justice Surya Kant, Justices Joymalya Bagchi and Vipul M. Pancholi asked Advocate A. Velan, appearing for the petitioner Sarvesham Mangalam Foundation, to provide specifics on the financial implications of implementing NAT across India and whether government facilities are adequately equipped to offer the test, particularly for economically weaker patients.

The matter is scheduled for further hearing on March 13.

The Delhi-based NGO has made the Union Ministry of Health and Family Welfare, along with all States and Union Territories, parties to the petition. At the heart of the plea is a constitutional question: whether the “Right to Safe Blood” is an intrinsic facet of the Right to Life under Article 21 of the Constitution.

The petition urges the Court to direct the Centre and States to make NAT testing mandatory in all blood banks for detecting TTIs, including HIV, Hepatitis B (HBV), Hepatitis C (HCV), malaria, and syphilis. NAT is a molecular diagnostic technique widely regarded as the gold standard for blood screening because it significantly reduces the diagnostic “window period” during which infections may go undetected.

According to the plea, while traditional screening methods like ELISA and rapid card tests remain in widespread use, they detect only antibodies and have a window period of 55–60 days. In contrast, NAT can reduce that period to 7–10 days, thereby sharply lowering the risk of infected blood entering the transfusion chain. Despite its proven efficacy, NAT implementation remains sporadic and non-mandatory across India.

The petition highlights a series of recent incidents described as “preventable tragedies.” In 2025, at least six thalassemic children reportedly tested HIV-positive after receiving transfusions at Satna District Hospital in Madhya Pradesh. In Jharkhand, five children were allegedly infected with HIV following transfusions at Sadar Hospital in Chaibasa. In 2023, 14 children in Uttar Pradesh contracted hepatitis and HIV after transfusions at a medical college, the plea states.

The petition emphasizes that India is often described as the “thalassemia capital of the world.” Thalassemia, an inherited blood disorder, requires patients to undergo transfusions every 15 to 20 days for survival. The disorder impairs the body’s ability to produce sufficient haemoglobin, the protein in red blood cells that carries oxygen. For thousands of such patients, the petition argues, blood transfusions have become a “gamble with death.”

Citing the landmark judgment in Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996) 4 SCC 37, the petitioner contends that financial constraints cannot excuse the State from its constitutional obligation to provide adequate medical care. The plea argues that failure to implement NAT solely due to cost considerations constitutes a grave breach of Article 21.

The petition also references orders from various High Courts. The Rajasthan High Court recently noted that NAT was not mandatory in all blood banks in the State and was available at only two centres, directing improvements in staffing and infrastructure. Similarly, the Odisha High Court directed the State to operationalize NAT-PCR facilities in 45 blood collection centres by March 2025.

Despite existing regulatory frameworks under the Drugs and Cosmetics Act, 1940, the National Blood Policy, and NACO guidelines, the petitioner alleges weak enforcement and fragmented practices in blood screening. The continued reliance on outdated testing methods, it argues, reflects a systemic failure that prioritizes cost over patient safety.

Terming the issue one of “national importance,” the foundation has sought the Court’s urgent intervention to declare safe blood a fundamental right and to establish uniform, mandatory NAT testing standards across India.