Coronavirus pandemic

India sees growing black market for plasma from recovered patients

A technician opening a deep freezer containing bags of blood plasma at India's state-run Institute of Liver and Biliary Sciences (ILBS) in Delhi. PHOTO: BLOOMBERG
A donor at the newly inaugurated plasma bank at the ILBS. Healthy donors can donate plasma after 14 days of recovery if they do not show any symptoms of Covid-19 and if they have the required level of antibodies. PHOTO: REUTERS

When Mr Adwitiya Mal's father-in-law was diagnosed with Covid-19 at a hospital in Delhi, doctors advised plasma therapy, given his worsening condition.

A "roller coaster of emotions" ensued for the family as they began a search for a potential donor. Social media circles as well as networks of friends and relatives were activated.

Two women came forward, but were ineligible as they had conceived earlier; women develop antibodies during pregnancy that raise the risk of a rare but potentially fatal transfusion reaction leading to lung damage in the plasma recipient.

Another person, who flatly asked for 30,000 rupees (S$556), never showed up.

Mr Mal's family was fortunate: a man who had offered to donate his plasma earlier turned out to be a successful match.

But for many other families in India desperate for anything that could save their loved ones, offering money is the only way to access blood plasma. Prices can range from 20,000 to around 300,000 rupees per donation, with a higher premium for rarer blood groups.

In plasma therapy for Covid-19 - which remains in a trial stage - a patient who has recovered from and has antibodies against the virus provides blood plasma to patients with the same blood group, to help speed up the latter's recovery.

Potential healthy donors can donate plasma after 14 days of recovery if they do not show any symptoms of Covid-19 and if they have the required level of antibodies.

Nearly two-thirds of India's current tally of over a million cases have recovered, but a lack of willing donors and a late start to set up authorised plasma banking centres have led to a flourishing black market for this "liquid gold".

Mr Akhil Ennamsetty, a lawyer from Warangal in Telangana who has donated plasma twice, set up an online group last month to help connect plasma donors and seekers. He has encountered several middlemen representing families.

"They offer to pay money for any potential donor. The amount varies based on various factors like demand and rareness of a particular blood group," he told The Straits Times. "Many genuine donors I have been touch with have also said they are getting direct calls from these middlemen."

This black market exists in spite of legal provisions in India that proscribe such practices. A 1996 order from the Supreme Court outlaws paid donors and unlicensed blood banks. The National Blood Policy, drafted in 2007, also prohibits the sale and trade of blood.

Dhoond, an online initiative that Mr Mal co-founded in June to link donors and recipients, has a database of around 300 donors. But it has 10 seekers for every one donor on its platform. This dearth, he said, was because many recovered patients were too weak to donate.

"Not only are they weak physically, they are also traumatised mentally. They have come back from the jaws of death and are being asked to again return to a potentially high-risk area, a hospital, to donate," he told The Straits Times.

"There are some who believe that they would rather save their antibodies for a family member than someone unknown," he added.

Dhoond has blacklisted two donors so far for asking money from recipient families.

Since the country's first plasma bank came up in Delhi on July 2, various state governments have set up similar banks to regulate the donation of blood plasma.

The Delhi government opened its second plasma bank last Tuesday at the Lok Nayak Jai Prakash Narayan Hospital, which is the city's biggest government facility dedicated to Covid-19 patients.

Dr Suresh Kumar, the medical director of the hospital, said it managed to draw in 11 donors in its first two days of operation.

"If we contact 10 patients, one or two are ready to donate. People have the misconception that donating plasma can cause injury or weakness," he said.

A petition was filed this month in the Delhi High Court seeking the creation of a statutory body to make it mandatory for hospitals to obtain plasma from their patients who recover subsequently.

Besides positive incentives, recommendations to bring in more donors include making the process of donating safer and easier. "One way to do this would be to set up plasma donation centres that are independent of hospitals, to reduce the fear of exposure to a potential second coronavirus infection," said Mr Ennamsetty.

Recent research has shown that people who have recovered from Covid-19 may lose their immunity to the disease within a few months, leaving them vulnerable to becoming reinfected.

Join ST's Telegram channel and get the latest breaking news delivered to you.

A version of this article appeared in the print edition of The Straits Times on July 20, 2020, with the headline India sees growing black market for plasma from recovered patients. Subscribe