Explained: Constitutionality of Blood Donation Guidelines in India

In Health, Legal
August 14, 2025
Jatinder Kaur
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Blood Donation Constitutionality in India is now before the Supreme Court in Santa Khurai. This plain-language explainer shows why identity-based donor bans likely fail Articles 14/15/21—and how behaviour-based screening plus modern tests can keep recipients safe, protect dignity, and align with the HIV and Transgender Acts.

New Delhi(ABC Live): The Constitutionality of the Blood Donation Guidelines in India is under direct scrutiny after the 2017 rules permanently excluded some groups by identity. Because this constitutionality question goes to equality, privacy, and safety, it affects donors, recipients, and regulators alike [7][11][15][16][17]. In short, the Constitutionality of Blood Donation Guidelines in India is about whether we can keep blood safe and treat people fairly.

Why the Constitutionality of Blood Donation Guidelines in India Matters

India needs about 14.6 million blood units each year. So, we must keep blood safe while also avoiding discrimination [22]. Today, fourth-generation assays and NAT detect infections much earlier and lower residual risk. Thus, blanket bans by identity look harder to defend when neutral questions and better tests can manage risk [24][26][28].

Legal Framework for the Constitutionality of Blood Donation Guidelines in India

Statutes that shape donor rules (simple view)

Drugs & Cosmetics Rules (Schedule F, Part XII-B): Set standards for blood centres; the 2017 guidelines sit inside this system [4].
HIV & AIDS (P&C) Act, 2017: Bans discrimination; protects privacy and consent [1].
Transgender Persons (Protection of Rights) Act, 2019: Forbids discrimination in healthcare [2].

Constitutional rights & leading cases

Articles 14 & 15 (equality and non-discrimination): Navtej protects sexual orientation; NALSA protects gender identity [15][16].
Article 21 (privacy, dignity, health): Puttaswamy requires proportionality—the tool must be needed, narrow, and balanced [17][18].

The impugned policy (what is being reviewed)

The 2017 NBTC/NACO Guidelines treat some people as always at risk, via Clauses 12 and 51. In short, they rely on who you are rather than what you did, which is the core constitutional problem [7].

Case focus driving the constitutionality review

Thangjam Santa Singh @ “Santa Khurai” v. Union of India (WP(C) 275/2021)

Forum: Supreme Court; status: pending [11].
What the Court said (May 2025): Do not brand an entire community as risky; take expert help and remove discrimination without hurting safety [12][13].
What the petitioner seeks: End identity-based bans; use neutral, behaviour-based screening; follow the HIV Act and the Transgender Act [1][2][11].

Data for the constitutionality analysis

Key facts (epidemiology & capacity)

HIV in adults (15–49): ~0.20%; risk is higher in some key groups, but not all members of any group [19][20].
Annual demand: ~14.6 million units; narrow eligibility can worsen shortfalls [22][23].

Safety and testing (why methods matter)

Residual risk (per million donations): ~HIV 3.1, HCV 4.4, HBV 16.1 with serology alone; NAT reduces risk by ~69–96% depending on the virus [24][25][26].
Window periods: Fourth-gen tests + NAT shrink the window and improve detection [27][28].

Global practice (individual risk over identity)

UK (FAIR, 2021), Canada (2022), USA (2023/2025): All use behaviour-based questions for everyone and time-bound deferrals, including for PrEP/PEP [29][30][31][33][34][35][36][37][38][39][40][41].
Implication for India: When testing plus neutral questions achieve safety, identity bans are not the least-restrictive means—key to the Constitutionality of Blood Donation Guidelines in India [17][18][29][33][35].

Proportionality test applied to the guidelines

Legitimate aim: Keep the blood supply safe — Yes [4].
Rational link: Screening reduces risk — Yes, but identity ? uniform risk, which weakens the fit [12][13].
Least restrictive means: No. Neutral, behaviour-based questions plus modern tests manage risk without blanket identity bans [29][33][35].
Balance: Identity-wide bans hurt dignity and equality; thus, they fail Articles 14, 15, and 21 (Navtej, NALSA, Puttaswamy)—the heart of the Constitutionality of Blood Donation Guidelines in India [15][16][17].

Likely outcome for the Constitutionality of Blood Donation Guidelines in India

The Court will likely strike down or read down the identity-based parts of Clauses 12 and 51 [7][12][13][15][16][17].
The Court will likely keep neutral, behaviour-based, time-bound deferrals and strong testing [24][26][29][33][35].
The Union will likely rewrite the rules in line with the HIV Act and the Transgender Act [1][2].

What should change (clear steps)

Fix the text now: Remove identity-based lines in Clauses 12 & 51. Replace them with the same behaviour questions for all donors (recent partners, specific acts, recent STIs, needle sharing, PrEP/PEP timing, etc.) [7][35].
Protect privacy: Follow the HIV Act—take informed consent, keep data private, give clear counselling [1].
Strengthen testing: Keep serology; phase in more NAT; publish safety audits [24][26].
Train and track: Update e-RaktKosh forms and SOPs; train staff; open a grievance channel [21].
Until rules change: Do not refuse donors by identity; use neutral questions and respect privacy [1][7].

FAQs (quick answers)

Does this weaken safety?
No. Neutral questions plus modern tests keep safety high, as shown in the UK, Canada, and the USA [29][33][35].

What legal ideas decide this?
Proportionality and anti-stereotyping. The State must choose the narrowest tool that works (Puttaswamy, Navtej, NALSA) [15][16][17][18].

Why stress privacy?
People answer honestly when they feel safe. Privacy and consent—required by the HIV Act—improve truthful screening and safety [1][28].

Bottom line: Constitutionality of Blood Donation Guidelines in India

The Constitutionality of Blood Donation Guidelines in India turns on fit and fairness. Because identity-wide bans are overbroad, they are unlikely to survive Articles 14, 15, and 21. Therefore, the sound solution is behaviour-based screening for everyone, backed by modern testing and strong privacy—keeping, recipients safe and ending stigma.