On Wednesday, the Supreme Court of India sought detailed information from a public interest litigant pressing for nationwide implementation of Nucleic Acid Amplification Testing, or NAT, in all blood banks. The bench, led by Chief Justice Surya Kant and joined by Justices Joymalya Bagchi and Vipul M. Pancholi, asked pointed questions: How much would such testing cost? And is it available in government hospitals, particularly for poor patients?
The petition, filed by the Delhi-based organization Sarvesham Mangalam Foundation, frames the issue in constitutional terms. It asks the court to declare that the “Right to Safe Blood” is an intrinsic part of the right to life under Article 21 of the Constitution.
At stake is whether the state’s obligation to protect life includes mandating more advanced screening for donated blood — a measure that advocates say could significantly reduce transfusion-related infections.
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What NAT Does — and Why It Matters
Nucleic Acid Amplification Testing is considered one of the most sensitive methods available for detecting viral infections in blood donations. Unlike conventional serological tests, which detect antibodies or antigens that appear days or weeks after infection, NAT identifies viral genetic material itself. This shortens the “window period” during which infections like HIV, hepatitis B and hepatitis C might go undetected.
The petitioner’s plea argues that without NAT, patients remain vulnerable to transfusion-transmissible infections, or TTIs, including HIV, hepatitis B, hepatitis C, malaria and syphilis. The foundation contends that the current system represents a “systemic and ongoing failure” to adequately protect recipients of blood transfusions.
Among the most vulnerable, advocates say, are patients with thalassemia — a genetic blood disorder that requires transfusions every 15 to 20 days. For these patients, repeated exposure to blood products magnifies the risk of infection.
Public health experts have long debated whether NAT should be mandatory across India. While some private hospitals and advanced urban centers use the technology, its adoption in government-run facilities remains uneven.
The Cost Question
The court’s questions suggest that feasibility may be as central to the case as principle.
Mandating NAT nationwide would require significant investment in equipment, trained personnel and quality control mechanisms. Each NAT test costs more than conventional screening methods, and scaling the system across thousands of blood banks could substantially increase operational expenses.
The bench asked the petitioner’s counsel, A. Velan, to provide concrete figures on the financial implications of implementing NAT and to clarify whether government hospitals currently possess the necessary infrastructure. The court’s inquiry reflects an underlying concern: how to reconcile technological advancement with equitable access.
Health policy analysts note that introducing NAT in government facilities could reduce long-term healthcare costs associated with treating transfusion-related infections. However, they caution that the upfront expenditure would be considerable and would require coordinated implementation across states and union territories.
The Union Ministry of Health and Family Welfare, along with all state governments and union territories, have been made parties to the petition, indicating that any directive could have nationwide ramifications.
A Broader Public Health Reckoning
The case arrives at a time when the judiciary has increasingly engaged with questions of healthcare access and constitutional rights. In previous rulings, the Supreme Court has expanded the interpretation of Article 21 to include various aspects of health and dignity.
By framing safe blood as a constitutional entitlement, the petition seeks to shift blood safety from a matter of policy discretion to one of fundamental rights.
At the same time, the issue touches on longstanding disparities in India’s healthcare system. While metropolitan hospitals may adopt cutting-edge screening technologies, many district-level facilities struggle with basic infrastructure. Public health experts argue that strengthening blood safety must be accompanied by broader systemic improvements, including donor screening, quality assurance and centralized monitoring.
For now, the court has not issued any directive. Instead, it has asked for data — a sign that it is weighing the practical and financial dimensions of what could become a landmark decision.
As the matter proceeds, the central question remains: how far does the state’s duty to protect life extend in an era of evolving medical technology — and at what cost?
About the author — Suvedita Nath is a science student with a growing interest in cybercrime and digital safety. She writes on online activity, cyber threats, and technology-driven risks. Her work focuses on clarity, accuracy, and public awareness.
