What Happened
- The Union government defended before the Supreme Court its policy barring transgender persons, men who have sex with men (MSM), and female sex workers from donating blood, calling it a public health measure rather than discrimination.
- The Additional Solicitor General argued that the National Blood Policy is based on sourcing from "safe donor pools" and that HIV prevalence among these groups is 6 to 13 times higher than adult HIV prevalence, citing the Department of Health and Family Welfare Annual Report 2020-21.
- The government noted similar restrictions exist in most European countries for sexually active MSM, and that blood transfusion is a last resort for critically ill patients — hence risk of transfusion-transmitted infections (TTIs) must be eliminated.
- The bench was told the issue must be assessed from a public health perspective, not only from an individual rights perspective, keeping in mind India's diverse healthcare realities.
Static Topic Bridges
National Blood Policy and Transfusion-Transmitted Infections (TTIs)
India's National Blood Policy (2002) and the Drugs and Cosmetics Act regulate blood donation and transfusion safety. The National AIDS Control Organisation (NACO) oversees blood safety standards. A key concern is eliminating transfusion-transmitted infections, including HIV, Hepatitis B, and Hepatitis C. The policy categorises certain demographic groups as "high-risk" based on epidemiological data and defers them from voluntary blood donation.
- National Blood Policy 2002 aims to achieve 100% voluntary blood donation and eliminate paid/professional donation
- Blood Transfusion Council at the national level provides policy guidance; State Blood Transfusion Councils implement
- Window period problem: standard blood screening tests may miss newly acquired infections — hence high-risk deferral policies add an extra safety layer
- NACO's Annual Report data shows HIV prevalence significantly higher among MSM, transgender persons, and female sex workers compared to the general adult population
Connection to this news: The government's affidavit directly cites NACO's epidemiological data to justify risk-based deferral, framing the exclusion as a blood safety policy rather than identity-based discrimination — the central legal question before the court.
Fundamental Rights vs. Public Interest: Article 14, 15, and 21
The petitioners challenging blood donor exclusions invoke Article 14 (equality before law), Article 15 (prohibition of discrimination on grounds including sex), and Article 21 (right to life and dignity). The government's counterargument invokes the state's duty under the Directive Principles (Article 47 — improvement of public health) as justification for reasonable restrictions. The proportionality doctrine, increasingly applied by Indian courts, asks whether a restriction is suitable, necessary, and proportionate to its stated aim.
- Article 15(1) prohibits discrimination on grounds of religion, race, caste, sex, or place of birth — but sexual orientation as a protected ground was established in Navtej Singh Johar v. Union of India (2018)
- The Supreme Court in NALSA v. Union of India (2014) recognised transgender persons as a third gender with full constitutional rights
- Permanent deferral vs. risk-based temporary deferral: global debate on whether blanket exclusions are scientifically justified when individual risk-assessment or time-based deferral is possible
Connection to this news: The case places the court at the intersection of public health necessity and constitutional dignity rights, requiring it to determine whether a blanket exclusion — rather than individual risk-based screening — satisfies the proportionality test under Articles 14–21.
India's HIV/AIDS Response and NACO
The National AIDS Control Organisation (NACO) was established in 1992 under the Ministry of Health and Family Welfare. India's HIV/AIDS response is implemented through the National AIDS Control Programme (NACP), currently in Phase V. Key vulnerable populations — MSM, transgender persons, and female sex workers — are classified as "high-risk groups" (HRGs) in public health targeting frameworks, as HIV prevalence rates among them are disproportionately higher than in the general population.
- India has approximately 2.4 million people living with HIV (PLHIV) — third largest in the world
- HIV prevalence among transgender persons: estimated 3.1% vs. 0.22% adult prevalence (NACO data)
- NACP's harm-reduction approach includes targeted interventions for HRGs while also protecting blood supply safety
- India adopted the UNAIDS 95-95-95 targets (95% diagnosed, 95% on treatment, 95% virally suppressed)
Connection to this news: The government's affidavit draws directly on NACO's epidemiological data — 6–13x higher HIV prevalence in excluded groups — to make the case that donor deferral is consistent with evidence-based blood safety practices, not animus toward marginalised identities.
Key Facts & Data
- HIV prevalence among transgender persons, MSM, and female sex workers is 6 to 13 times higher than adult HIV prevalence (NACO Annual Report 2020-21)
- National Blood Policy aims for 100% voluntary non-remunerated blood donation
- Similar MSM deferral policies exist in most European countries
- NALSA v. Union of India (2014): SC recognised transgender persons' fundamental rights
- Navtej Singh Johar v. Union of India (2018): SC decriminalised consensual same-sex relations (Section 377 IPC)