The technology existed to catch what killed that child
In the quiet arithmetic of blood banking, a gap between what is possible and what is practiced has cost lives in India. Four children with thalassemia in Maharashtra received contaminated transfusions; one died, three now carry HIV — infections that a technology called NAT could have detected weeks before conventional tests would have. Mylab Discovery Solutions, a Pune biotech firm, is pressing the Indian government to mandate this more sensitive screening nationwide, arguing that affordability is no longer an obstacle, only political will remains.
- Four children with thalassemia received HIV-contaminated blood in Maharashtra — one died, three will carry the infection for life, and the National Human Rights Commission has issued formal warnings to government departments.
- Only 2% of Indian blood banks use NAT testing, leaving tens of millions of annual transfusions screened by older methods that cannot detect viruses during their incubation window — a gap measured in weeks that can mean the difference between safety and death.
- Mylab Discovery Solutions, which built India's first domestic RT-PCR kits during the pandemic, is now lobbying hard for mandatory NAT adoption, armed with a product it claims is at least 40% cheaper than global competitors.
- Thirty-three countries have already mandated NAT screening for HIV and twenty-seven for hepatitis B, while India — with 1.4 billion people and a high burden of transfusion-transmitted disease — has yet to require it at any level of its healthcare system.
- Elite institutions like AIIMS Delhi already use NAT; smaller hospitals and blood banks do not, held back by cost and the absence of any legal requirement — a disparity that makes patient safety a function of geography and institutional wealth.
In May, four children in Maharashtra who depended on regular blood transfusions for thalassemia tested positive for HIV after receiving contaminated blood. One of them died. The National Human Rights Commission issued notices to government departments, signaling it viewed the tragedy not as an accident but as a systemic failure. The technology to have prevented it existed. Almost no one was using it.
Mylab Discovery Solutions, the Pune-based biotech firm that produced India's first domestic RT-PCR test kits during the pandemic, is now making the case for mandatory nucleic acid amplification testing — NAT — across India's blood banking system. The argument rests on a stark contrast: traditional screening misses viruses during their incubation window, when the pathogen is present in blood but the body has not yet produced detectable antibodies. NAT bypasses that delay by identifying viral genetic material directly. For hepatitis B, that window shrinks from 59 days to 25–30. For hepatitis C, from 70 days to 12. For HIV, from 22 days to 11. Those are not abstractions — they are the days in which a contaminated unit can pass undetected into a patient's bloodstream.
Despite its advantages, a 2019 study found that only about 2% of Indian blood banks perform NAT screening, and roughly 7% of collected blood units undergo the test. Mylab became India's first domestic NAT manufacturer in 2019, joining only two other companies globally. Its product, NATSpert, uses real-time PCR to detect multiple pathogens — including hepatitis B, hepatitis C, HIV, malaria, and syphilis — in a single test, and the company claims it costs at least 40% less than competing kits. Gautam Wankhede, Mylab's director of medical affairs, has argued that this price point removes the last credible barrier to wider adoption.
Well-resourced institutions like AIIMS in Delhi and the Postgraduate Institute in Chandigarh already use NAT. Smaller hospitals and blood banks do not — partly for cost reasons, partly because no policy requires them to. Mylab has been in sustained dialogue with government agencies and private healthcare operators, building the case that mandatory adoption is both feasible and overdue. Thirty-three countries have already mandated NAT for HIV screening; twenty-seven have done so for hepatitis B. India has not moved.
The Maharashtra case remains the sharpest illustration of what that inaction costs. The blood was available. The children needed it. The safer test was not required. One child is dead. Three others will spend their lives managing an infection they should never have received. The decision to mandate NAT — to require that every transfused unit be screened by the most sensitive method available — has not yet been made.
In May, four children in Maharashtra tested positive for HIV after receiving blood transfusions. One of them died. They had thalassemia, a condition that demands regular transfusions throughout life, and the blood they received was contaminated. The National Human Rights Commission took notice and issued warnings to government departments. It was preventable. The technology existed to catch what killed that child and infected the others. It still exists. Almost nobody is using it.
Mylab Discovery Solutions, a Pune-based biotech company that gained prominence manufacturing India's first domestically produced RT-PCR test kits during the pandemic, is now pushing hard for something simpler but potentially more consequential: mandatory blood screening using nucleic acid amplification testing, or NAT. The company's leadership sat down recently to explain why a technology available for years remains almost entirely absent from India's blood banking system.
The numbers tell the story. A 2019 study found that only about 2 percent of Indian blood banks perform NAT testing. Roughly 7 percent of all collected blood units in the country undergo NAT screening. This means tens of millions of transfusions happen annually using older detection methods that miss infections during their incubation periods—the window when a virus is present in blood but hasn't yet triggered the antibodies that traditional tests look for. Hepatitis B can hide for 59 days using conventional screening. NAT finds it in 25 to 30 days. For hepatitis C, the gap widens from 70 days down to 12. For HIV, the window shrinks from 22 days to 11. Those days matter. They are the difference between a safe transfusion and a death sentence.
NAT works by detecting the genetic material of viruses directly—hepatitis B, hepatitis C, HIV, malaria, syphilis—rather than waiting for the body's immune response. Mylab's version, called NATSpert, uses real-time PCR technology to identify multiple pathogens in a single test, streamlining the process compared to the two other commercial kits available globally. The company claims its approach is at least 40 percent cheaper than competitors, a significant advantage in a country where cost remains a barrier to adoption even when safety is at stake. Gautam Wankhede, the company's director of medical affairs, emphasized that affordability could be the lever that moves the system. Well-funded institutions like the All India Institute of Medical Sciences in Delhi and the Postgraduate Institute in Chandigarh already use NAT. Smaller hospitals and blood banks do not, partly because they cannot afford it, partly because it is not required.
Mylab became the first Indian manufacturer of NAT technology in 2019, joining only two other companies globally. Since then, the company has been in sustained conversations with government agencies and private healthcare operators, trying to build the case for mandatory adoption. The argument is straightforward: India has high rates of transfusion-transmitted infections. The technology to prevent them exists and is now affordable. The only missing piece is policy.
The Maharashtra case illustrates what happens without it. Four children needed blood. The blood banks did not have NAT-tested supplies. Contaminated units were transfused. One child died. Three carry HIV infections they will manage for life. The NHRC's response—notices to departments—suggests the commission views this not as an isolated tragedy but as a systemic failure. It is. Thirty-three countries have already implemented NAT screening for HIV. Twenty-seven have done so for hepatitis B. India, with its population of 1.4 billion and its high burden of transfusion-transmitted disease, has not.
Wankhede framed the push as a major step forward for Indian healthcare, one that could be taken immediately if the will existed. The technology is here. The price is competitive. The evidence of harm from its absence is mounting. What remains is the decision to make it mandatory—to say that every unit of blood transfused in India must be screened by the most sensitive method available, not the cheapest or the easiest. That decision has not yet come.
Citações Notáveis
Our technology is based on PCR. It is at least 40% cheaper than the close competition.— Gautam Wankhede, director of medical affairs at Mylab Discovery Solutions
If taken, it will be one of the major steps in the healthcare sector.— Gautam Wankhede, on widespread NAT adoption across Indian blood banks
A Conversa do Hearth Outra perspectiva sobre a história
Why hasn't NAT become standard if the technology has been available for years?
Cost and regulation. NAT was expensive when it first arrived, and India's blood banking system evolved around cheaper alternatives. Without a mandate, hospitals have no incentive to upgrade. The burden falls on individual institutions to justify the expense.
But Mylab says their version is 40 percent cheaper than competitors. Doesn't that change the equation?
It should. That's precisely why the company is pushing so hard right now. They're arguing the price objection is no longer valid. The real barrier now is inertia and the fact that government hasn't made it mandatory.
What makes NAT so much better at catching infections?
It detects the virus itself, not the body's response to it. Traditional tests look for antibodies, which take time to develop. During that window—weeks for some viruses—an infected person can donate blood that tests clean but carries the virus. NAT closes that gap.
The Maharashtra case—was that a one-off, or does it happen regularly?
The article mentions it as one of many incidents over several years. The NHRC's response suggests they see a pattern, not an anomaly. When you have only 2 percent of blood banks using the safer method, preventable infections are probably more common than we know.
What would it take to change this?
A government mandate. Make NAT testing mandatory for all blood units. Once that happens, blood banks will adopt it, prices will stabilize, and the system shifts. The technology and the affordability are already there. It's a policy decision.
Does Mylab have a financial stake in this beyond selling kits?
Of course. But their interest aligns with patient safety here. They profit if NAT becomes standard, but patients also benefit directly. It's one of those rare moments where the business case and the human case point the same direction.