South East Asia accounts for 25% of the world's population but collects only 9% of the world's blood supply, with the result that it faces a serious shortage of blood. It collects 7 million units a year but needs a total of 15 million units.

The problem is further compounded by inappropriate use of blood without separation into its components, with 80-85% of blood being used as whole blood, according to Dr Neelam Dhingra-Kumar, medical officer in the blood transfusion safety division of the World Health Organization (WHO).

If blood was used more appropriately, the number of transfusions could be brought down by 30%, says the International Red Cross. The Supreme Court in India banned the use of blood from professional blood sellers because they were considered a high risk group for HIV. However, these sellers now claim to be family members of patients needing blood, when in fact they are being paid to donate, said Dr Dhingra-Kumar. With only 61% of blood from voluntary donors, the situation remains grim.

"Up to 30% of blood in India comes from commercial sources, and some proportion of this is still untested," said Geoffrey Dennis of the International Red Cross. Private commercial blood banks, often offering unscreened blood, are allowed to flourish in both Bangladesh and Pakistan because these countries do not have any national blood policy. The quality of screening is also not always to the desired level in the entire region, warned Dr Dhingra-Kumar.

Mr Dennis is also worried that despite the fact that hepatitis C is a serious threat, the virus is not tested for in India, not least because it would add to the costs. In the screened blood in the region the seroprevalence of hepatitis B is 0.06-8.5% and of hepatitis C is 1.2-3%, according to the WHO. In certain other countries, it is still higher. In Islamabad, Pakistan, testing results in 1998 showed that 8.1% of blood was infected with hepatitis C. India embarked on upgrading its poor blood banking system in 1992 with a World Bank loan of $84m (£53m) for the AIDS-I project. The country currently has four million HIV positive people, and the government has secured another loan, of $191m, from the World Bank for its AIDS-II project.

Five to 10 per cent of HIV infections in South East Asia are transfusion induced.