Following the banking cycle of umbilical cord blood in India: the disparity between pre-banking persuasion and post-banking utilization

Abstract

To address critique of the rare uptake of umbilical cord blood (UCB) in private banks, hybrid-banking models would combine the advantages of 'public UCB banking' and private UCB banking by responding to both market forces and public needs. We question both by following the cycle of UCB banking in India: the circulation and stagnation of UCB as waste, gift, biological insurance, enclaved good, source of saving lives, and commodity through various practices of public, private and hybrid UCB banking. Making the journey from 'recruitment', 'collection' and 'banking' to 'research' and 'therapy' allowed us to identify concerns about the transparency of this cycle. Drawing on archival research and fieldwork interviews with different stakeholders in UCB banks in India, this article shows how private/hybrid cord blood banks are competing for their market share and its implication for the circulation of UCB: speculation, stagnation and opacity.

Cord Blood Banking: Antenatal Care Provider’s Roles and Responsibilities

“…After that, the 22-item questionnaire was filled by the obstetricians. It consisted of five statements assessing the awareness of obstetricians about UCB banking [ 1 – 5 ] with responses recorded as correct or incorrect, ten statements assessing the attitude of obstetricians on UCB banking [ 6 – 15 ] with responses as Yes, No, or Do not know, and five statements on expectations of obstetricians from UCB banking (16-20) with responses coded as Yes, No, or Do not know. Finally, for secondary analysis, the subjects were asked to self-rate their knowledge about UCB banking on a Likert scale of 1-5 (1 being outstanding and five being very poor).…”

“…A detailed comparison of the two was given by Sullivan, stating that private banks publicise UCB banking in the disguise of “biological insurance” of an unborn child [ 4 ]. Patra and Sleeboom-Faulkner critically reviewed the UCB banking cycle in India and found an obvious disparity between prebanking persuasion and postbanking utilization [ 5 ].…”

Hybrid UCB banks in China – public storage as ethical biocapital

“…Although UCB stem cells have been studied for decades and the first UCB stem cell transplantation was already performed in 1988, clinical translation was not widely used. Therefore, this translational technology is still quite new and, in many respects, remains controversial (Patra & Sleeboom-Faulkner 2016;Hauskeller & Beltrane 2016). For example, there are disputes about the range of applicable clinical indications, the number of units needed in relation to the weight of potential patients, and the storage life of UCB stem cells (Dickenson 2013).…”

“…Realizing the complexity of hybrid models, Hung-Chieh Chang (2016) has argued against the tendency to use traditional classifications of UCB banks to characterize hybrid UCB banking; instead, she argues that they should be defined according to their use. Taiwan for instance, has UCB banks with varying aims, ranging from research and medical use, to charitable work and business development (Chang 2016), while Patra & Sleeboom-Faulkner (2016) have suggested that a taxonomy of UCB banking categorized in terms of size, institutional embedding, collaborative network, service provision, and research may be more useful to understand the commercial, public, and collaborative activities of UCB banks. It is important, then, to pay attention to how hybrid UCB banking models are embedded in society, as their practices are largely conditioned by regulatory, economic and social conditions.…”

“…The case of hybrid UCB banking in India shows that there is a large disparity between pre-banking persuasion strategies employed by UCB banking activities and post-banking utilization. It has been argued that the UCB banks there, who actually seem to present themselves as hybrid, due to a lack of regulation have been able to recruit donors under false pretences and fail to account for the storage and utilization of UCB (Patra and Sleeboom-Faulkner 2016). In the case of hybrid UCB banking in China, however, the integration of private and public storage is politically supported and regulation using the 'private-for-profit model'.…”