What is the price of human life? How far will we go in putting someone else’s life at risk?

 

or Six degrees of separation, human morality, profit, trust & risk

What is it about human nature that makes us take risks with other people’s lives? What is it about our relationship to money that can corrupt human activity? Why is it that some risky behaviour attracts attention while other similarly risky behaviour passes unnoticed?

Headline!      Contaminated blood supply leads to people being infected with the human form of BSE.

Headline!      Contaminated blood results in haemophiliacs being infected with HIV and hepatitis.

Both of these headlines relate to events that have happened. Both of these events can be understood as risky behaviour that has a link to money.

Back in the 1980s the Conservative government relaxed the rules surrounding cattle feed. This meant that cattle feed became cheaper. Unfortunately it also meant that scrapie, the form of BSE found in sheep, was able to jump species and enter our cattle herds. While BSE filled the headlines something more sinister was happening. The chemical element, a prion or rogue protein, that causes scrapie and BSE was jumping species again, this time into humans. A new variant of Creutzfeldt-Jakob Disease, known as vCJD, began to appear in Britain. Then in 2003, Deryck Kenny was the first person to contract the disease by secondary infection, after receiving a blood transfusion. Our blood supply was compromised and it led to a ban on the use of UK plasma donations.

Just a few years ago Lord Archer chaired an enquiry into the scandal of how the lives of haemophiliacs were devastated because they were given Factor VIII, a plasma product that was contaminated with HIV and hepatitis. In the United States the blood supply industry is big business. Contrary to the advice of the World Health Organisation, the US uses paid donors to fuel the blood supply industry. It does not always ask relevant questions about those who are making the donations of blood. This had disastrous consequences for the haemophiliac population. Blood was collected from US state prisons, which were known to be rife with HIV and hepatitis sufferers. The rest as they say is history. Bill Clinton, when Governor of Arkansas, appointed Health Management Associates, whose president was a long-time friend and political ally. As part of the deal, the company collected blood from prisoners. The US authorities knew of the risk from HIV and hepatitis that this blood posed, so there was no market open for HMA in the States. Instead, even though they knew of the health risks, they went ahead and secured a contract for this contaminated blood with a buyer in Montreal. The blood was also peddled elsewhere in the world. A report in WND[i] cross references to an article in the Calgary Sun that Clinton signed the deal off.

Two stories of human tragedy where risks were taken to lower costs! So we know that risky human behaviour driven by a monetary factor can and does lead to human suffering on an unacceptable level. The difficulty for us is that it is like the proverbial horse that has bolted, insomuch as the risky behaviour is only revealed after the damage has been done. Then we get the headlines that make us sit up and take notice.

It is now nearly 40 years since the WHO looked very carefully at the blood supply industry. At its Assembly in 1975 it passed a resolution that challenged governments to set high standards with regard to its blood supply. Lord Owen, Minister of Health at the time, recognised the importance of the WHO resolution. He fought hard, often against those holding the purse strings, to get this country to follow the two key elements of the WHO resolution. Our aim was to become self-sufficient in blood supplies and that the blood donation scheme should be non-remunerated. Self-sufficiency from non-remunerated donation of blood has remained the gold standard set by the WHO since 1975. The WHA recognised that as soon as money enters the equation and blood is treated a ‘just another commodity’ then the risks to those at both ends of the chain increases.

The US is not alone in allowing blood donors and plasma donors to be paid. China, with a massive market for the buying and selling of blood products, also allows paid donations. A recent report, to which Lord Owen referred in his letter to our Prime Minister, revealed that the blood supply in China has serious contamination issues. In his book, The Red Market, investigative journalist Scott Carney uncovered the gruesome realities of what was happening in the lucrative global marketplace for blood, bones and organs. He reckoned that his body on that market was worth about $250,000 or £160,000. He uncovered alarming stories about the depths to which suppliers will go to get cheap blood. This included victims of the 2004 tsunami that not only killed thousands but devastated the livelihoods of survivors[ii]. He found desperately poor people willing to sell blood and organs. Some of the blood donors he discovered were being over bled and in a listless parlous state. Furthermore, Lord Owen comments in his letter that after reading an extensive report about supply and demand of blood in China, he believes it “unwise to rely on the incorruptibility of the blood supply inspectorate,” and that “the worldwide plasma supply line has been in the past contaminated and … will also certainly continue to be contaminated.”

If you watch programmes like the Antiques Roadshow you may become familiar with the word provenance. In the world of antiques provenance is everything. If you have listened to recent stories about horsemeat, the same word provenance can also be applied. So what was all the fuss about? What’s the harm with an entrepreneur keeping costs low like this? Well, some people may have an allergic reaction to horsemeat. But the major difficulty with the horsemeat scandal was not about the safety of horsemeat but about trust. It was about transparency. Could we trust what it said on the packaging? It was also about the potential dangers to health for those who might be allergic to horsemeat.

The popularity of television consumer programmes like Rogue Traders and Fake Britain highlight dodgy commercial activity. One such programme last week gave coverage of the day-to-day work of Trading Standards. It told the story about ham topping on pizzas not being ham. Yet another story of provenance. We don’t like being taken for a ride.

Human morality, risk-taking, commercial activity, provenance, trust – how these all link together is critical in the blood supply industry.

The use of blood products in the treatment of patients, even within the best regulated supply chains, carries an inherent risk. It is extremely difficult to screen both donors and donations with 100% certainty of removing all contamination not least because there may be yet undiscovered pathogens involved. Neither does science know enough about incubation periods for diseases like vCJD to be able to speak with certainty about the effect thus far of contaminated blood that has been used

If that is true then is it right to increase the risk faced by some of the most vulnerable people in society? And according to the principles of ‘Six Degrees of Separation’, those people are really quite close to us. I realise that what I am writing is pretty scary stuff. But it’s real people lives we are talking about. Do you know someone who has haemophilia in the family? I certainly do. I recall the relief for that family when their children were all girls. But what of future generations for that family? Do you know someone who has undergone heart surgery? I do. Do you know someone who has suffered major trauma or has serious burns or has recently had a baby born with health complications? I could go on. We all know these people and I am sure I wouldn’t want their lives to be put at any greater risk than was unavoidable. Nor I suspect would you. It’s crucial that we don’t knowingly add to the risks people who face these kinds of disease or trauma.

And yet this government is willing to increase, knowingly, the level of risk that these real people will face. For what these family members, friends and acquaintances have in common is that they need plasma products as part of their treatment. And this government is about to sell to the highest bidder the company, which it owns, that both supplies plasma and turns that raw material into the products needed by these patients. That company is Plasma Resources UK (PRUK). This government is not willing to invest in this critical part of the blood service but rather chooses to put patients at greater risk by losing control of our supply of blood plasma and subjecting them to the greater risk of sourcing treatments on the open market. And they are doing so, when they know that a test to identify those who carry the vCJD virus is now being used. It can’t be long before it is once again possible to use plasma freely donated by people in this country. There is nothing like the blood donor and plasma donor schemes for showing us a true ‘Big Society’.

This is going on right under our noses. And it seems to be happening almost unnoticed. Is it because the word plasma does not have the same resonance as blood? Maybe there are other news stories that demand out attention. BUT, do we have to wait until a tragedy unfolds before people sit up and notice? Surely the time for action is now. Surely the government should be held to account for actions it is taking that will compromise the health of its citizens!

You can support the campaign to stop the sale of the Blood Plasma Service by following this link:

http://you.38degrees.org.uk/petitions/save-our-blood-tranfusion-service

By signing the petition you will strengthen the efforts of Adrian Sanders MP and Lord Owen to persuade the Government to stop the sale immediately.

You could also take action by bringing this article and the two below to the attention of the media or journalists that you know. A good way to contact journalists is to google ‘journalists NHS Health’

Further Reading (with sources)

http://www.opendemocracy.net/ournhs/lucy-reynolds/selling-our-safety-to-highest-bidder-privatisation-of-plasma-resources-uk

https://geoff6751.wordpress.com/2013/05/31/government-plans-to-sell-off-blood-plasma-service-pruk-will-put-patients-at-greated-risk/


[i] http://www.wnd.com/1998/09/1216/ (Retrieved 12 Jun 2013)