The Blood Business

Anyone who needs a blood transfusion is already in physical trouble. Unless someone is willing to donate blood for him, he is likely to be in economic difficulties as well. Blood is in short supply throughout the U.S., and it must often be obtained commercially at an ultimate cost to the patient of up to $40 a pint. Even at high prices, such blood is occasionally tainted.

The reason for this shortage is not scientific but social. American hospitals have ample facilities for acquiring, storing and administering blood. What they lack is willing contributors of the raw material. According to officials of the 1,330-member American Association of Blood Banks, who met last week in Washington, D.C., voluntary donations from all sources* yield 85% of the 8.5 million pints of whole blood used in the U.S. each year. For the rest, blood banks must buy blood, sometimes from alcoholics and drug addicts desperate for a bottle or a fix. To satisfy the growing demand for plasma, a blood component used in emergency treatment, research and vaccine production, some companies have even gone abroad. Several American firms are buying plasma in Puerto Rico and South America and, according to unconfirmed reports, underdeveloped West African nations. One American-owned firm, Hemo Caribbean, buys blood for plasma from Haitian peasants who are so poor that they must sell the stuff of life in order to survive.

Contamination. The blood business is dangerous. Tests for hepatitis, a sometimes fatal liver ailment that is becoming increasingly prevalent among the group that sells blood commercially, are not always reliable. Dr. Charles Edwards, head of the Food and Drug Administration, believes that contaminated blood, most of it from commercial banks, is responsible for 1,500 to 3,000 hepatitis deaths in the U.S. each year.

New federal regulations will require the licensing of all U.S. blood banks and plasma suppliers, including those importing from abroad; the new rules, though not as strict as A.A.B.B. regulations, may reduce the health risks somewhat. Even more promising is an A.A.B.B. plan to eliminate the need for commercial blood. The association proposes that blood banks increase the supply of donor blood by offering such nonmonetary rewards as arranging for donors to get transportation to hospitals, awards, or even prize coupons for participating in blood programs. The organization believes that such measures, together with an intensified promotion campaign, could meet 90% of the nation's blood requirements by 1974 and 100% by the end of 1975.

Judging by the experience of other advanced countries, that goal is plausible. Japan, Britain, France and Denmark have been able to rely solely on unpaid donors. The U.S. should be able to do the same. Only 3% of those Americans who qualify as donors now actually give blood. Four percent could provide all the blood needed in the U.S.

* There are three basic types of donations: the unrestricted gift to a blood bank; the donations for blood insurance through such groups as companies and organizations; and the donation to be credited to the account of a specific patient. Hospitals generally make no charge for blood from these sources, but may charge for processing.

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