policy in AIDS-ravaged South Africa that barred many
blacks and even the country's president from donating blood
led to a substantial drop in HIV-tainted blood
supplies, a study found. "Hundreds or more would have
gotten infected from blood transfusions" without the
race-based policy, said senior author Michael Busch of
the Blood Systems Research Institute in San Francisco.
Even so, Busch
said that's not an argument in favor of it. Rather, it
underscores "the dilemma of trying to maintain a safe blood
supply in the challenging arena of epidemic infectious
disease and social expectations," he said.
barring many blacks from donating blood was in effect from
1999 to 2005. The research looked at nearly 900,000 blood
donations collected from the policy's first year as it
was phased in and compared that with almost 800,000
donations collected during 2001-2002, when the
policy was in full swing.
HIV was detected
in 0.17% of donations in the earlier period, but that
dropped by half, to 0.08%, in the second year, the
Anthon du P.
Heyns, the top executive of the South African National Blood
Service, and colleagues collaborated on the study, published
in Wednesday's Journal of the American Medical
Association. The study looked at donations in the Blood
Service's inland region.
The World Health
Organization estimates that up to 10% of HIV infections
globally are acquired from blood transfusions. The risks are
highest in countries such as South Africa, where it's
believed 5.3 million to over 6 million people are
infected, the highest number worldwide.
that 24 HIV-infected units of blood entered that
nation's blood supply in 1999, the JAMA article
said. Concern over tainted blood and the country's AIDS
epidemic prompted the policy, which included "enhanced
donor selection" and education, the authors said.
Under the old and
new policies, prospective donors are asked to answer a
questionnaire about their medical history, sexual practices,
and drug use.
donors' race as a marker of risk was the policy's most
controversial component, and it prompted an outcry after
President Thabo Mbeki's donated blood was discarded in
2004, due in part to his race.
the blood bank's policy of excluding donations from
sexually active gay men also has come under fire in a
country where AIDS is an overwhelmingly heterosexual
disease. Officials say that too is now under review.
The old policy
involved closing blood donation sites in high-risk
regions, a practice that severely skewed the donor pool "so
that black individuals, who comprise 79% of the
population, contributed only 4.2% of the blood supply
in 2001-02, down from 10% in 1999," the authors
The South African
health ministry in December 2004 declared that race was
not an acceptable risk indicator, and officials decided last
February to adopt a new policy. Now individual blood
samples are tested.
"We do not defend
the past practice at all," Heyns said. "We also will
not resume the previous risk management policy where race
predict that the newest testing methods will greatly
reduce the risk of getting HIV-tainted donations. (AP)
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