Blood means business. Make no mistake about it, Blood testing, Blood collection, processing, storage and transfusion is a major international big money enterprise. A business that is, at best, poorly and inconsistently regulated, often by bureaucrats.
Amazingly, a barrel of crude oil costs about $25, while a barrel of plasma can yield products easily worth $90,000 and much more. The Blood and plasma industry is as international as oil, with the United States playing the role of OPEC.
Each year, Americans alone donate over 16 million units of Blood, which are tested and processed into more than 26 million units of Blood and Blood derivative products. About 4.8 million Americans receive Blood transfusions of various kinds from these Blood products each year. These numbers vary a bit, depending on the source, however the numbers most certainly do get larger every year.
That well publicized "Bloodmobile" with real heroes trailing out with a t-shirt in hand, is only a small part of the story. In the United States, Blood comes mainly from paid donors. [Now let me think..... did I learn something about this kind of thing in school?] The extention of a commercial relationship back to the source is not really good for product quality. There is no doubt that many marginally suitable donors, or even unsuitable donors, such as alcoholics and drug users, are accepted by Blood donor centers in an exchange that Douglas Starr calls "ooze for booze" in his fascinating book, Blood: An Epic History of Medicine and Commerce. This well entrenched procedure has led to high rates of disease among recipients of Blood, Blood products and Blood transfusions. See a typical FDA Recall Bulletin.
On the subject of paid Blood donors, Dr Alex Gromyko of the United Nations affiliated WHO (World Health Organization) states, "Financial and other ‘rewards’ for donation attract high-risk populations such as drug abusers and sex workers. This means that screening out unusable Blood uses up scarce and expensive Blood testing resources. Also, since donors may have acquired HIV, but may not have developed the antibodies to the virus, the risk of undetected infections is great." Of great concern is that the safety of the Blood system in the United States is, in part, dependent on the honesty of the donor during the pre-donation interview!
In all fairness, we are fully aware that the FDA has a near impossible task. On one end, Congress and their constituents are pushing and pulling and pointing fingers. On the other end of the problem, there is an ever-increasing and ever more sophisticated demand a perfect Blood supply. Further, and making matters worse, is the burden of testing for often "unknown" diseases..... FAST! Blood processing and Blood banking businesses are in a similar, almost impossible situation.
There exists an exhaustive and definitive "short story" on the Blood business. Though dated (1989), the information, most of the enforcement red flags, and virtually all of the attitudes and bureaucracies are, in virtually every case, still as they were. Gilbert M. Gaul, then a staff writer for the Philadelphia Inquirer, researched and wrote a long article known as "The Blood Brokers." At that time, there was great resistance from the establishment to the thesis behind the series. This monumental cutting edge series earned Mr. Gaul a well deserved and coveted Pulitzer Prize.
This article was serialized and published in the Inquirer in five front page parts:
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last updated 03/10/2013 bloodbook.com