Congressmen Continue to Fight Blood Ban
0In the wake of a July 26 hearing on the lifetime ban on gay blood donors conducted by the Food and Drug Administration's Blood Products Advisory Committee, two Congressmen have kept up the push to rescind a ban that many see as discriminatory and unnecessary.
The ongoing push marks the continuation of efforts that began earlier this year. Senator John Kerry (D-Massachusetts), Rep. Mike Quigley (D-Illinois), and more than 40 members of Congress signed sent a letter last month to the chair of the Health and Human Services Advisory Committee on Blood Safety and Availability. The June 9 letter read, in part, "We join with medical experts at the American Red Cross, America's Blood Centers, AABB, and the American Medical Association, among others, in calling for a change in policy that better reflects the science of high risk behavior for HIV. The time has clearly come to review and modify this policy to strengthen the safety of the blood supply and remove any needless discriminatory rules from the process.
"In the wake of the major blood donor organizations stating that the lifetime ban on MSM blood donors is 'medically and scientifically unwarranted,' we urge you to utilize the most up to date and comprehensive medical and scientific data regarding high risk behaviors in your considerations," the letter added. "In order to improve the integrity of the blood supply, we believe it is imperative that all high risk behaviors be appropriately targeted in the screening process and that similar deferral periods are established for similar risks.
"As the policy currently stands, a number of potential oversights and medically unjustifiable double standards seem apparent," continued the letter. "For instance, there is no prescribed consideration of safer sex practices, individuals who routinely practice unsafe heterosexual sex face no deferral period at all while monogamous and married homosexual partners who practice safe sex are banned for life. In fact, a woman who has sexual relations with an HIV positive male is deferred for one year, while a man who has had sexual relations with another man, even a monogamous partner, is deferred for life.
"Even individuals who have paid prostitutes for heterosexual sex face a deferral period of one year while gay men face a lifetime ban," the letter noted. "These do not strike us as scientifically sound conclusions."
Sen. Kerry also submitted testimony for the FDA panel's July 26 hearing. "Members of the Blood Products Advisory Committee, I thank you for dedicating a portion of this meeting to reviewing the June 11 recommendations of the Health and Human Services Advisory Committee on Blood Product Safety and Availability (CBPSA) regarding the outdated and, as labeled by CBPSA, 'suboptimal' policy that prohibits any man who has had sex with another man, even once, since 1977 from ever donating blood," Kerry addressed the panel.
"With the American Red Cross, the American Medical Association, America's Blood Centers, and AABB, among others, calling for this policy to be reformed, it is certainly past time to examine scientifically and medically sound alternative screening procedures to ensure the highest level of safety possible for the nation's blood supply. Although members of CBPSA narrowly voted against the immediate repeal of this policy, I am pleased that they voted unanimously in favor of a path forward on this issue that I believe will ultimately lead to the replacement of this antiquated blood donor screening policy with one that truly is scientifically sound."
Added Kerry, "This is a discussion with real social significance for gay men. They are clearly the target of this policy, which was initiated in the early 80's when little was known about HIV / AIDS except that gay men seemed to be contracting it almost exclusively. Today, this lingering policy carries with it a social stigma for this population that is still engaged in battles for civil rights on a whole array of fronts.
"But, as much significance as this carries for gay men, I absolutely believe that this discussion must begin and end with the integrity of the blood supply and the safety of the recipients of blood transfusion. They deserve the strongest protections the United States of America can muster from diseases like HIV spreading through the blood supply.
"However," continued Kerry, "if this policy is not declared a necessity by the science of blood supply safety, then no one's health would be compromised were the policy appropriately modified, and the only leg the current policy would have left to stand on would be unjustifiable discrimination. Today, I join with medical experts at the American Red Cross, the American Medical Association, and many others in asserting that this policy is simply not called for by the science. In order to ensure the safety of the American people, there are better alternatives."
The senator continued, "It is crystal clear that we have come a long, long way over the last three decades in our understanding of HIV / AIDS. The science regarding contraction of this disease has advanced dramatically, the detection methods have become more and more perfected, and our understanding of what constitutes high risk behavior has grown far beyond the ignorant idea that sexual orientation is an indicator in itself.
Condoms have become standard use for millions of Americans of all sexual orientations, and healthy gay men can today consummate a union with lifelong, monogamous partners in marriage in my home state of Massachusetts and in several others. Does anyone believe that these men are at high risk of contracting HIV?
And yet, with all of this change, this policy lingers on and is today responsible for turning away thousands of healthy donors from blood clinics across the country, not because they have engaged in highly risky behavior, but because they are gay. This is blood that could save lives.
"I trust that, as we move forward in this process, we will be guided by science rather than the past in determining the best screening policies to help make our blood supply even safer for all who depend on it," Kerry added. "I am dedicated to working with Secretary Hamburg, Secretary Sebelius, and other concerned Members of Congress to expeditiously move us down that path."
Quigley Concurs
In an op-ed piece published July 26 at U.S. News & World Reports, Congressman Mike Quigley recalled that, "On June 11, an advisory committee to the Department of Health and Human Services, composed of health experts from around the country, voted 9-6 to maintain a policy that bans gay and bisexual men from ever donating blood," a decision Quigley called "dramatically eye-opening for the greater American public, because the committee acknowledged that this outdated policy allows high-risk individuals to donate while prohibiting low-risk donors who could contribute life-saving blood, which is in short supply."
Quigley revisited many of the points made by Sen. Kerry in the senator's testimony to the FDA's Blood Products Advisory Committee, going on to note, "Despite hints of progress, we still face challenges, the most significant of which is a lack of political will. The FDA has put revising this policy on the back burner, and while some have raised concerns, the FDA has for the most part continued to ignore this issue. We must demonstrate to the FDA that changing this outdated, discriminatory policy is a priority." Quigley advised healthy readers who may have been denied the opportunity to donate blood based on their sexual orientation to write to their elected officials.
"Let policymakers know you want to see a policy that encourages a larger, healthier, life-saving blood supply and that reflects current science rather than a stigma of the past," Quigley wrote.
Under the current Food and Drug Administration policy, the American Red Cross and other blood collection services are not allowed to accept blood from gay men or men who have had sex with another man since 1977. The lifetime ban also applies to current or former intravenous drug users, people who have had certain types of cancer or other diseases, and people who have lived in certain countries during specified periods of time during which they may have contracted communicable diseases.
In the case of HIV-tainted blood, critics argue that modern testing virtually eliminates any risk. Proponents of retaining the blood ban point out that there is a window of around two weeks after infection during which testing won't detect the virus in donated blood. But critics also point out that the current ban relies on donors telling the truth about their sexual history--a fact that means that all donated blood is screened regardless.
Critics also note that HIV is also spread through heterosexual contact, but straight people are not similarly banned. Heterosexuals who have had sex with HIV-positive partners or with prostitutes are required to wait for 12 months before giving blood, however, a requirement that advocates for dropping the ban say would be also be adequate in the case of gay men.
But some say that the risk--however remote--is still reason enough to keep the ban in place. A May 27 CNN article cited Dr. Jay Brooks of the University of Texas Science Center. Brooks favors equality before the law for gays, including family parity and military service, but from a purely scientific perspective, he said, the ban is necessary. "The interest of the recipient is greater than any donor," Brooks told CNN. "I'd hate to tell the one person who got HIV through a blood transfusion, 'Sorry, we changed the regulation.' "
Moreover, said Brooks, "I do not see this being a gay rights issue." Added Brooks, who is a professor of pathology, "Any group that's epidemiologically at risk of making blood unsafe, it's unfortunate [but i]t's a matter of epidemiology."
Concerns on both sides of the debate may eventually have to bow to the numbers. A May 26 Scientific American article noted that the rules for blood donation are so strict that only 38% of Americans are allowed under FDA rules to offer their blood--and the number of the eligible who actually do donate is far less: a mere 8%. Those relatively few individuals have to meet a pressing need; Scientific American said that 38,000 transfusions are needed each day.