The ban on paying people for blood disturbs the vital world market

Because of superstition and misconception, the vast global market for life-saving blood plasma products is dependent on the US, which is dangerous.

Barzyn Bahar tends to buy it and there are not enough sellers on the market to sell, but, oddly enough, it's not easy for him. For many years he has been trying to pay the Canadians for blood plasma, a straw-colored liquid strain of blood with an impressive healing power. 2014. Canadian company Plasma Resources (CPR) tried to open a clinic in Ontario, but local provincial activists banned provincial governments from collecting plasma for money. He did not drop his hands and chose another province of Alberta, but this year he forbade this practice. And on April 26, the CPR announced that it was about to open a center in British Columbia, and the government had thought of similar laws. The CPR was able to open two centers in distant Saskatchewan and New Brunswick, but they were also against it.

The world needs more and more plasma and only one of altruistic donations will not meet the demand. 2016. Plasma exports to the world amounted to 126 billion. US dollars – more than airplanes. But because of ethical, social and medical problems on the plasma – that is why there may be outbreaks of diseases, as happened in the 20th century. In the nineties, when HIV and hepatitis spread through the infected blood, the use of the arms for less pure blood (with all components) is donated almost exclusively on a voluntary basis.

None of these fears has a solid basis. However, because of the plasma charge, it is interrogated almost everywhere in the world, not just in Canada. You can only pay for it in a few countries – the United States, China, somewhere in Canada and some European countries. These countries are well equipped with plasma products – only three quarters of the US and another 10%. – in China, Germany, Hungary and Austria, where it is also allowed to reward it. There are more than a thousand plasma collection centers in the world, including 700 in the US. Head of the Business Association, which represents more than half of the world's plasma-based companies, said that Jan Bult said that none of them consumed plasma in countries where reimbursement was banned.

Only the countries that pay for plasma pay for it themselves (Italy, where the donors get free time, is almost delivered). Half of the US plasma – 20 million. Collected pieces – sent to Europe. Canada imports 80% of the US. plasma products. Australia imports 40 percent. plasma products.

In those countries where it is forbidden to pay for plasma, drug manufacturers collect the bulk of the amount required in the US. Three of the largest plasma companies in Europe are Grifols, Irish Shire and Swiss Octapharma. Another large company in the field – CSL Behring – is owned by an Australian company. Four of these companies account for almost four-fifths of the plasma collection centers. Some products are produced in the USA, but usually elsewhere. Switzerland, which receives very little plasma, in 2016 Exported plasma products for 26 billion US dollars.

Plasma-exported medicines. It differs from plasma, which, together with red and white blood cells and platelets, is intended for transfusion. This plasma is used to save lives, blood loss after a trauma or surgery. Pure blood, however, rarely exceeds the limits of the state and is rarely rewarded for it. Safety guidelines from the World Health Organization recommend voluntary donation.

Fortunately, blood transfusion needs less and less – blood banks are managed more efficiently and modern medicine is much more advanced. According to Kevin Wallis, there is almost 20 years of maintenance at the South London Storage Facility blood storage, which meant that the hospital had three bags of blood for one operation at a time, and nowadays it often does not need it. Although the population is growing, the demand for red blood cells in English hospitals has dropped from 2 to 1.4 million for 15 years. for the year.

Pharmaceutical plasma is different. By minimizing potential risks, it is sterilized by heating or by special chemicals. Plasma can be used in various ways. If the blood is difficult to crush, it helps with the plasma product in the presence of haemophilia. It can also strengthen the weakened immune system, for example after chemotherapy. Still in the 20th century In the 1960s 10% Newborn deaths in the United States led to a serological conflict when the fetal and maternal blood groups did not match. Plasma products can save a baby today.

Previously, such products were used to produce plasma derived from volunteers who are volunteers of pure blood donation. But donations are no longer in demand. 1990. 40% of the pure blood was obtained. plasma products, and by 2015 – already 13% Nowadays plasma is mostly used for apheresis when the blood is taken by centrifugation, which separates the plasma. Then the red blood cells are mixed with an anticoagulant and then poured back into the donor. It can take about 10-15 minutes to give your blood to your bloodstream. Aferesis usually lasts for at least an hour.

Plasma rebounds faster than red blood cells. So in one session, donors can give it more and donate more often.

In many countries, donors can donate about 500 ml of pure blood, which receives only 250 milliliters of plasma, with a frequency of once every two months. Plasma donors can give up to 800 milliliters of plasma, and the United States can do this twice a week. Mathematics is simple. A single plasma donor can give up to 80 liters per year and a pure blood donor is only 1.6 liters of plasma. According to J. Bulto, remunerated multiple donors are being studied – which helps to ensure the safety of plasma products.

Nevertheless, the payment for blood is still stigmatized. Sue Lederer from the University of Wisconsin tells Richard Titmus' book The Gift Relationship, published in 1970, which states that paying for blood is not only badly ethical but also less effective than voluntary donation. American donors often received no money and the discount coupons that could be used in the nearest stores for alcoholic beverages were an unhealthy practice called "blood davei – gingerbread". Plasma-donating prisoners can shorten prison times.

However, in the 20th century The disaster occurred in the nineties – half of the tens of thousands of hemophiliac patients received infected plasma products and were infected with HIV or hepatitis. Thousands died of AIDS-related diseases. Many argued that blood money encouraged donors to lie about dangerous behavior, such as risky sex or drug use. Official investigations took place in Canada and Ireland. In France and Japan, health officials and entrepreneurs were on the streets. US pharmaceutical companies are involved in collective action.

The long handle slid away. The British government has launched an independent investigation last November.

The US still legally has the right to pay for pure blood. But the hospital does not agree. However, the plasma is still protected against the risk of contamination. Modern inspection and sanitary procedures are extremely effective. According to Graham Shero, head of the non-profit Canadian Blood Services, plasma-derived products from paid donors are "just as safe as free".

Other superstitions about paying for plasma are also deeply rooted. For example, there are data that reinforce the suspicion of losing the poor. US plasma centers focus on poorer corners of the country. According to The Economist, an analysis of population data, it is generally preferable to select districts with a loss of 27.4%. of the population, t. y. considerably more than 16.5 percent. looking for an average of the US poverty rate.

It is also worrying, and Sher Sher is for lowering pure blood donations when he is in charge of plasma therapy. But if that were true, the problem would be sharpening, because in the past five years nearly twice as many plasma centers have appeared in the world. Peter Jaworski from Georgetown University is skeptical about this. In his opinion, the evidence suggests that "donating blood is not indispensable" by collecting plasma for money by rejecting anecdotal stories. For example, Americans volunteer to offer the same amount as Canadians in terms of per capita.

The ugliness of the idea of ​​paying for plasma also involves dangers. According to Grifols, there is a danger of not handling plasma products due to the lack of a geographical imbalance. The fierce debate about the high dependence on imports from the US was strongly debated in Budapest at this important annual conference on the plasma industry. Representatives from different countries (including Canada) acknowledged that more efforts were needed to expand existing stocks. The obvious first step is to legalize the reward for plasma.

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