Five Quarts_ A Personal and Natural History of Blood - Bill Hayes [99]
Shortly after the first vote, I spoke with FDA medical officer Andrew Dayton, a nice guy who carefully defended the agency’s position. “We have a strong congressional and public mandate for zero error,” he explained. “If we change the policy and something happens, it’s a very big issue. We have to be ultraconservative.”
Of course, I absolutely understood that great precautions must be taken with our blood supply, but what made sense in 1985 no longer does, given the triple HIV testing done on donated blood. To my mind, the ban perpetuates an early-AIDS-era myth that the blood of gay men is intrinsically different, dirty, or bad, a fallacy that harks back to the ancient belief that the blood contained the essence of a person. I recalled how this misconception had reared its ugly head early in the history of blood banking, during the early 1940s. Posters plastered across major East Coast cities called upon Americans to do their part for the war effort by donating blood—one powerful image showed a wounded GI using his rifle in an attempt to lift himself, with the headline “Your Blood Can Save Him”—except that there was some invisible fine print: Black blood wasn’t always welcome. In Red Cross blood drives carried out in the eleven months leading up to Pearl Harbor, all African Americans were expressly prohibited, as per a new policy established by the U.S. military. As journalist Douglas Starr explains in his book Blood: An Epic History of Medicine and Commerce (1998), the armed forces were segregated at the time and “its leaders thought it best for morale not to collect African American blood,” the assumption being that white soldiers would object to having “colored” blood put into their veins. The possibility that some black soldiers might not want Caucasian blood did not figure into this decision. As Starr continues, the policy was “liberalized” soon after December 7, 1941, when the Red Cross successfully lobbied the military to accept blood from black citizens, though it would be processed separately and labeled for use only in “Negroes.” Following the war, the institutionalized segregating of blood continued in many American hospitals, particularly in the South, into the late 1960s. Ignored throughout these turbulent times was the perspective of prominent scientists who, one after the other, declared that, in terms of race, blood is blood is blood. The practice was medically baseless.
World War II blood-drive poster (Courtesy of the American Red Cross Museum. All rights reserved in all countries.)
I launched none of this heavy history at Andrew Dayton during my talk with him because, I must admit, I was hoping that he might have a surprise for me, some stunning revelation to turn my frustration with the gay ban 180 degrees. Well, he did turn it a few degrees. If the FDA policy were changed, Dayton told me, the biggest danger would not be gay donors per se but, instead, the workers handling the blood. The problem would be human beings making human mistakes—the employees who accidentally release HIV-infected blood instead of disposing of it. This already happens, he acknowledged. About ten units of tainted blood products are mistakenly okayed for release in the United States every year, causing two or three HIV infections. “The problem is not the large blood banks,” Dayton said, “but smaller blood collection facilities, typically in hospitals, which don’t have the staff or automated equipment. They do it manually and have the highest risk of error.”
When I asked what the FDA is doing to reduce such errors, Dayton admitted, “It’s not quite clear what direction to take.” He was unequivocal, however, on one point: “It’s important to keep high-risk donors from even giving a unit of blood.”
The ban on gay donors conceivably could change, he conceded, if specific research were done. “What we’re lacking is seroprevalence rates, the frequency of HIV infections in men who haven’t had sex with another man for one year versus five years versus twenty-three.” He added, “I think that if we got results that said rates are virtually