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Cover-ups and cost-cutting—the truth behind the contaminated blood scandal

The Infected Blood Inquiry this week delivered its final report, five years after it began. Yuri Prasad details the history of the cover-up and argues that it resulted from a culture of cost cutting and profit-seeking—and a medical establishment that acted with impunity
Issue 2906
Thousands of people were given contaminated blood or blood products in the late 1970s and 1980s (Pic: Factor 8 Campaign UK)

Thousands of people were given contaminated blood or blood products in the late 1970s and 1980s (Pic: Factor 8 Campaign UK)

The contaminated blood scandal is the worst treatment disaster in the history of the NHS. It killed at least 3,000 ­people and wrecked the lives of many more. It was a crime the medical establishment and politicians try to cover up.

From the early 1970s until 1991, professional medical services gave up to 30,000 people blood infected with HIV and hepatitis. Thousands went on to suffer with the diseases. The blood had come from the United States, where firms profited by buying it cheap from desperately poor people—the homeless, prisoners and those with drug addiction. They then refined it and sold it on, making huge profits.

Most of those contaminated were ­haemophiliacs who needed a special blood product called Factor Eight so that their own blood could clot. But others caught the diseases after a blood transfusion. In some cases, doctors knew tainted blood had made their patients sick but refused to tell them what had happened. Instead, patient medical records were hidden, altered or destroyed.

Others were simply never told of their infective status at all and unwittingly went on to infect people close to them. There was also a systemic cover-up by both the Conservative and Labour Parties to hide the truth. That’s because many politicians knew the blood was contaminated in the first place.

The homophobic stigma surrounding HIV/Aids meant victims suffered horrendous consequences. Many lost jobs, homes, relationships and much more. Colin Smith’s parents were told that their son had HIV in 1984 when he was two-years-old. The doctor “didn’t even take us into a room. He just told us in a corridor in front of other patients,” his mother recalls.

When Colin died aged just seven, local people painted “Aids dead” on the family home and scratched it on their car. Bob Threakill was told he was HIV‑positive in 1985. By 1991 he was admitted to hospital with almost no normal lung tissue left.

“He weighed about five stone,” said his wife Sue. “And he died the kind of death you would not wish on a rabid dog.” For years politicians, big ­pharmaceutical firms, medical officials—and even doctors—sought to cover up the outrage. They claimed that at the time HIV/Aids was barely understood and there was no solid evidence of a link between blood products and infections. But that was a lie.

The warnings the government ignored

Factor Eight was a revolutionary treatment for haemophilia. Made by pooling many batches of donated blood and extracting specific parts from it, the treatment helped patients live a near normal life. Developed in the late 1960s, medical authorities licensed Factor Eight for use in Britain in 1973.

By 1975 alarm bells were ringing. ITV’s World In Action programme showed footage of poor people in Los Angeles queuing to donate their blood for cash. An American scientist warned that US Factor Eight was “extraordinarily hazardous” and some British doctors told the Department of Health that it should stop importing blood products.

Faced with this evidence, Labour health secretary David Owen announced that he planned to make Britain self-sufficient in blood by 1977. But his government later dropped the commitment due to cost. An internal memo from Austrian firm Immuno AG noted in November 1976 that it was planning to make some of its products with unpaid blood donations collected in Europe.

But the firm said that the British would not want the new versions, because its market “will accept a higher risk of hepatitis for a lower-priced product”. In 1980 the director of the Public Health Laboratory Dr John Craske revealed that a study had been conducted on children with blood clotting disorders. 

Results showed that blood products such as Factor Eight carried a “high risk” of infecting patients with hepatitis. And there was a 20-30 percent chance of patients then contracting chronic hepatitis, a cause of liver cancer and failure. Two years later, the US Centres for Disease Control noted that three haemophiliacs had recently developed fungal pneumonia in their lungs.

This was associated with a mysterious new illness then known as Gay Related Immune Deficiency. This would later be known as Aids. It was to spread quickly, particularly among gay men and intravenous drug users in America and then beyond.

In May 1983 Dr Spence Galbraith, the director of Britain’s Communicable Disease Surveillance Centre, wrote to Dr Ian Field. He was the senior principal medical officer at the Department of Health. He urged that all US blood products should be withdrawn from use until the risk of Aids for haemophiliacs was “clarified”.

The BBC’s Panorama programme recently revealed that an official at the British embassy in Washington also sent Dr Field a similar warning in June 1983. Yet in November the government insisted there was no evidence that HIV could be transmitted in blood.

The then-health minister Kenneth Clarke said, “It has been suggested that Aids may be transmitted in blood or blood products, there is no conclusive proof that this is so.” He reiterated the position in a written parliamentary response in November 1983 and other ministers repeated it in January 1984.

By then haemophiliac Kevin Slater had Aids. At 20-years-old he was the first person with a bleeding disorder reported to have the disease. He died two years later in June 1985. It took until December 1985 before the Department of Health would publicly accept that blood products were a “vector” in the spread of HIV/Aids.

But even after several pharmaceutical firms began heat treating their blood products to reduce inflection risks, the government was sceptical. It demanded full test results before agreeing to pay extra for treatments. When trials backed the companies’ claims of greater safety, ministers waited an extra year before recommending heat treated Factor Eight. And because the Department of Health refused to issue a recall some hospitals were still using it in late 1985.

In November 1989 Tory prime minister Margaret Thatcher insisted that “all patients received the best treatment available in the light of the medical knowledge at the time”. At least some doctors, scientists and health officials would have known that was nonsense—but they chose to stay silent.

Big pharma saw blood as red gold

The search for profit meant US blood firms ignored all the early warnings. According to an internal memo in December 1982, big pharma company Bayer discovered that chimpanzees had developed Aids-like symptoms after being treated with Factor Eight.  

As the risks became clear, Bayer kept on selling the potentially infected version of its treatment—even after creating its safer, heat-treated version in February 1984. The firm rejected the idea of recalling its infected Factor Eight from Asian countries because it could cost “up to $2 million worth of sales”.

A year later, Bayer’s marketing plan said, “Aids has not become a major issue in Asia.” The company outlined how it would dump the infected product in countries including Taiwan, Hong Kong, Malaysia, Singapore and Argentina. It added that “hysteria over Aids could reduce our sales by as much as $400,000”.

Revlon Healthcare-owned Armour Pharmaceuticals suppressed evidence that between 1985 and 1986 HIV had been discovered in its heat-treated version of Factor Eight. Rather than withdrawing the product, the firm covered it up. Six patients in Britain contracted HIV from that version of Factor Eight, which had been licenced as safe from blood-borne viruses.

“The issue is not one of regulation, but rather of marketing,” said Dr Mike Rodell, vice president of regulatory and technical affairs at Revlon Healthcare. He said the company was at risk of losing £4.7 million in sales. There is little to suggest that Rodell was counting the dead with the same attention as the money.

No charges have ever been brought in Britain for anyone involved in the infected blood scandal—and hardly any compensation given out.

How to explain the failures of doctors and the medical establishment?

It’s easy to understand the cynical motivations of big pharma. But doctors and the wider medical establishment also played a crucial role in the scandal. How can their actions be explained?

Many doctors believed that the risk of stopping the use of Factor Eight posed a greater risk to their patients than that of blood-borne infections. Early in the crisis that was perhaps an understandable reaction. 

In 1962, ten years before Factor Eight became available, the average life expectancy for a person with severe haemophilia was 37. By 1980 it was practically normal. But by 1984 the scale of risk was already well understood by most clinicians. 

Yet there was no rebellion in their ranks. One reason for that is class and the hierarchical way that healthcare and medicine are structured under capitalism. Patients were encouraged to see doctors as paternalistic geniuses. In other words “their betters”.

And top doctors revelled in their status. They didn’t want their patients refusing their advice and treatments, so avoided exposing any potential scandal. The close relationship between doctors and pharmaceutical firms was also partly to blame.

Big pharma paid for doctors and their partners to attend conferences in sunny climates, sponsored research staff, and funded doctors’ projects. In other words, the drug companies bribed doctors and officials to ignore the growing infected blood crisis until it was too late.

‘Our lives have been destroyed’

Without victims and their families campaigning for justice, the true extent of the crisis and cover-up would never have been revealed. The inquiries and investigations over the years are drawn from their experience, and the vast knowledge that they accumulated.

One of those campaigners was Gary Kelly, a socialist from Glasgow. He battled for 22 years with the effects of the HIV infection he contracted after a bone marrow transplant in 1986. Gary suffered a series of heart attacks that he blamed on anti-viral drugs he was forced to take after being contaminated.

A year before he died in 2008, Gary wrote for Socialist Worker on the struggle for justice. “Our health was put in jeopardy because of costs. David Owen, who was the health secretary in 1974, had authorised funding for Britain to be self-sufficient in blood supplies,” he wrote.

“But this was held up for years. Reports by the Medical Inspectorate show that the blood transfusions labs were more like abattoirs, condemned under health and safety laws. Many people who were infected were not traced by the NHS. Seven people have only been diagnosed in the last few years.

“Many of them have died. It is completely possible that they infected others unknowingly.” He went on, “Our government and medical professionals have been protecting themselves. They have failed to apologise or even recognise us.

“Our lives have been destroyed and that of our families, by a government who put commercial interests before our health. Hopefully, after a public inquiry, the lord advocate will bring charges against those guilty people. They have condemned us to life without parole.”

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