Who profits from blood plasma donations in the US? Politics Weekly America podcast
2023-04-21 00:20:43
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If you've ever donated blood, you probably know that great feeling at the end. When you're handed a cookie or some chocolate and told to relax for a few minutes after doing something that will hopefully help someone who needs it now, imagine that alongside a sugary treat, you get handed a check for a few hundred dollars. In the U...S, there is an industry that goes largely unnoticed, one where companies make their money by buying and selling blood plasma.
There is an estimate that within a few years, it will be worth more than $50 billion.
Today, I speak to a journalist who has been investigating an industry that she says relies on the most economically vulnerable people in America to make a profit.
I'm Joni Grieve in for Jonathan Friedland, and this is Politics Weekly America.
So I am a journalist, I've been a journalist for, I think, 25 years.
Kathleen McLaughlin is a journalist who writes about science, culture and politics all over the world.
So I was based in China for 15 years.
She has been investigating this for-profit medical industry for more than a decade now, and she recently published a book based on what she found titled Blood Money. Her interest in this industry is personal, though.
Yeah, I was diagnosed about 20 years ago with a very rare autoimmune disease and it's similar. I think most people know multiple sclerosis, it's similar to that, but it affects different body parts. So it is called chronic inflammatory demyelinating polyneuropathy. It's one of those diseases that's so rare. They didn't give it a great name.
It's just kind of a description of the symptoms. What happens is essentially my immune system attacks the wrong parts of my body when it gets agitated. And the treatment for that is a medication that's made from human blood plasma, so it is the immune system component of plasma. And every four to six weeks, I have an infusion of this drug that's made from plasma. And I depend on it to kind of maintain a normal life.
And how many people are there who, like you, rely on blood, plasma in some way for their treatment?
Oh, I would say millions around the world, in the United States, my specific disease, I think there are somewhere around 100,000 people who have it, so it's not that common. But this drug is used to treat various illnesses around the world, and there are other illnesses that depend on medications made from plasma. And the thing about the plasma collection in the United States is a lot of what is collected here is actually exported around the world.
So the U.
S plasma system is treating people or providing medications to people around the world, not only in the U.S.
Where do those donations end up?
The primary destination is Europe. One of the major companies in this industry is actually based in Spain. And so the products, primarily, I would say go to Europe and other developed nations because it is an expensive product. But they do go around the world.
So for you and many other people, Kathleen, blood plasma treatment is 100 necessary and it makes a huge impact on your life. So when and why did you start investigating where all this blood plasma comes from?
Yeah, for me, it really goes back to China, so when I was living in China and working there. I spent a lot of time reporting on the problems in their blood supply and plasma supply, which depended on poor people selling their blood plasma in exchange for, you know, better, incomes. And the system became contaminated with HIV, and it spiraled into a massive AIDS catastrophe. There, when I returned to the United States, I met a woman who had been a whistleblower in China and had exposed what happened back there. And she was kind of living in exile in the U..S. I spent several days with her at her home in Salt Lake City and at the end of our interviews, and kind of spending a lot of time together. She drove me to a plasma center in Salt Lake City and we went inside and talked to the people there. And she said to me, you need to find out what's going on in the U.S, because it's reminiscent of what happened back in China.
And I asked her if she was concerned that there was viral contamination, and she said no. But they're depending too much on people who are low-income to sell their plasma, and that went wrong in China. So what's going on here?
And it's striking that we're using the word industry when talking about something like blood plasma. But as you've written, Kathleen, that is exactly what this is, because blood plasma is being sold for a profit in the U.S. How widespread are these donation-for-profit clinics in this country?
So at the current moment, we have around 1,000 for-profit donation centers in the United States. And the thing to know about that is 15 years ago we had one-third as many. So the volume of these centers has tripled in the last 15 years. And they're scattered all over the country, but predominantly found in lower-income Zip codes. So the industry has really done a specific job of targeting people who need the money, and, you know, paying them just enough to keep them coming back.
Do any u.
S states restrict the practice of selling blood plasma for money. It seems like all this is pretty legal, right?
It's more restricted by wealth and income. So you won't find plasma centers in wealthy neighborhoods and wealthy cities. You will find them in lower-income cities, in lower-income neighborhoods. You'll find them in places that have large colleges, large universities that tend to have a lot of students who need extra money. You'll find a big proliferation of them on the U.S..-Mexico border because Mexican citizens cross into the U.S.
To sell plasma? So I would say it's not restricted by law, it's restricted more by our own economic divides.
I think that is such an important point to bring up because obviously blood plasma is a crucial tool for treating you and many other Americans. But the concern here seems to be, who is being targeted for donations? Is that right?
That's right, and I think that who is being targeted and whether or not they're being exploited. So there is a lot of concern, and I share this concern that the industry is exploiting people and preying on economic inequality. So this medication is necessary, but I have to wonder if the profits are necessary and whether or not. We should be looking at what kind of profit should be allowed on medications like this. And I also think that most Americans who sell plasma are not aware that a good share of the plasma is going to other countries.
So, because this practice is restricted in most of the rest of the world, the U.
S has become the world's largest supplier of blood plasma. So there is a targeting of lower income people, and it's very deliberate. You can see it in where these plasma centers pop up.
As you've already touched on, the where behind these donations is really fascinating. You mentioned the Mexican border earlier. But also when our listeners hear mention of Flint, Michigan, a lot of them will probably think about the city's 2014 water scandal.
The crisis has left Flint deprived of clean water for nearly two years. It caused hundreds of Flint children to be poisoned with lead. Twelve people died of the waterborne legionnaire's disease, and officials are investigating they suspect it was caused by the poorly treated water.
When drinking water, there was contaminated with lead and possibly other harmful bacteria and chemicals. But these locations are also known for blood plasma donations. Can you tell us a little bit about that?
Flint specifically, and I think, like you said, everyone knows the story of Flint, I mean, Flint basically was the birthplace of the American middle class. And for decades, there was the possibility of people building wealth and earning incomes that would allow them to raise a family. When the auto industry abandoned Flint, they left it to Wither. And an interesting fact by the numbers to me about Flint is there are five or six paid plasma donation centers in Flint, which at this point has about 80,000 people.
Now, by comparison, there's a city near where I live, Missoula, Montana, which has 100,000 people and one plasma center. So you can really see the difference in how these companies target the poorest places.
And how lucrative is this industry? how much money does it produce in a given year?
In 2021, the industry generated more than $24 billion. There is an estimate that within a few years it will be worth more than $50 billion. So it's a major export product. Blood and blood plasma and associated products are one of the top 10 U.S exports products.
Plasma specifically, we export more plasma than soybeans, so it's really a massive product coming from the United States.
And when someone goes to one of these for-profit centers, how much money can they make for a donation?
You know, that's interesting, because it really depends on where you live. I have heard people earning $400 a month for going eight times in a month, the highest amount I've seen is $1,200 a month for one month. And it really depends on, in some ways, supply and demand. So if the industry is looking for more plasma, the prices will go up if they need more donors.
If they're in a particular area where they have fewer donors, the prices go up, it just depends where you live in the U.S. And from what I've seen, it seems that the targeting tends to offer the minimum amount of money. That will keep people coming back the maximum amount of times that they can. The other piece of it is because people don't know exactly how much money they're going to make in a month. It's not really a steady income that people can depend on. So if there were more transparency around the industry, I think it would be fairer to people who do it.
And these clinics that are run to make a profit, how does their operation differ from, say, hospital donations? Are the rules the same in terms of how many times you can donate or how much you can donate?
No, they're actually quite different and this is really interesting to me. So you can donate plasma at the Red Cross, which I think everyone knows is a non-profit, that's the place you go to donate blood. They have a very good reputation as being purely altruistic.
You can donate plasma at the Red Cross in some locations. If you do that, you are limited to donating 13 times a year. And that's, I think, what the Red Cross believes is an appropriate way to protect a donor's health. If you donate plasma at a for-profit center where you get paid, you can do it up to 104 times a year. So there's a massive gap in between what the Red Cross allows and what for-profit centers allow, just in terms of frequency.
The process itself is the same wherever you do it, so you go into the donation center. They put a needle into your vein with an IV sheet, and then they hook you up to a centrifuge. That spins your blood into parts and they keep the plasma. And the plasma, just for those who don't know, is the protein component of our blood. So the actual process is pretty much exactly the same.
The primary difference is the frequency that people are allowed to donate when they're doing it for money.
So for people who regularly donate blood, plasma, do we see any physical effects in those people?
You know, anecdotally, it really depends on the person. So I have talked to plasma donors who faint immediately after the process, I have talked to donors who need to sleep the rest of the day after they donate plasma. I've also met donors who it doesn't bother at all, and they've done it for years. The most common thing I would say people describe to me is just feeling weird and tired, more so than with blood donation.
And that might just be partly the frequency. This is another problem, though, I think, with the industry. There just hasn't been much long-term study on what happens to people and whether or not this affects their health in the long term. So I think one of the things we do need to do is look at more scientific study of what this does to a person's body. If you do it for years on end.
And when you talk to these companies that offer money for plasma donations, what do they say? how do they explain their business practices?
Well, you know, the plasma industry is very interesting. They say that the payment is a token for a person's time, so they have in court fought the designation of selling plasma as labor. So this is basically positioned as a token of appreciation for the person's time. However, because the amount differs depending on how many times you go in a month, it's difficult to not see it as labor.
The pitch I would say that companies make to donors specifically is get paid to save a life. And that's the kind of marketing that you will see all over. In some places, though, the marketing is actually really targeted as a job. So I saw an ad in a college football stadium last fall. That said, pays well part time, so really skirting the line of positioning it as a job.
And they don't mention the saving a life part. Now, if you go to a plasma center, you will see posters that say, Save a life, you know, and they'll have pictures of people that need the medication. But I would say they position it as both being an altruistic thing, but primarily, it is positioned to people as being a way to make money.
To be honest, Kathleen, I really did not know how prolific this industry was until I started reading your work. And I think that's true of many people in the U.S. Why do you think this isn't more widely known?
I think it's deliberate. I think there are several reasons for it. First of all, poverty is deeply stigmatized in the United States. We are not very good at talking about it and the things that people need to do to get by when they aren't wealthy, so that plays into it.
I mean, one thing that's always been very interesting to me in this work is that. We talk about blood donation as a heroic act, and people who donate blood are seen as very heroic. And they're doing this great thing to help people. People who donate plasma are doing something that's exactly the same. But the practice is stigmatized and linked to poverty, so I think that's one aspect of it.
The other piece of it is the industry itself, I don't think, wants as much attention, so the two factors work together. You have a deep stigmatization of poverty in the United States, and then you have an industry that doesn't like to have a lot of attention around what it's doing. When I first started working on this book, I thought I was going to find out that. A few hundred thousand people in the United States every year sell plasma. The number is almost certainly in the millions, and as high as 20 or 25 million.
So it's really massive, and just one of the things that's been very interesting to me is since I started working on this. The number of my friends and their family members who have told me that they sell plasma is just kind of mind-blowing. It's really everywhere.
KATHLEeN, I'm interested in getting your opinion on why we're largely fine with companies making profits off some body parts, but not others again, as we've talked about. Maybe some of this comes down to the fact that the blood plasma industry is pretty unknown. But why do you think legislatures have not yet intervened with the selling of things like blood plasma for a profit? But simultaneously, there's been a strict prohibition on the sale of organs since the passing of the National Organ Transplant Act in 1984. Why does that discrepancy exist?
So I'm not sure that people are so much fine with it and okay with it, but I don't think that most people know. The other piece to that to remember is that most people in positions of power in the United States are not the kind of people that come from financial backgrounds. Where they might have had to sell plasma at one point or another, so this practice is restricted to, I would say, people who of lower incomes, the working poor and the working class. And the other part of this that's been interesting to me is that people who sell plasma don't necessarily want to expose this industry as being predatory. Because they depend on it for an income. So you're not going to find a lot of calls from people who depend on the practice to shut it down.
So there isn't a real groundswell of public support to look into this and regulate it more heavily. The only people I have seen who are in politics who've mentioned the practice tend to be progressives who want universal health care and universal basic income. Which are two things that could actually solve some of our problems. But that would also require political will to address these underlying problems in our society. I don't think we've had a national conversation about whether or not this is okay. And if donors should be paid more and treated better, particularly in terms of not being expected to donate so often.
To finish up, Kathleen, I'd love to know why you felt moved to write this book. Do you hope that it'll spark some kind of change in this industry?
Yeah, I mean, when I first went into this, I thought it was going to be a science book and I was going to be really looking only at the science behind things. But it became very clear to me right away that this was a story of economic inequality and how embedded economic inequality is in our country. And my hope is that people will think about that more deeply and maybe make some changes. Like, do we really want to be a country where 19-year-old college students need to sell their body parts in order to buy groceries? And that's kind of.
My hope now is that people will think about why this practice is growing and why so many people depend on it. And if we should address the underlying problems that have created it.
Kathleen McLaughlin, Thanks so much for joining me on Politics Weekly America this week.
Thanks Joni, it was great.
There will be a link to where you can buy Kathleen's book on the episode description for today's show on the Guardian website. Please don't forget to subscribe to the Guardian's new podcast series, Cotton Capital, which is looking at the Guardian's links to transatlantic slavery. New episodes are released every Monday. Episode 3 follows journalist Deneen L. Brown as she travels to the Sea Islands in the United States to meet descendants of the West Africans. Who picked the cotton that made Manchester rich?
Just search for Cotton Capital wherever you get your podcasts and hit Subscribe. But for now, it's goodbye. The producer is Danielle Stevens and the executive producer is Maz Ebtehaj. I'm Joni Grieve. Thanks, as always, for listening.
This is The Guardian.
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