TODAY Derek From is a successful lawyer in Canada. Twelve years ago, he was roughing it in Arizona, trying to break into the recording industry. So he started selling his blood plasma. Twice a week, he sat for an hour in a Grifols Biomat centre, as an apheresis machine whirled, siphoning the plasma out of his blood. For this, he took home $45. “As a poor person” at the time, he found that “a huge economic benefit”.
It was also part of a thriving industry. Blood products made up a remarkable 1.6% of American exports in 2016. Since 2005 blood-plasma collections have nearly quadrupled. To critics, this is evidence of a rapacious industry coercing the poor to auction bits of themselves to make ends meet. In fact, plasma, 90% of which is water, is quickly replenished. Giving it has no obvious negative health effects—though the long-term consequences of repeated siphoning have not been fully studied. Strict testing (and later heat-treating) of the extracted plasma ensures that those with communicable diseases who might lie about risky behaviour for cash—like drug addicts—are quickly discovered, and the tainted blood products are not shared.
To focus on the perceived hardship of plasma donors, moreover, is to ignore the needs of the patients it helps. Consider Jim Crone, who as a 25-year-old man suddenly fell ill with Guillain-Barré syndrome, an autoimmune disorder where the body begins attacking its own nerves. Within days, he was confined to hospital, breathing through a ventilator and nearly completely paralysed—able to communicate only by blinking. He was treated with intravenous immunoglobulin, and nearly a decade later, is now in remission. “Without it, I would be laid up in a hospital bed in intensive care and fighting for my life, quite frankly,” he says.
The World Health Organisation lists immunoglobulins and coagulation factors—both plasma-derived products—as essential medicines. Yet poor countries are often desperate for them and rich countries rely on American imports. Without financial incentives, supplies are hard to come by. “It’s not in people’s nature”, says Mr From, “to let a phlebotomist poke a needle in your arm and suck your blood out.”