Scientist defends racial profiling of potentially HIV-infected blood

Dominique Herman:

Racial profiling of blood was not only constitutional but downright desirable if one was to limit the number of units of potentially HIV-infected blood used for transfusions, according to Anita Kleinsmidt, of Witwatersrand (Wits) University's bioethics division.

Under a constitutional inquiry to determine whether racial profiling of blood donors was justifiable discrimination or racism, she found that racial profiling was "fair and just discrimination" as it served a required broader need - that of protecting the safety of the national blood pool.

On the second day of an Africa Genome Education Institute conference on race on Thursday, she said our Bill of Rights was not absolute and there were occasions when individual rights gave way to "overridingly important social concerns". Not all infringements of fundamental rights - such as those of equality and dignity - were unconstitutional.

Physician Trefor Jenkins, ex-head of the department of human genetics at the SA Institute for Medical Research and Wits, said possible consequences of the new blood policy, which prohibits racial profiling, could be an increase in the number of HIV infections via transfusions and consequent litigation and compensation; priority access to anti-retroviral therapy; an increase in the demand for autologous transfusions and for freezing blood for possible future need.

Jenkins even suggested the eventual demise of our national blood service.

Kleinsmidt's investigation of the constitution and how it related to racial profiling of blood was in response to the public furore that erupted in 2004 when an SA National Blood Service (SANBS) nurse discovered risk categorisations being used by the service to eliminate black donors. The debate was fuelled later when President Thabo Mbeki's donated unit of blood was discarded.

The minister of health at the time slammed SANBS's risk management as racist and demanded that it be eliminated. The policy has been shelved, and nucleic acid amplification testing (Nat) introduced.

With conventional testing, antibodies to HIV have to build up in the blood for as long as six weeks or longer after infection until they reach a detectable level. The Nat test reduces this "window period" to between five and 11 days.

Nat testing costs the country an additional R150-million a year and Kleinsmidt wondered whether that was an appropriate use of public health money when racial profiling worked effectively.

She reported that SANBS's four risk categories, determined from HIV tests conducted on donated blood collected from the inland region in 2005, showed that the highest positivity rate lay in new male and female donors who were black, coloured females and lapsed black donors - both male and female.

"I am a coloured female," she said, by way of explanation of the classification to the mostly international audience of scientists and academics.

Professor of health sciences at the University of London, George Ellison, described the risk groups as an "unpalatable truth". He said race was "useful, if not crucial, in some contexts."

Kleinsmidt said a hidden benefit of racial profiling was that it was a useful indicator of the risk in various groups for certain diseases and people should look at it as a way of examining their own risks and activities rather than engage in the "emotional" response that their dignity was compromised.

A separate risk implicit in abolishing the system of racial profiling was raised: those using the blood service as a diagnostic centre to get tested. This would attract "dangerous" donors.

Another participant said that if the stigma surrounding one's HIV status in this country did not exist, the whole problem of racial profiling, and the issue of using blood services as diagnostic centres, would disappear.

Unscreened blood flows through patients in Pak

Unscreened blood coursing through veins

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