UNDER THE MICROSCOPE

Recently, House Bill 8820, titled “An Act Promoting the Adequate Supply of Blood Plasma, Authorizing the Collection, Storage, and Commercial Distribution of Blood Plasma and for Other Purposes,” was filed in the House of Representatives, which will allow commercial blood-plasma collection centers in the Philippines. This directly contradicts RA7719, “An Act Promoting Voluntary Blood Donation, providing for an Adequate Supply of Safe Blood, Regulating Blood Banks, and Providing Penalties for Violation Thereof,” which bans the use of remunerated/paid blood donors and established the National Voluntary Blood Services Program (NVBSP). Alarmingly, HB8820 seeks to repeal sections 3(a) and (f), 7, and 8 of RA7719, thus allowing for paid blood donors and the legal operation of commercial “plasma collection centers.”

Having worked for the establishment of the NVBSP in my capacity as officer-in-charge of the fledgling Philippine Blood Center and as the division head of the Philippine Children’s Medical Center where I established the Pediatric Blood Center, I am very apprehensive about the effects of HB8820 if enacted into law. 

It has been 30 years since RA7719 was signed into law, and we now have a functioning National Voluntary Blood Services Program (NVBSP) involving public and private hospitals. We have successfully campaigned to close down commercial blood banks, which used to operate until 1994.

What HB8820 seeks to do is to insert a Trojan Horse into RA7719, definitely a big step backward for blood banking, to the detriment of the patients who are in need of safe and affordable blood. 

The trend worldwide is for voluntary blood donations, which are far safer and better in quality than blood from paid donors, who may conceal their history of poor health and exposure to blood-borne infections such as HIV, hepatitis B and C, syphilis, and malaria. Paid donors’ resort to frequent blood “donations” to continue receiving money. Many are actually anemic, making their blood poor in quality for transfusing into anemic patients. We experienced this in the past when only commercial blood banks existed. 

In 2018, the country collected over 1.12 million units of blood, exceeding the target of one percent of the population voluntarily donating blood annually. Donations naturally decreased during the pandemic but have bounced back to 920,000 units since last year. It cannot be said that there is a blood shortage. What we really have is a maldistribution of blood products, where remote areas in need of blood products cannot access the supply from urban centers, where the blood centers are. 

Plasma comprises 55 percent of our blood; a single 450 ml unit of blood yields approximately 200 ml. of plasma. Fifty percent of frozen plasma products are discarded due to the mandatory expiration of one year, since there is low demand for fresh frozen plasma. Therefore, there is an excess of 92,000 liters of plasma in the Philippines per year, enough to conduct plasma fractionation to produce plasma products such as IVIG (Intravenous immunoglobulin), coagulation factors, albumin, and others for the country’s needs. The bill is silent on this fact.

Why is there a need for commercial plasma collection centers? In essence, these are commercial blood banks, since they will collect whole blood from paid donors, to be separated into packed red cells, platelet concentrate, and plasma. It is the packed red cells and platelet concentrates that are in much demand, and therefore, these commercial operators will be “distributing” these “by-products” — for a fee, of course, thereby circumventing the intent of RA7719.

This development comes just as the NVBSP has been reduced to a unit of the Disease Prevention and Control Bureau (DPCB), which has nothing to do with assuring the quality and safety of blood products. The NVBSP is backstopped by a law. It should be a flagship program of the DOH, but the recent reorganization did exactly the opposite, marginalizing the importance of a safe blood supply in the country. This development and the filing of several bills on blood and plasma in conjunction with HB8820 augurs poorly for patients in need of blood.

Few will be making big profits out of this change, exploiting the desperately poor Filipinos into selling their blood so they can feed their families at their health’s expense. It is not unlike prostitution, selling their blood instead of their bodies. Both are totally degrading and detrimental, both to themselves and their eventual “consumers.” 

In this increasingly desperate climate, where more and more Filipinos are sinking into poverty, and the prices of essential commodities are skyrocketing, the temptation to sell themselves will be too much to resist. Pity the poor Filipino.