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Prevention/Epidemiology
South African Blood Service to Stop Calculating Donors' Risk of HIV Infection Based on Race

December 7, 2004

The South African National Blood Service on Friday said that it would no longer use race as a risk factor for HIV infection in donated blood after the country's health minister said the policy "smacks of racism," London's Guardian reports. SANBS previously used a system where regular donors who are white or Indian are deemed Category 1 -- or at lowest risk for HIV or other diseases -- while black donors are classified as either Category 3 or Category 4 because HIV and hepatitis are thought to be "more widespread" among blacks, according to the Guardian. Robert Crookes, medical director of SANBS, said the system was the "most logical, medical, ethical and legally defensible" available (Carroll, Guardian, 12/4). However, it was unclear exactly how the agency classified the blood because donors were not asked to give their race when they donated, the SAPA/News24.com reports. The change in policy came in response to a case before South Africa's Commission for Conciliation, Mediation and Arbitration filed by a SANBS nurse who was fired for objecting to policy, which she considered to be racial profiling. SANBS fired Poppie Bereng after she insisted that a clause be inserted in her contract saying that she did not have to be involved in drawing blood from black people because their blood usually is destroyed. CCMA demanded that Bereng be reinstated at SANBS, and the case prompted Health Minister Manto Tshabalala-Msimang on Thursday to denounce the policy of using race as a risk factor for the transfusions.

Plans, Actions
Department of Health spokesperson Sibani Mngadi said that race will no longer be used to determine donated blood's risk level, adding, "The current risk-rating model needs to be reviewed as a matter of urgency, and other scientific determinants should be identified and integrated into the model to determine risk more accurately" (Barnes, SAPA/News24.com, 12/3). But it was "not immediately clear" whether SANBS would continue to use race as a factor when profiling the safety of blood donations, SAPA/SABC News reports. "Until we get instructions from the minister of health and until they tell us what measures to take that we can ensure that everyone receives the safest blood possible, we will continue using the current methods," Diane de Koning, director of donor services for SANBS, said. The group will hold a board meeting on Tuesday to discuss the current risk-rating methods for blood safety, according to Mngadi (SAPA/SABC News, 12/6).

Mbeki's Blood Also Destroyed
As part of the policy, SANBS also "routinely" incinerated blood that had been donated by South African President Thabo Mbeki because of his race, the SAPA/News24.com report. Mbeki, along with other South African public figures, has donated blood in the past to promote awareness drives for blood transfusions (SAPA/News24.com, 12/3). Ravi Reddy, SANBS director of technical services, said when Mbeki donated blood, the agency "had to take a decision whether to abort bleeding the president, which would have been a disaster from a publicity point of view, or whether to draw blood and then dispose of it." Mbeki spokesperson Bheki Khumalo said that the president "did not want to be involved in a public discussion on the matter," Reuters/lexpress.mu reports (Reuters/lexpress.mu, 12/5).

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