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S. Africa Race Policy May Have Cut HIV
By LINDSEY TANNER, AP Medical Writer
Tue Jan 31, 4:01 PM ET

CHICAGO - A controversial policy in     AIDS-ravaged South Africa that barred many blacks and
even the country's president from donating blood led to a substantial drop in     HIV-tainted
blood supplies, a study found.

"Hundreds or more would have gotten infected from blood transfusions" without the race-based
policy, said senior author Dr. Michael Busch of the Blood Systems Research Institute in San
Francisco.

Even so, Busch said that's not an argument in favor of it. Rather, it underscores "the dilemma
of trying to maintain a safe blood supply in the challenging arena of epidemic infectious
disease and social expectations," he said.

The policy barring many blacks from donating blood was in effect from 1999 to 2005. The
research looked at nearly 900,000 blood donations collected from the policy's first year as it
was phased in, and compared that with almost 800,000 donations collected from 2001-02, when the
policy was in full swing.

HIV was detected in .17 percent of donations in the earlier period, but that dropped 50 percent
to .08 percent in the second year, the researchers reported.

Dr. Anthon du P. Heyns, the top executive of the South African National Blood Service, and
colleagues collaborated on the study, published in Wednesday's     Journal of the American
Medical Association. The study looked at donations in the Blood Service's Inland region.

The     World Health Organization estimates that up to 10 percent of HIV and AIDS infections
globally are acquired from blood transfusions. The risks are highest in countries including
South Africa, where it's believed 5.3 million to over 6 million people are infected, the
highest number worldwide.

That compares with slightly more than 1 million infected people in the United States.

Evidence suggests that 24 HIV-infected units of blood entered that nation's blood supply in
1999, the JAMA article said. Concern over tainted blood and the country's AIDS epidemic
prompted the policy, which included "enhanced donor selection" and education, the authors said.

Under the old and new policies, prospective donors are asked to answer a questionnaire about
their medical history, sexual practices and drug use.

Using potential donors' race as a marker of risk was the policy's most controversial component,
and it prompted an outcry after President Thabo Mbeki's donated blood was discarded in 2004
partly because of his race.

More recently, the blood bank's policy of excluding donations from sexually active gay men also
has come under fire in a country where AIDS is an overwhelmingly heterosexual disease.
Officials say that, too, is now under review.

The old policy involved closing blood-donation sites in high-risk regions, a practice that
severely skewed the donor pool "so that black individuals, who comprise 79 percent of the
population contributed only 4.2 percent of the blood supply in 2001-02, down from 10 percent in
1999," the authors said.

The South African Department of Health in December 2004 declared that race was not an
acceptable risk indicator, and officials decided last February to adopt a new policy. Now
individual blood samples are tested.

"We do not defend the past practice at all," Heyns said. "We also will not resume the previous
risk management policy where race was used."

The researchers predict that the newest testing methods will greatly reduce the risk of getting
HIV-tainted donations.

___

Associated Press writer Alexandra Zavis in Johannesburg, South Africa, contributed to this
story.

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