HEALTH: The strange dark world of the for-profit blood industry

Donating blood is a charitable gesture that saves lives and conjures up images of Red Cross drives and good Samaritans doing their part. Selling plasma — the watery, yellowish protein component of blood — is something else entirely.

In a sign of just how desperate some members of America’s working poor are for money, they sell their plasma, although it’s far from a lucrative gig. Donors are paid around $25 for a first visit, perhaps $5 more for the next few visits and up to $100 for a 10th donation. It’s a job that might buy a tank of gas or some groceries at the most.

One Idaho family of regular donors scheduled their daughter’s 18th birthday at a local plasma center. They wanted her to be able to start selling plasma on the very first day she was legally able to do so.

Plasma is the watery, yellowish protein component of blood.

Plasma extraction is similar to donating blood, with the donor sitting in a chair for about an hour as their vital liquids are mined through a needle in the vein. Most people are eligible, providing they aren’t too old or obese. People with high blood pressure are also ineligible, as well as those with ailments like the flu, or transmissible diseases such as hepatitis or HIV. There aren’t any known negative health effects resulting from the process, although at least one donor reports feeling next-level fatigue on the days his plasma is taken.  “Losing plasma seems to drain the body almost to the bone,” the man confided to author Kathleen McLaughlin in “Blood Money: The Story of Life, Death, and Profit Inside America’s Blood Industry” (Atria). “It’s a different kind of tired.”

“Paid plasma extraction is . . . nothing but a low-paid, exploited job,” writes McLaughlin.

Still, the people who line up at plasma centers often rely on the money. In Florida in 2014, when a woman was told she couldn’t donate that day due to obvious illness, she swore to employees she’d “kill [them] all” before smashing her Honda Accord through the front windows of the facility.

Plasma extraction is similar to donating blood, with the donor sitting in a chair for about an hour. After the procedure, donors are often very tired.

Science has used plasma to produce medicines that work, McLaughlin writes.

“In the 1950s and 1960s, doctors began treating immunocompromised patients with injections of immune cells derived from the plasma.” Today those medicines help with cardiac surgeries, burn treatments and for infants with blood disorders — but from the beginning, the pharmaceutical industry has mined plasma, mostly from people with little choice. In the 1960s, Arkansas forced inmates in state prisons to donate, paying the incarcerated a paltry sum before re-selling it to a Little Rock biomedical company for $50 each. In the Henan province of China in the 1990s, a “weird plasma economy” occurred where entire villages donated to make easy money. The Chinese government failed to mention the dangers of donating, and as many as a million residents ended up with HIV.

Today, only 5 countries allow plasma-for-cash sales — including Austria, Germany, Hungary, and the Czech Republic — but the United States is the biggest producer. Called the “OPEC of plasma,” the US produced blood products in 2021 worth upwards of $24 billion. That’s 2.69% of the country’s total exports.

plasma donations
In the 1950s and 1960s, doctors began treating immunocompromised patients with injections of immune cells derived from the plasma.

McLaughlin believes Americans donate so much not because they’re altruistic, but because this country has more economic inequality than most. Of the more than 100 plasma donors she interviewed over 2 years, most admitted doing it only for the “extra income.”

That’s likely why over the course of her research, McLaughlin found plasma centers mostly in disadvantaged cities like Flint, Mich., where the dying automobile industry led to massive unemployment, and El Paso, Texas. (Prior to Covid, as many as 10,000 Mexicans regularly crossed the border to earn money for selling blood parts before returning to their Juarez homes.)

“In the way that pawn shops once were a sign of a community on the ropes, the vampire-like presence of the plasma industry can now tell you a lot about a city or town,” McLaughlin writes. “This appears to be a pattern across the Rust Belt, in the South, and in the Southwest along the border with Mexico.”

donated blood
In 2021, the US produced blood products worth upwards of $24 billion. That’s 2.69% of the country’s total exports.

McLaughlin’s interest in the industry resulted because she benefits from it: Suffering from an immune disorder, the author is kept alive by intravenous human immunoglobulin (IVIG), the most common product produced from plasma. But her individual story is also telling in that the plasma sold for about $25 ends up being made into medicine which costs $10,000 for a six month supply (this amount is, fortunately, covered by her insurance.) When the author shared the price discrepancy with a Flint plasma donor, he could only laugh.

“Why have we decided that the blood of the working poor in the United States should feed a massive, profit-motivated global industry?” McLaughlin asks. One donor in Idaho shrugged off the question, saying that “people do all kinds of crazy things for money.”

blood money
McLaughlin found plasma centers mostly in disadvantaged cities.

Emily, a plasma seller in Texas, agreed — while also highlighting who’s being taken advantage of primarily to increase the global profits of international conglomerates.

“I’m thankful and grateful it’s a possibility,” she says, explaining that her numerous driving violations led to legal troubles she couldn’t afford. “Sometimes there’s nothing else we can do. I would sell my kidney if I could have, in order to pay for my probation.”

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