Botswana native forbidden to give blood FDA limits giving by people from sub-Saharan Africa.

July 12, 1991|By Shanon D. Murray | Shanon D. Murray,Evening Sun Staff

Dorothy Whisler's brother served in the Persian Gulf with the U.S. Army, and that was one of the reasons she volunteered in May to donate blood at the Red Cross' yearly blood drive at Western High School.

The 18-year-old northeast Baltimore woman said she wanted to give part of herself for a "good cause."

Her offer was not accepted.

Dorothy Whisler is a native of Botswana. In line with a federal Food and Drug Administration policy instituted in 1988, many

blood banks, including those administered by the American Red Cross, don't accept blood donations from natives of, or recent visitors to, sub-Saharan Africa. The reason? The prevalence there of HIV-2.

That virus, which causes acquired immune deficiency syndrome, slightly different from HIV-1, which has infected an estimated 1 million or more people and resulted in about 150,000 AIDS deaths in the United States since 1981.

Botswana, where Whisler was born, is in central southern Africa, directly north of South Africa. Whisler moved with her family to the United States when she was 3.

"Geographical restrictions are ridiculous," the woman said. "No one has the opportunity to choose where she is born. I can understand if I chose an unsafe sexual lifestyle.

That is a matter of choice. They turned me away because I was born in Africa."

Unlike its "cousin" HIV-1, HIV-2 is found almost entirely in certain parts of Africa and was identified as an AIDS-causing virus in 1985. The federal Centers for Disease Control in Atlanta said just 18 cases of HIV-2 have been reported in the United States.

Due to fears about HIV-2, the Red Cross won't accept blood from natives of sub-Saharan Africa, or those who have visited there recently for a lengthy period. It will accept blood from people who have had contact with these nine African nations: Morocco, Mauritania, Algeria, Libya, Egypt, Tunisia, Sudan, Somalia and Western Sahara.

But some people view the exclusion as racial discrimination and are upset that agencies such as the Red Cross aren't making an extra effort to screen out tainted blood from donors of sub-Sahara African origin.

The test used for HIV-1 does not detect HIV-2, and a test that is available is too expensive, according to Red Cross officials. They are awaiting federal approval of a less costly test, they said.

The FDA updated its policy in December 1990 to allow blood donations from all people, regardless of geographic origin, if the blood bank provides licensed screening for HIV-2, said Brad Stone, an FDA spokesman.

According to the FDA, Genetic Systems Corp. in Seattle developed the first and only HIV-2 antibody test in North America. The FDA licensed it in April 1990. The test reportedly has a 99.8 percent sensitivity to HIV-2.

Because the number of cases of HIV-2 infection in the United States is still minuscule, blood banks throughout the nation have the choice of either adopting the licensed HIV-2 screening procedures or continuing with the sub-Sahara Africa exclusion. The Red Cross continued with the geographic restriction.

"The Red Cross' decision is racial for the simple fact that a test is available," said Dorothy Whisler's

mother, Baba. "When I talked to a representative about my daughter's rejection, she made it sound like a test did not exist."

Dr. Gerald Sandler, chief medical officer for the Red Cross in Washington, said the HIV-2 antibody test would be too costly to adopt, but a test still being developed may be used by the organization later.

A spokesman for Genetic Systems, a company that develops and markets screening tests for AIDS and other infectious diseases, concurs that the cost of the test -- about $4 per unit of blood -- is part of the reason that only 3 percent of the American blood supply is screened for HIV-2.

The Red Cross has elected to wait for a HIV-1/HIV-2 combination antibody test that was developed by Abbott Laboratories, a research company based in Illinois. Red Cross officials believe that the FDA will approve that test in months or even weeks.

"The combination test will easily fit with our equipment and will operate with an 80 to 90 percent accuracy," Sandler said.

"This is not a black and white issue," said Dr. Tyson Tildon of the University of Maryland School of Medicine and a member of the Maryland Red Cross board.

Tildon emphasized that the ban restricts white South Africans and any white visitors to the region as well as blacks.

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