Although 18 months have passed since a special Health Ministry panel proposed to change the criteria for blood donations so most Israelis of Ethiopian origin and gay men could donate blood, the recommendations have yet to be adopted and no one is sure when they will be.
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The recommendations call for accepting blood donations from anyone of Ethiopian origin who has lived in Israel for over 10 years, and from men who have not engaged in sexual relations with other men in the preceding 12 months. The recommendations have yet to be published, and there has been no explanation of why they aren’t being implemented.
In a response on Sunday, the Health Ministry said the issue is under discussion and when the review is completed, “we will define precisely the directives regarding blood donations.”
Currently, only Ethiopian-Israelis who were born in Israel can donate blood, and gay men cannot give blood if they’ve had homosexual relations since 1977. These restrictions have been in place for decades and stemmed from a concern that HIV-tainted blood might enter the nation’s blood banks. HIV is the virus that causes AIDS.
The committee to reevaluate these criteria was appointed by former Health Minister Yael German. It was headed by Prof. Manfred Green, head of the University of Haifa’s School of Public Health, and operated from early 2014 until it submitted its conclusions to then-Health Ministry Director General Prof. Arnon Afek in April 2015. It researched the issue all over the world and concluded that the restrictions could be relaxed to bring Israel into line with guidelines in other countries.
Since the recommendations were submitted ministry officials have only met twice to discuss them, both times without Green present. After Haaretz asked the Health Ministry why no progress had been made on implementing the recommendations, the ministry issued an urgent invitation to committee members to attend a meeting on the issue November 24.
The refusal of the nation’s blood banks to accept blood donations from Ethiopian-Israelis been a bone of contention for over 20 years. In 1996, it was revealed that thousands of units of blood donated by Israelis of Ethiopian origin had been destroyed rather than used, and the controversy left a deep scar on the Ethiopian immigrant community.
The most recent incident to make headlines occurred in December 2013, when a special blood drive was held at the Knesset and then-Yesh Atid MK Pnina Tamano-Shata was not allowed to donate blood because she was born in Ethiopia, although she had lived in Israel since she was 3. The blood technicians cited Health Ministry regulations prohibiting the use of blood from someone who was born or lived for more than a year in an HIV-prevalent country since 1977, which includes countries in Africa, Southeast Asia and the Caribbean.
German appointed the committee one month later. Panel members included experts on infectious diseases and hematology, the directors of the large hospital blood banks and public-health experts, including an expert from Yale University and a British expert on blood and organ transplants. Other members were Prof. Asa Kasher, who was responsible for the ethical considerations, Dr. Yuval Livnat, chairman of the Israel AIDS Task Force, and Asher Elias, a social activist from the Ethiopian community.
The committee was tasked with revisiting the Blood Donor Questionnaire, which was last updated decades ago, and to focus on three key issues: Blood donations by those of Ethiopian origin, donations by men who have sex with men, and the age limit for donations (currently 65 for a first-time donor, and 70 for people who give regularly). The committee, as noted, called for easing restrictions on the first two groups, and doing away with the age limit for blood donations.
“The committee did very serious work that encompassed a lot of knowledge,” said Green, the committee chairman. “We collected material from all over the world, we consulted with numerous professionals, including people outside the committee. The recommendations we submitted in the end were unequivocal and supported by all members of the committee.
“People from endemic areas can donate blood after 10 years. That’s the accepted guideline and we believed it would be proper to adopt it here as well,” Green continued. “Israel is the only country in the world that forbids people from these areas to donate blood.”
Another committee member, Dr. Daniel Danai, chairman of the Association of Physicians of Ethiopian Origin, noted that Israel is the only country in the world that restricts blood donations from Ethiopians altogether. “There isn’t a single country — not even places like Canada, the United States or Britain, where the HIV-infection rates are higher than in Israel — that specifies Ethiopia as a place where those who visited there can’t donate blood,” he said. “This injustice has to stop.”
Dr. Gil Hirschhorn, the committee’s coordinator, said the committee’s work is not complete and that the recommendations still need some “fine tuning.” But he admitted that the ministry was moving slowly. “They’re dealing with it at low intensity,” he said.
Why this is so when the changes are clearly so important to the Ethiopian immigrant community is not clear. “When they don’t want recommendations to be accepted, they won’t be accepted. There are those who have no interest in getting the recommendations accepted,” said Elias, without elaborating.
German, who appointed the committee, said the recommendations about Ethiopian blood donations “Are revolutionary from any point of view. The moment they are accepted it means that 98 percent of the Ethiopian community will be able to donate blood, and the State of Israel can finally erase this shame.”
Both German and other sources say that despite the committee’s research, there still remains strong opposition from the director of the Magen David Adom blood bank, Prof. Eilat Shinar, to loosening the restrictions. “The blood bank has a very conservative approach,” German said.
Shinar, however, said she has no objection to the recommendations, but added, “adopting the recommendations must be accompanied by additional steps and monitoring mechanisms and follow-up to preserve the safety of the blood.”
German also blames Health Minister Yaakov Litzman, who succeeded German as health minister last year. The hostility between them is well known, and Litzman in general isn’t motivated to advance any of German’s initiatives. In this case, German believes the reason the recommendations regarding the Ethiopian community aren’t being adopted is the accompanying recommendations that relax restrictions on donations from homosexual or bisexual men.
In December 2014, the U.S. Food and Drug Administration canceled the blanket ban on blood donations from homosexual and bisexual men which had been in place since 1983, and now permits donations from men who had not had sex with other men during the previous 12 months. The Israeli committee took this FDA recommendation into account.
German notes that even though the more liberal policy still leaves most homosexual men out of the donor pool, it is still important on declarative level. But she believes that the lifting of restrictions for the Ethiopian community is critical. “I have no doubt that first we must implement the conclusion regarding the Ethiopian community. The blood of the Ethiopian community is good enough for the battlefield but not good enough for donations? We must erase this stain.”