Every time Bruno Dostie contemplates his brother’s fate, he catches a chilling glimpse of what may prove to be his own destiny. Bruno, a 30-year-old Montreal postal worker, and his brother Luc, 31, are both hemophiliacs. Both are also HIV-positive, infected a decade ago with injections of blood tainted by the human immunodeficiency virus that is the major cause of AIDS. So far, Bruno has remained free of any symptoms of the disease, but Luc has not been so lucky. “He’s very sick now,” Bruno says. “And when I look at what is happening to him I cannot help but wonder if the same thing is going to happen to me.” He pauses before adding, in a voice edged with anger: “It scares me but it also makes me mad—especially when I hear that there was a chance that it all could have been avoided.”
Bruno’s sense of outrage has increased in recent weeks because of evidence suggesting that he and his brother—as well as more than 1,000 other similarly afflicted Canadians—were hapless victims of bureaucratic bungling and inefficiency. Most of those victims were, like the Dostie brothers, hemophiliacs, dependent for survival on regular transfusions of blood-clotting agents. All were infected during the early 1980s by HIVcontaminated blood products supplied and distributed by government-regulated agencies. Ever since their cases came to light, Canadian authorities have maintained that little could have been done to prevent the tragedy. But recent disclosures by past and present government advisers have cast doubt on that claim. “The situation is incredibly confused and complex,” says David Page, president of the Montreal-based Canadian Hemophilia Society. “But it is becoming more and more clear that lives might have been saved—or at least prolonged—if a few government agencies had acted more quickly.”
Testing blood for AIDS: claims of bureaucratic bungling and inefficiency
The latest revelations in the spreading controversy over Canada’s tainted blood came last week from Dr. Michael O’Shaughnessy, a Vancouver-based AIDS research scientist who in 1984 was working as a senior director of the Federal Centre For AIDS with the department of health and welfare. In an interview for the French-language Radio-Canada network, O’Shaughnessy confirmed that senior Health and Welfare officials knew that HIV was rampant among hemophiliacs a year before they removed the last of the potentially contaminated blood from the national blood supply. O’Shaughnessy said that he advised Health and Welfare in July, 1984, that he had detected HIV in a staggering 56 per cent of blood samples taken from hemophiliacs. Despite his findings, the department did not fully implement mandatory heat treatment of blood products, which kills the virus, until July, 1985. Still, O’Shaughnessy was quick to absolve Health and Welfare of any blame for the delay, arguing that at the time he made his discovery there was no proven way to rid blood products of HIV. “It’s one thing to know you can get AIDS from blood,” he said, “but it’s another thing to know what to do about it.”
The government’s critics disagree. Even in 1984, Page said, there was an alternative—a process known as cryoprecipitation. In order to survive, hemophiliacs must regularly replenish the blood-clotting agent that is missing in their blood. In 1984, they could do this by one of two methods. The most efficient was through regular injections of Factor VIII, a plasma-based product. But since thousands of donors are required to produce a single lot of Factor VIII, the chances of HIV contamination are high. By contrast, cryoprecipitates offer far less risk of infection because they are produced from the blood of no more than 10 donors.
Page also disputes the argument that the authorities did not have the technology in 1984 to cleanse HIV-contaminated Factor VIII. ‘They knew by then that it was probably a blood-bom vims and they also knew that other blood-bom viruses, like hepatitis B, were killed by heat treatment,” he says. Indeed, a study published in the British medical journal Lancet in September, 1984, provided conclusive proof that heat treatment killed the AIDS virus. “Despite the evidence,” Page complains, “it still took them months to respond.” Even some federal health officials in charge of Canada’s blood distribution system acknowledge that they were slow to react. Last spring, the government established a
public inquiry that will investigate the events of a decade ago with a view to revamping the entire system. Public hearings are expected to begin later this year. “If we can establish blame, not necessarily on anyone in particular but even just in the system, then the government would be morally compelled to provide compensation,” said Winnipeg Liberal MP Rey Pagtakhan, a physician who has been in the forefront of the struggle to investigate the use of tainted blood.
Ottawa has already given humanitarian aid of $120,000 each to about 1,000 hemophiliacs and blood tranfusion recipients who contracted the virus in the early 1980s. Meanwhile, there are signs that Ottawa is not planning to wait for the results of the inquiry before reforming the country’s blood distribution system. “We are in the middle of thinking about reorganizing so that we can make decisions faster,” says William Dobson, executive director of the Canadian Blood Agency, one of the key agencies that regulates the distribution of blood products.
For many critics, the changes cannot come too soon. “Are we really equipped now to face the future?” Pagtakhan asked rhetorically. “I don’t think so.” He added: “It’s a cumbersome system that simply does not work fast enough during an emergency or crisis.”
The victims of the last emergency, a decade ago, offer tragic proof of that assertion. Of the more than 1,000 hemophiliacs and blood transfusion recipients who are known to have been infected by the AIDS virus at the time, a third are now dead. Many of the rest are still struggling to come to terms with their plight. “I freaked out for a long time after I learned I was HIVpositive,” Bruno Dostie recalls. “I just kept asking myself over and over again, Why me?’ ”
The young man, whose parents moved him as a child from Quebec’s Eastern Townships to Montreal so that he could receive treatment for his hemophilia, has managed to overcome his initial rage. But he is still bitter. “I’ve got a brother who is going to die and he’s only 31,” he says. “Even though I live in hope of medical science finding a cure for AIDS, I have to face the fact that I may follow him.” He gives his head a single shake. “I don’t really know who to blame, except maybe a system with so many professional secrets.” There is another long pause. “But it just doesn’t seem fair.”
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