Confusing and conflicting blood donation rules obstruct Black blood donors in England

I scroll through Instagram, my feed alternating between pictures of my friends and adverts for makeup, clothes and natural hair products “especially formulated” for Afro-Caribbean textured hair.

My eye is drawn to the next advert: this time, it’s an appeal with a grinning man in a medical chair, donating blood. “We need more black donors to donate blood” the caption reads, urging readers to visit the website to sign up.

Image: NHS Blood Service campaign, 2020

I’m a healthy and fit 29 year old woman and a universal blood donor too. I care immensely about blood donation so I clicked the link and was taken through a list of questions to determine my eligibility.

What I found surprised and confused me. According to one part of the NHS Blood Donation Service, I was ineligible to donate because I had travelled to an African country in the past few months. What is more, my black British partner may also be denied to donate because as his partner, I classified as a person who “has, or you think may have been, sexually active in parts of the world where HIV/ AIDS is very common. This includes most countries in Africa.”

I work in HIV prevention in England so I was shocked that this would constitute as adequate grounds for refusal. As an individual, I test for HIV every year, and every time I have a new partner. I know that when I travelled I had no exposure to HIV.

I decided to look deeper into it. I visited a different part of the NHS blood donation website and completed their eligibility tool, and it informed me that based on visiting a certain city within Kenya that I would only need to wait 4 weeks, not 4 months. Confused by the information discrepancy, I called the service on the telephone and they confirmed that the rules had changed in response to the FAIR evidence review on blood donation eligibility, so I could now donate after only a 4 week wait. They registered me over the phone without any other issue and gave me an appointment to donate.

However, my doubts still remain. Will I turn up to the appointment and still be turned away? After going to all the effort for the good of my community? Will I ever bother to try registering again? Will other people in the community assume they cannot donate and never bother to register? Particularly in COVID times, very few people are actively seeking to go to healthcare centres to access services they may see as ‘non-essential’ to them – although they certainly are classed as essential to the NHS.

Black donors are ten times more likely to have the Ro and B positive blood types urgently needed to treat the 15,000 people in the UK suffering from sickle cell disease, a debilitating condition that is especially prevalent in people with an African or Caribbean background. Only 1% of current blood donors are black, yet while they are running urgent appeals to get more black donors through mass media advertising campaigns, they are simultaneously denying potentially thousands of willing donors on an outdated and discriminatory rule that is not individualised, not evidence-based, and vague and difficult to interpret. And while the website and telephone helpline send mixed messages, there has also been no indication from the government that their policy has changed.

I recently found out that the NHS blood service is set to overturn the blanket ban on gay men donating blood, which was banned on similar grounds as those which would affect me or my partner based on the thin possibility of HIV. This is fantastic news and needs to be similarly applied to all groups. It is disappointing to see such progress made for some marginalised groups, while failing to do so for others when there are no clear obstacles for doing so.

In fact, the discriminatory question around ‘partners of’ those from ‘many African countries’ has already been removed from both Scotland and Wales, leading to questions to why England alone is going firmly against the scientific advice of FAIR and declining to remove the discriminatory question, especially at a time when the blood service actively encouraging Black communities to donate blood and blood products due to shortages.

We need the Blood Service and the government to take an individualised approach to blood donation from people from Black backgrounds who are more likely to be affected by the discriminatory blanket ban than other groups.

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