HIV-tainted blood scandal (Japan)

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Japan's HIV-tainted blood scandal, known in Japanese as 薬害エイズ事件 (yakugai eizu jiken), refers to an event in the 1980s when between one and two thousand Japanese patients with haemophilia contracted HIV via tainted blood products. Controversy centers on the continued use of non-heat-treated blood products after the development of heat-treatments that prevent the spread of infection.

1 Early years
2 "AIDS Year One"
3 The tainted blood scandal exposed
4 Charges
5 Sources
6 See also

[edit] Early years

Acquired Immune Deficiency Syndrome, or AIDS, is a communicable disease caused by the Human Immunodeficiency Virus, HIV. AIDS is currently considered incurable. The first reported cases of AIDS occurred in Los Angeles in 1981. See full article at AIDS.

It was not until 1985 that the first cases of AIDS were officially reported in Japan [1]. As early as 1983, however, Japan's Ministry of Health and Welfare was notified by Baxter Travenol Laboratries (BTL) that it was manufacturing a new blood product, licensed by the U.S. Food and Drug Administration (FDA), which was heat-treated to kill HIV. BTL was interested in licensing this new product in Japan. Japan's own Green Cross Corporation, the main Japanese provider of blood products protested that this would constitute unfair competition, as it was "not prepared to make heat-treated agents itself" [Leflar]. The Ministry of Health responded by ordering screening of untreated blood products, clinical trials of heat-treatments, and a campaign to increase domestic blood donations. Green Cross meanwhile distributed letters of "safety assurance of unheated blood products" to patients, many of whom suffered from haemophilia [Miyamoto].

[edit] "AIDS Year One"

On January 17, 1987, Japan's AIDS Surveillance Committee reported that "for the first time" a Japanese woman had contracted AIDS. Described as a "habitual prostitute," the woman had reportedly had sexual intercourse with "a hundred men," including "non-Japanese," and had lived in Kobe with a "non-Japanese" sailor from whom the Committee concluded she had contracted HIV. On January 18, Shiokawa Yuichi, chair of the government commission in charge of AIDS policy, announced that the disease was now a threat to "ordinary people living ordinary lives." He proclaimed 1987 Japan's "AIDS Year One" [Treat].

Kobe exploded in panic. Thousands of people went in for testing and visited health centres, and "armies of reporters" tracked the woman down like a "criminal," publishing her photograph, real name, and address in newspapers. Much later it was admitted, after the woman's family filed a lawsuit, that she had never been a prostitute [Ikeda].

AIDS was seen as a foreign disease; some began to refer to it as a kurobune, literally a "black ship," a reference to the American invasion by Commodore Matthew Perry in 1853. "No Foreigners Allowed" signs began to appear at businesses throughout Japan; Japanese people were warned not to have sex with foreigners and to be wary of those who had. A government-produced pamphlet showed an image of the Statue of Liberty holding a book on AIDS and towering over a trembling Mount Fuji. Hospitals began advertising that they had no HIV-positive patients, and the Diet introduced a bill to ban HIV-positive foreigners from entering Japan. [Treat].

[edit] The tainted blood scandal exposed

In May and October of 1989, HIV-infected haemophiliacs in Osaka and Tokyo filed lawsuits against the Ministry of Health and Welfare and five Japanese drug companies. In 1994 two charges of attempted murder were filed against Dr. Abe Takeshi, who had headed the Health Ministry's AIDS research team in 1983; he was found not guilty in 2005. Abe resigned as vice-president of Teikyo University.

In January of 1996, Kan Naoto was appointed Health Minister. He assembled a team to investigate the scandal, and within a month nine files of documents related to the scandal were uncovered, despite the Ministry of Health's claims that no such documents existed. As Minster, Kan promptly admitted the Ministry's legal responsibility and formally apologised to the plaintiffs.

The reports uncovered by Kan's team revealed that, after the report about the possibility of contamination, untreated blood products were recalled by the Japanese importer. However, when the importer tried to present a report to the Ministry of Health, it was told that such a report was unnecessary. The Ministry claimed that there was a "lack of evidence pointing to links between infection with HIV and the use of unheated blood products." According to one official, "we could not make public a fact that could fan anxieties among patients" [J.E.N].

According to the files, the Ministry of Health had recommended, in 1983, that the import of untreated blood and blood products be banned, and that emergency imports of heat-treated products be allowed. A week later, however, this recommendation was withdrawn because it would "deal a blow" to Japan's marketers of untreated blood products [Updike].

In 1983 Japan imported 3.14 million litres of blood plasma from the US to produce its own blood products, as well as 46 million units of prepared blood products. These imported blood products were said to pose no risk of HIV infection, and were used in Japan until 1986. Heat-treated products had been on sale since 1985, but there was neither a recall of remaining products nor a warning about the risks of using untreated products. As a result, untreated blood preparations stored at hospitals and in patients' home refrigerators were used up; there have been cases reported in which individuals were diagnosed with haemophilia for the first time between 1985 and 1986, began treatment, and were subsequently infected with HIV, even though it was known that HIV could be transmitted in untreated blood preparations, and treated products had become available and were in use at that time.

As early as 1984, several Japanese haemophiliacs were discovered to have been infected with HIV through the use of untreated blood preparations; this fact was concealed from the public. The patients themselves continued to receive "intentional propaganda" which downplayed the risks of contracting HIV from blood products, assured their safety, and promoted their use. Of some 4500 haemophiliacs in Japan, an estimated 2000 contracted HIV in the 1980s from untreated blood preparations [J.E.N].

[edit] Charges

Matsushita Renzo, former head of the Ministry of Health and Welfare's Pharmaceutical Affairs Bureau, and two of his colleagues, were found guilty of professional negligence resulting in death. Matsushita was sentenced to two years in jail. A murder charge was also brought against him. Matsushita, who after retirement became president of Green Cross, is one of at least nine former Ministry of Health bureaucrats who have retired to executive positions in Japan's blood industry since the 1980s (see ama kudari).

[edit] Sources

"AIDS," in Encyclopaedia Britannica Online

Feldman, Eric A., and Ronald Bayer, eds, Blood Feuds: AIDS, Blood, and the Politics of Medical Disaster," New York: Oxford University Press, 1999.

Leflar, Robert B. "Cancer, AIDS and the Medical Information Fulcrum," in Japan Quarterly vol. 44. April-June 1997.
Miyamoto, Masao. "Castration, the HIV Scandal." Speech. Massachusetts Institute of Technology. Cambridge, Mass: April 10, 1996.
Treat, John Whittier. Great Mirrors Shattered: Homosexuality, Orientalism, and Japan. New York, New York: Oxford University Press, 1999.
Ikeda, Eriko. Society and AIDS, in Japan Quarterly vol. 42. January-March 1995.
"Japan Sent Back HIV-Tainted Blood Products to US in '83," in Japan Economic Newswire February 8, 1996.
Updike, Edith Hill. "Anatomy of a Tragedy: An AIDS Scandal Shakes Up Japan, Inc.," in Business Week, March 11, 1996.