In 1988 the Report of the Presidential Commission on the Human Immunodeficiency Virus Epidemic accused the industry of being “unnecessarily slow” in reacting to the AIDS threat. Blood banks had been urged to discourage members of high-risk groups from donating blood. They had been urged to test the blood itself, screening it for signs of coming from high-risk donors. The blood banks delayed. They pooh-poohed the risks as so much hysteria. Why?

In his book And the Band Played On, Randy Shilts charges that some blood bankers opposed further testing “almost solely on fiscal grounds. Although largely run by non-profit organizations like the Red Cross, the blood industry represented big money, with annual receipts of a billion [a thousand million] dollars. Their business of providing the blood for 3.5 million transfusions a year was threatened.”

Furthermore, since nonprofit blood banks depend so heavily on volunteer donors, they hesitated to offend any of them by excluding certain high-risk groups, homosexuals in particular. Gay-rights advocates warned darkly that forbidding them to donate blood would violate their civil rights and would smack of the concentration-camp mentality of another era.

Losing donors and adding new tests would also cost more money. In the spring of 1983, the Stanford University Blood Bank became the first to use a surrogate test on blood, which could indicate whether the blood came from donors at high risk for AIDS. Other blood bankers criticized the move as a commercial ploy to attract more patients. Tests do increase prices. But as one couple, whose baby was transfused without their knowledge, put it: “We certainly would have paid an additional $5 a pint” for such tests. Their baby died of AIDS.

The Self-Preservation Factor

Some experts say that the blood banks are sluggish to respond to dangers in blood because they do not have to answer for the consequences of their own failures. For instance, according to the report in The Philadelphia Inquirer, the FDA (U.S. Food and Drug Administration) is responsible for seeing that the blood banks are up to standard, but it relies heavily on the blood banks to set those standards. And some of the officials of the FDA are former leaders in the blood industry. Thus, inspections of blood banks actually decreased in frequency as the AIDS crisis unfolded!

In 1985 blood banks began to test blood for the presence of the antibodies that the body produces to fight the AIDS virus. The problem with the test is that a person can be infected with the AIDS virus for some time before developing any antibodies that the test would detect. This crucial gap is called the window period.

The idea that there is 1 chance in 28,000 of getting AIDS from a blood transfusion comes from a study published in The New England Journal of Medicine. That periodical set the most likely window period at an average of eight weeks. Just months before, though, in June 1989, the same journal published a study concluding that the window period can be much longer​—three years or more. This earlier study suggested that such long window periods may be more common than once thought, and it speculated that, worse, some infected people may never develop antibodies for the virus! The more optimistic study, however, did not incorporate these findings, calling them “not well understood.”