Contaminated blood scandal in Japan

Last updated December 04, 2024

In the 1980s, between one and two thousand haemophilia patients in Japan contracted HIV via contaminated blood products. Controversy centered on the continued use of non-heat-treated blood products after the development of heat treatments that prevented the spread of infection. Some high-ranking officials in the Ministry of Health and Welfare, executives of the manufacturing company and a leading doctor in the field of haemophilia study were charged for involuntary manslaughter.

Background

Acquired immune deficiency syndrome, or AIDS, is a communicable disease caused by the human immunodeficiency virus, HIV. AIDS is not curable.^{[ citation needed ]} The first recognition of the emergence of an AIDS-like disease occurred in Los Angeles in 1981.^{[ citation needed ]}

It was not until 1985 that the first cases of AIDS were officially reported in Japan. As early as 1983, however, Japan's Ministry of Health and Welfare was notified by Baxter Travenol Laboratories (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. The 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".^[1] 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. The Green Cross Corporation meanwhile distributed letters of "safety assurance of unheated blood products" to patients, many of whom had haemophilia.^[2]

AIDS spreading in Japan

The first known case of infection with HIV in Japan occurred in 1979, affecting a haemophilia patient who was prescribed blood products by his doctor. A second patient was a Japanese male artist who had lived abroad for some years. Some other cases were also reported in the early 1980s and these patients were haemophilia patients or had homosexual experiences. After the intense media coverage on an HIV-positive woman who had contracted the virus through heterosexual intercourse, the disease became well known in Japan and the government ordered a study into the dispute over the safety of blood products.^[3]

Lawsuits

In May and October 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. Takeshi Abe, who had headed the Health Ministry's AIDS research team in 1983; he was found not guilty in 2005.^{[ citation needed ]} Abe resigned as vice-president of Teikyo University.^{[ citation needed ]}

In January 1996, Naoto Kan 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 Minister, Kan promptly admitted the Ministry's legal responsibility and formally apologised to the plaintiffs.^{[ citation needed ]}

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].^{[ citation needed ]}

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].^{[ citation needed ]}

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.^{[ citation needed ]}

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].^{[ citation needed ]}

Charges

Renzō Matsushita, 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 ).^{[ citation needed ]}

Related Research Articles

Haemophilia, or hemophilia, is a mostly inherited genetic disorder that impairs the body's ability to make blood clots, a process needed to stop bleeding. This results in people bleeding for a longer time after an injury, easy bruising, and an increased risk of bleeding inside joints or the brain. Those with a mild case of the disease may have symptoms only after an accident or during surgery. Bleeding into a joint can result in permanent damage while bleeding in the brain can result in long term headaches, seizures, or an altered level of consciousness.

Haemophilia A is a blood clotting disorder caused by a genetic deficiency in clotting factor VIII, thereby resulting in significant susceptibility to bleeding, both internally and externally. This condition occurs almost exclusively in males born to carrier mothers due to X-linked recessive inheritance. Nevertheless, rare isolated cases do emerge from de novo (spontaneous) mutations.

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The tainted blood disaster, or the tainted blood scandal, was a Canadian public health crisis in the 1980s in which thousands of people were exposed to HIV and hepatitis C through contaminated blood products. It became apparent that inadequately-screened blood, often coming from high-risk populations, was entering the system through blood transfusions. It is now considered to be the largest single (preventable) public health disaster in the history of Canada.

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HIV/AIDS in China can be traced to an initial outbreak of the human immunodeficiency virus (HIV) first recognized in 1989 among injecting drug users along China's southern border. Figures from the Chinese Center for Disease Control and Prevention, World Health Organization, and UNAIDS estimate that there were 1.25 million people living with HIV/AIDS in China at the end of 2018, with 135,000 new infections from 2017. The reported incidence of HIV/AIDS in China is relatively low, but the Chinese government anticipates that the number of individuals infected annually will continue to increase.

Contaminated hemophilia blood products were a serious public health problem in the late 1970s up to 1985.

The Lindsay Tribunal was set up in Ireland in 1999 to investigate the infection of haemophiliacs with HIV and Hepatitis C from contaminated blood products supplied by the Blood Transfusion Service Board.

In April 1991, the doctor and journalist Anne-Marie Casteret published an article in the French weekly magazine the L'Événement du jeudi showing that the Centre National de Transfusion Sanguine knowingly distributed blood products contaminated with HIV to haemophiliacs in 1984 and 1985, leading to an outbreak of HIV/AIDS and hepatitis C in numerous countries. It is estimated that 6,000 to 10,000 haemophiliacs were infected in the United States alone. In France, 4,700 people were infected, and over 300 died. Other impacted countries include Canada, Iran, Iraq, Ireland, Italy, Japan, Portugal, and the United Kingdom.

<span class="mw-page-title-main">Ryūhei Kawada</span> Japanese politician

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Jeanne Marie Lusher, M.D. was an American physician, pediatric hematologist/oncologist, and a researcher in the field of bleeding disorders of childhood, and has served as the director of Hemostasis Program at the Children's Hospital of Michigan until her retirement on June 28, 2013.

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Arthur Leslie Bloom (1930–1992) was a Welsh physician focused on the field of Haemophilia.

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References

↑ Leflar, Robert B. (April–June 1997). "Cancer, AIDS and the Medical Information Fulcrum" . Japan Quarterly. 44: 94.
↑ Miyamoto, Masao. "Castration, the HIV Scandal and the Japanese Bureaucracy". Massachusetts Institute of Technology. Cambridge, Mass: April 10, 1996.
↑ A Study of Awareness and Attitudes toward AIDS Among Adolescents Archived 2011-07-18 at the Wayback Machine , Hiroyoshi Nishitanedam Kagoshima University