Today marks one year since the then Health Secretary Sajid Javid announced changes to discriminatory blood donation rules that primarily impacted Black people of African heritage. Having already been implemented in Scotland and Wales, this finally brought England into line with its neighbours.
Off the back of the AIDS crisis, blanket bans were put in place to protect the blood supply, the latter at least an objective everyone can agree with. However, as the science has changed over four decades the rules have not kept up. We now understand more about blood-borne viruses, their prevalence and onward transmission. It was never justifiable to ban whole communities, but it has become completely untenable in recent years.
A coalition, including ourselves, National AIDS Trust and Freedom to Donate convinced the NHS Blood and Transplant system to create the independent FAIR (For the Assessment of Individualised Risk) steering group. Its final recommendations were that a more individualised risk assessment focusing on behaviours would be better.
They said the four UK blood systems should ask questions about new sexual partners and particular acts of penetrative sex, not if you had sex with men or recently with people who have ever had sex in high-prevalence countries. The former impacted gay and bisexual men heavily, and the latter – literally warning against those who had sex in “most countries in Africa” – was hugely prohibitive for donors of Black African ethnicity.
On 14 June 2021, new eligibility rules for blood donation came into force, allowing more gay and bisexual men to donate blood and plasma in the UK. The question regarding sex with someone in parts of the world where HIV is common was removed in Scotland and Wales but shamefully remained in place in England.
This question not only contributed to stigmatising attitudes and misinformation about HIV, but also limited blood supply. Despite consistent calls from the blood service for more Black donors, this question meant that Black people of African heritage were unnecessarily prevented from donating much-needed blood and plasma.
This awful policy simply had to go in England.
Before the FAIR process had started Dr Francis Gĩthae Murĩith was raising the issues involved in the media. Jacqui Gitau, Director of African Families in the UK, encouraged us to press harder.
My colleague Michael Brady led us through the FAIR process. But we need to widen our coalition. Together with the Sickle Cell Society, Sicklekan, the African Caribbean Leukaemia Trust and One Voice Network we made the case to Matt Hancock and his successor Mr Javid. Two women MPs of colour on the Health and Social Care Select Committee – Taiwo Owatemi and Sarah Owen – wrote time and again to successive Health Secretaries calling on them to end the 'African blood donor' ban. Florence Eshalomi MP did the same.
Finally – twelve months ago to this day – the health secretary agreed. The decision could not stand. His colleague Maria Caulfield saw the ban out before the end of the calendar year, finally removing it on 23 December, hours before officials went home for Christmas.
This campaign was a huge success as the demand for rare blood subtypes, such as Ro, which is more common in people of Black heritage, continues to increase. MP Florence Eshalomi highlighted how important this change is for Black sickle cell patients like her late mum, who often require Ro blood for frequent transfusions. There is now one less barrier for Black donors.
Jacqui Gitau, Director of African Families in the UK, who had spurred us on, said about the change:
'It’s almost 18 years since the blood donor service sent me away from the queue to give blood. I know others it happened to since. I saw campaigns to increase donors from African and other Black ethnicities, but I knew they were superficial. They were not genuinely seeking to help Black patients when they were turning away Black donors.
'Thankfully, over the years, I have learnt how to channel my fire and through the power of collaboration with Terrence Higgins Trust, together we made change happen. I am pleased that now any African heritage person wanting to donate blood is free to do so.'
Following the change, NHS Blood and Transplant contacted 12,000 people of Black African heritage who had been previously turned away. They notified them of the change and informed them they may now be eligible. It was a moment to be proud of.
NHS Blood and Transplant run a small campaign with our coalition’s support to get the news out there. But it is not yet enough.
We are of course proud that another piece of HIV stigma is out of the rules of the country. But we will not rest until the historic prescience of this ban does not hold back donors of Black heritage. We will continue to raise awareness of the policy change and let people know there is little holding them back.
Together we can rebuild trust and encourage more Black donors to come forward.
- Glenda Bonde is Director of Equity, Diversity and Inclusion at Terrence Higgins Trust, a sexual health practitioner and former nurse and midwife
