Every 18 minutes in Aotearoa someone needs a lifesaving blood or plasma transfusion but less than 4% of eligible New Zealanders donate blood.
Aotearoa needs 40,000 more blood donors over the next year to meet the growing demand and avoid having to import blood from other parts of the world.
A big part of the problem is New Zealand’s blood donation criteria is stopping thousands of people from being eligible to donate.
Firstly, sex workers and men who have sex with men are banned from donating blood in New Zealand - unless they abstain from sex for three months.
Secondly, there has been a 23-year-old long ban on people giving blood who lived in the United Kingdom, France or the Republic of Ireland for six months or more between 1980 and 1996.
This is because of an illness called Creutzfeldt-Jakob disease (vCJD) - also known as mad cow disease.
What is mad cow disease?
Mad cow disease is a brain disorder in adult cattle that was spread to humans through diseased meat. Since 1996, 177 people have died from vCJD, while over four million cows were slaughtered to prevent it from spreading.
What does mad cow disease have to do with blood donations?
The ban was put in place because the disease can be passed on through blood. But only three confirmed cases have ever been linked to a blood transfusion, Massey University infectious disease ecologist David Hayman says.
Hayman estimates the risk of this happening again now is at “one in a billion”.
“We are 23 years since the peak of cases and there’s only been 232 in the whole world, 178 of those were in the UK. There's no one in the world that we know of living with vCJD now.”
“Those restrictions were put in place because they thought there was a high potential risk. We can't screen for it, therefore, we'll exclude it. But we think the risk is extremely low.”
The trouble is mad cow disease can have a long incubation period, meaning that humans who have been exposed to the disease may not show symptoms for a long time.
New Zealand Blood Service (NZBS) told Re: News they are currently reviewing this criteria and are hoping to lift the ban soon. Australia and America lifted their bans in 2022 and the Red Cross is now also accepting donors who lived in the UK between 1980 and 2001.
“New Zealand is aiming to follow suit – however, a number of steps need to be undertaken before the criteria can be changed,” NZBS says.
NZBS has put forward a submission to Medsafe to change the criteria, which can take three months or longer to review. If it’s approved, NZBS says it may take up to two months to change their systems and update the public.
“It's good that it's being looked at,” Hayman says. “There are many people, including myself, who would definitely go give blood if they were allowed.”
It’s estimated the ban cuts out 10% of eligible donors, but Hayman says this number could be much higher.
“Honestly, we don’t know how many potential donors this is excluding. We use 10% as an estimate because that is the proportion of active donors that stopped when these restrictions came into place. It could be much more.”
Calls to change New Zealand’s ‘discriminatory’ HIV blood donation criteria
Currently, sex workers and men who have sex with men are banned from donating blood in New Zealand unless they abstain from sex for three months. This includes men in long-term monogamous relationships and men who use condoms.
The ban was made to prevent the risk of spreading HIV. However, the prevalence of the virus has decreased significantly since then, Body Positive executive director Mark Fisher says.
“All blood gets screened for HIV, however, the risk is if someone has been recently infected with HIV, it might not show up on the test for three months. So people might get missed.”
“But in reality most of our diagnoses for HIV were late. So people who have had HIV for a long time but haven’t been tested and it’s been picked up on a blood test.”
Fisher says to get around this, some countries will bank the blood for three months, then the donor will come in again three months later and be screened again. If the donor’s blood is negative for HIV they will release the first batch of blood.
“So there are other ways to do it, but they aren’t being done,” he says.
Similar donation criteria has been scrapped in England, Wales, Scotland, Canada and The United States. These countries have instead moved to individualised risk assessments for every donor - regardless of gender or sexual orientation.
In the United States, for example, any person who has had anal sex with new partners or more than one partner in the last three months would be deferred.
The updated guidelines mean most gay and bisexual men who are in monogamous relationships with other men will no longer need to abstain from sex to donate blood.
Mark Fisher wants the same thing to happen here in Aotearoa.
“If you are in a stable relationship, or you're married, then you have no risk,” he says.
“But it’s a case of them not believing or trusting you. My partner has to have blood taken out every six weeks for a blood draw and they just flush it. He’s got really valuable blood but it all goes down the drain, even when he’s in a stable relationship and there’s no risk.”
When will the criteria change?
NZBS says it is in the process of reviewing the three-month stand-down period for men who engage in anal or oral sex.
“We’re committed to following in the footsteps of other international blood services such as those in the United Kingdom, Canada, and the United States and working towards removing this deferral in favour of a more individualised risk assessment when screening for potential blood and plasma donors in New Zealand,” it said.
But NZBS says the “earliest possible implementation timeline” may not happen until later in 2024. It says Medsafe needs to approve the change and plasma manufacturing partner (CSL Behring) will need to identify any technical changes that are required before anything goes ahead.
The other challenge is the proposed new criteria would still exclude people who are on PrEP.
PrEP (Pre-Exposure Prophylaxis) is an extremely effective HIV prevention medication. Clinical studies have shown that if PrEP is taken every day it reduces the risk of acquiring HIV through sex by up to 99%.
“Excluding people on PrEP implies that PrEP doesn't work,” Fisher says.
“They are not acknowledging that PrEP is more safe and effective than condoms. And, to be on PrEP you need to be tested every three months so this population is probably the most screened for HIV.”
Fisher says the same can be said for sex workers who are also included in the ban.
“Sex workers are one of the most tested because safe sex is part of their workplace. So there is a really low risk in that space too.
“We have a blood shortage because they are stopping so many people from donating,” Fisher says. “Do they really want to solve the blood issue or not?”
Until these changes are made, New Zealand is counting on those who are currently eligible to donate. So for those who can give blood, what is it like?
How it feels to give blood
I gave blood for the first time last week and it was so damn chill.
From start to finish the process was smooth and felt really rewarding. The staff was also ridiculously friendly - at one point one of the nurses was dancing to Shaggy’s ‘It Wasn’t Me’. I left wondering why I hadn’t done it sooner.
So if you have ever considered donating blood, let this be your sign!
Here’s what you can expect:
- Overall the process takes about an hour, but most of this time you are reading information, getting your details checked and waiting for 10-15 minutes after the donation to make sure you are feeling fine. The actual blood donation only takes about 5-10 minutes.
- I decided to book in advance through the NZ Blood website. Some places also welcome walk-ins, but booking guarantees you a seat. I recommend taking the quiz to check if you are eligible to donate before you rock up.
- When you arrive you will be asked to read some information about the donation process and also the criteria for donating. If you are eligible, they will confirm some personal information and check your ID (make sure you bring your driver's license or another photo ID otherwise you won’t be able to donate).
- Then you’ll do a mini health check - you’ll get weighed, have your height measured, and do a quick finger prick to check you have enough blood to donate. The nurse will also ask you a few questions about your medical history.
- Then you’ll hop into the chair and have your blood taken - to me, this felt like a normal blood test. Aside from the quick prick, you don’t feel anything else and it’s over before you know it.
- Once the donation is done (you can only donate 500mL of blood) they will get you to sit in the waiting area and you have full reign of the snacks - there are cookies as well as tea, coffee, juice, and water to keep you hydrated. I went at the end of the day, so it was just me there and they ended up giving me the leftover snacks - so huge wins.
- After 10-15 of waiting - you can go. And that’s it!
- You can also download the NZ Blood app, and once your blood is processed it will tell you your blood type and also where your blood donation goes.
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