Red Cross Memos Show It Knew Aids Risk, Shunned Test

WASHINGTON - The American Red Cross and other blood-bank groups refused to adopt a screening test in January 1983, publicly contending there was no hard evidence people could get AIDS from transfusions. But internal documents show Red Cross officials acknowledged the disease could be transmitted through blood.

The nation's three major blood collectors - the Red Cross, the American Association of Blood Banks and the Council of Community Blood Centers - said in a joint public statement on Jan. 13, 1983:

"The presently available medical and scientific evidence that AIDS can be spread by blood components remains incomplete. . . . We do not advise routine implementation of any laboratory screening program for AIDS by blood banks at this time."

The groups refused to adopt the test for hepatitis B, a surrogate test that Centers for Disease Control officials said could have been in place by March 1983. The current AIDS or HIV test hadn't been developed yet.

They maintained that the test was too expensive and that there was no hard evidence that people could get acquired immune deficiency syndrome from transfusions, despite CDC officials' assertions that the disease posed a serious threat to the blood supply.

Privately, however, officials at the Red Cross believed that AIDS could be transmitted through blood, according to internal documents obtained by The Associated Press.

Paul Cumming, the Red Cross planning and marketing manager,

wrote in an internal memo: "The available evidence strongly suggests that AIDS is transmissible" through blood.

"As time goes on we are liable to get more and more pressure to utilize" blood tests and donor screening. "CDC increasingly needs a major epidemic to justify its existence," Cumming wrote to a colleague on Feb. 5, 1983.

"To the extent the (blood) industry . . . sticks together against CDC, it will appear to some segments of the public at least, that we have a self-interest which is in conflict with the public interest, unless we can clearly demonstrate that CDC is wrong," Cumming wrote.

"In the short run, our position has all the earmarks of a lose-lose one. The question would seem to be, How do we minimize the short-run loss and hopefully gain in the long run?"

The CDC estimates that 6,567 Americans have developed AIDS from transfusions since 1981. Only 29 of those cases were caused by transfusions received after March 1985, when blood banks nationwide voluntarily began using a new HIV test. HIV, or th human immunodeficiency virus, was discovered as the cause of AIDS in 1984.

Cumming, in a recent telephone interview, rejected any second-guessing of his actions.

"Given the same information, the same environment at that time, I don't see that we made any mistakes. . . . There was no scientific evidence," said Cumming, a statistician who now does consulting work for the Red Cross and federal agencies.

Nearly all AIDS patients - homosexual men, hemophiliacs and intravenous drug users - also had suffered from hepatitis B at some time and produced antibodies to fight it that stayed in their blood.

Cumming said the hepatitis B blood test "was not a good test, by any criteria I know for a test" because it would have produced 1 million false positive results.

Questioned recently, the Red Cross said the effectiveness of the hepatitis B blood test was "an open question" in 1983.

"Had there been evidence indicating the efficacy of any surrogate test, the Red Cross would have implemented it," the organization said in a statement.

The Red Cross noted that its blood banks began in 1983 asking homosexual men with multiple partners not to donate blood. It started using direct questioning of potential donors in January 1991.

Because AIDS takes an average seven years to develop, many victims have only recently discovered their illness from infected transfusions or clotting factor they received between March 1983 and March 1985. Clotting factor is a concentrate of blood from hundreds of donors that hemophiliacs inject to stem uncontrolled bleeding.

Victims and their families have filed an estimated 500 lawsuits around the nation against hospitals, the Red Cross and other blood banks, according to Lawrence Gostin, a professor at Georgetown University Law Center. Nearly all of the cases have been settled out of court.

"The misery that was promulgated by this benign inaction killed thousands of people," said Dr. Donald Francis, an expert on epidemics and AIDS at the CDC in the 1980s.

Now a research official at Genentech Inc. in San Francisco, Francis sometimes testifies as an expert witness for plaintiffs in AIDS transfusion suits.

"Here was a group of certainly not evil people, who thought they were doing the right thing . . . who got caught up in a force that was anti-CDC, anti-action," Francis said in a telephone interview.

Dr. Gerald Sandler, a Red Cross official, publicly criticized a CDC study in early 1984 that warned of the risks of AIDS-tainted transfusions.

But in a memo, Sandler told a colleague in January 1984: "Problems related to transfusion-associated AIDS are increasing and require resolution. . . . No clear plan has been developed by the national blood-collection organizations to counter the increasingly apparent risk of (AIDS from transfusions) which, potentially, threatens all persons."

Asked about the memo, Sandler, now director of blood-donor services at Georgetown University Medical Center, said it was "an internal attempt to look as open-mindedly as possible on an issue."