On buying and selling blood

Could we 

1) ensure regular supply of blood for hospitals

2) provide better health and nutrition for many people in poor developing countries, and

3) curb the spread of HIV-AIDS

by buying blood from poor countries and selling it to rich developed countries?

Problem

Hospitals need blood. They depend on donations. It’s hard to have enough donations.

Opportunities

Hospitals in rich countries can afford to pay for blood. Many people in developing countries would be willing to give for a small amount of money and some food.

Solution

Set up operations in poor countries to offer people nutritious food and a small amount of money in exchange for their blood. Rigorously screen potential donors for disease and export the good blood to blood banks in rich nations. Impose an “export tax” whereby a certain percentage of the blood for export must be donated to domestic blood banks.

Obstacles and remedies

Of course, it can’t be that simple. Several issues, both ethical and structural, arise, but these problems can be minimized. For example:

It is unethical and will lead to a slippery slope for other organs

Blood is different from other tissues and organs in that it is naturally replenished

It exploits poor people

No. All potential donors must be rigorously screened to ensure eligibility. On the contrary, by paying the donors in not only cash but also nutritious food and supplements, they will be healthier than before.

 It exploits poor countries and reduces supply of their blood banks

The “export tax” in blood ensures that local blood banks are not starved of blood. In fact, they could actually see increases in their supply because more people will now be incentivized to give blood.

Westerners will perceive “tainted” blood from Africa

It’s just that: a perception problem. The actual chances of contamination can probably be statistically reduced through more rigorous testing. The rest is a matter of education and communication. It will be hard, but it can be done. Besides, for some potential recipients, it will be a choice between no blood and blood that is perceived to be tainted.

Unsuitable donors will be incentivized to donate

Yes, and that leads to one important positive spillover effect of paying donors for blood: HIV testing and prevention…

THE POSITIVE EXTERNALITIES ON HIV AIDS

People tend to engage in risky behavior when they don’t think about long-term effects. When they know their blood is worth money and food, the benefits of healthy living become more clear and present and they are less likely to engage in activities that could lead to HIV-AIDS, malaria, etc. In addition, this market could actually increase the number of people getting tested.

So why not just pay people to get tested?

Yes, it can achieve the goal but to a limited extent. Paying them to get tested is a one round game, but paying every 56 days or so for their blood is a multiple round game that creates greater incentives to comply.

 NB: Like many other ideas on this blog, this proposal is not based on research. It’s just a thought.