Governance of a Precious Commodity: The Global Blood Trade and Hemophilia Care in Transnational Perspective

Blood and blood products circulate, like drugs and vaccines, in a global market. Blood's use-value in a wide variety of therapeutic contexts makes it a highly significant natural resource, and among the most precious liquids that people can exchange. It is a little known fact that, ounce for ounce, the market price of blood is significantly higher than the price of crude oil. And while the geopolitical map has never been redrawn because of blood's status as a commodity, blood's ability to save lives and facilitate health has frequently generated conflict, controversy, and hard feelings. Like oil or HIV-AIDS drugs, the international blood trade is awash in stories that speak to life and death questions of identity, difference, and social justice across the globe. This paper utilizes the treatment of hemophilia (a bleeding disorder) as a lens onto how health's contested status as a right stands in tension to blood's emergence as a precious commodity. Specifically, the paper narrates the transnational experience of hemophilia management since 1960 and describes diverse problems raised by the fact that the commercial blood products used to treat many hemophilia patients in the 1970s and early 1980s were often tainted with viruses for AIDS and/or hepatitis C. In the 1990s, a series of well-publicized “tainted blood” scandals erupted in North America, Western Europe, and Japan. More recently, the international media has highlighted the effects of these tainted blood products in Asia, Africa, and Latin America. Using diverse source materials – ranging from media coverage and government reports to oral histories and published testimonies – this paper situates the various national tragedies surrounding HIV-infected hemophilia patients as a backdrop for addressing questions of social identity and justice that have emerged in the last half-century with respect to health's status as a global commodity and a contested right.