LONDON – The final report of the UK’s Infected Blood Inquiry will be published on Monday, almost six years after it began investigating how tens of thousands of people contracted HIV or hepatitis through blood transfusions and contaminated blood products in the 1970s. and 1980.
The scandal is widely seen as the deadliest to afflict Britain’s state-run National Health Service since its creation in 1948, with around 3,000 people having died as a result of being infected with the HIV virus and hepatitis, an inflammation of the liver.
The report is expected to criticize pharmaceutical companies and doctors, civil servants and politicians, although many have already died over time. It is also expected to pave the way for a huge compensation bill that the British government will be under pressure to pay quickly.
If not for the tireless activists, many of whom saw loved ones die decades before their time, the scale of the scandal might have remained hidden forever.
“This whole scandal has covered my entire life,” said Jason Evans, who was four years old when his father died at 31 in 1993 after contracting HIV and hepatitis from an infected blood plasma product.
“My father knew he was dying and he made a lot of home videos, which I have and played over and over growing up because that was all I had,” he added.
Evans was instrumental in then-Prime Minister Theresa May’s decision to establish the inquiry in 2017. He said he simply “couldn’t let it go”. His hope is that on Monday he and countless others can.
Here’s a look at what caused the scandal and what the impact of the report might be.
In the 1970s and 1980s, thousands of people who required blood transfusions, for example after childbirth or surgery, were exposed to blood contaminated with hepatitis, including a still unknown type that was later called Hepatitis C, and to the HIV virus. .
Those with hemophilia, a condition that affects the blood’s ability to clot, were exposed to what was sold as a revolutionary new treatment derived from blood plasma.
In the UK, the NHS, which treats the vast majority of people, began using the new treatment in the early 1970s. It was called Factor VIII. It was more convenient when compared to an alternative treatment and was dubbed a miracle drug.
Demand quickly outstripped domestic sources of supply, so health authorities began importing Factor VIII from the US, where a high proportion of plasma donations came from prisoners and drug users who were paid to donate blood. This dramatically increased the risk of plasma contamination.
Factor VIII was produced by mixing plasma from thousands of donations. In this grouping, an infected donor would compromise the entire batch.
The inquiry heard estimates that more than 30,000 people were infected by blood or blood products compromised through transfusions or Factor VIII.
In the mid-1970s, there was evidence that hemophiliacs treated with Factor VIII were more prone to hepatitis. The World Health Organization, which warned in 1953 about the risks of hepatitis associated with the mass accumulation of plasma products, has urged countries not to import plasma.
AIDS, the biggest public health crisis since World War II, emerged in the early 1980s. Originally thought to be isolated to the gay community, it soon began to appear among hemophiliacs and those who received blood transfusions.
Although the cause of AIDS – HIV – was only identified in 1983, the previous year warnings had been sent to the UK government that the causative agent could be transmitted through blood products. The government argued that there was no conclusive evidence. Patients were not informed of the risk and persisted with treatment that placed them in mortal danger.
The inquiry is expected to conclude that lessons learned as early as the 1940s were ignored.
Activists argue that since the 1940s it was clear that heat killed hepatitis in another plasma product, albumin. They say authorities could have made Factor VIII safe before it was sold.
Evidence presented at the inquiry suggested that the authorities’ main objection was financial. Unheated Factor VIII was prescribed by the NHS until the end of 1985.
Campaigners hope the main conclusion of the inquiry will be that Factor VIII concentrates should never have been licensed for use unless they were heated.
In the late 1980s, victims and their families sought compensation for medical negligence. Although the government set up a charity to make one-off support payments to people infected with HIV in the early 1990s, it did not admit responsibility or liability and victims were pressured to sign a pledge not to sue the Department of Health for get the money.
Crucially, the exemption also prevented victims from suing for hepatitis, despite, at that stage, only knowing about their HIV infection. Years after the signing, victims were told that they had also been infected with hepatitis, particularly hepatitis C.
There was no further group litigation until Evans, whose mother “broke down” after his father’s death and who was called an “AIDS boy” at school, filed a lawsuit alleging misconduct in public office against the Department of Health.
Combined with political and media pressure, May announced the independent inquiry. It was, she said, “a terrible tragedy that simply should never have happened.”
The government accepted the compensation request, with most estimates putting the final bill in the region of £10 billion ($12.7 billion). In October 2022, authorities made interim payments of £100,000 to each survivor and bereaved partner.
The government is expected to announce different payments for different infections and also work out how and when bereaved families can request interim payments on behalf of the estates of people who have died.
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