Hepatitis B: So So Gay argues that the Government must do more to deal with the disease. Photograph courtesy of the US Centers for Disease Control and Prevention.
Unsurprisingly, the news that the Government intends to lift the lifetime ban on gay (and bisexual) men donating blood brings forth a mixture of elation and condemnation from campaigners. Few doubted that the lifetime ban was unjustified. The great majority of sexually transmitted diseases are detectable during routine screening of donated blood. It seemed that the lifetime ban sprang more from fear than from practicality, playing into long-standing concerns that gay men’s blood is little more than a public health hazard.
The Government says that the new rules take account of the fact that hepatitis B can remain undetectable in blood for as long as 12 months. We do not intend to argue against the science behind this concern; hepatitis B is a serious disease that causes great suffering, and the Government is entirely right to rely upon scientific evidence when protecting public health. Gay men are at particularly high risk of catching and transmitting the disease. On that basis, we do not think that the deferral period is unfair per se.
However, in retaining the new deferral period, the Government has tacitly acknowledged a significant failure in British health policy. In 1992 the World Health Organisation recommended a mass vaccination programme to control hepatitis B. Most countries – 85 per cent of them, at the last count – have implemented national vaccination programmes. The UK stands almost alone in the developed world in not implementing such a programme, leaving millions of people at risk of catching the disease.
Last week the House of Lords Select Committee on HIV and Aids called the Government’s policies on HIV prevention ‘woefully inadequate’. We might apply the same argument equally to hepatitis B; awareness of the disease is pitifully low, and as many as half of those infected with it do not know they have it. It is unfashionable to call for more public spending at a time of fiscal austerity, but while budget managers make hard decisions we can’t help but think that the public would be better served if the NHS spent more on hep B awareness, and rather less, perhaps, on homeopathy.
We also note some campaigners’ suggestions that the rules should reflect risky behaviour rather than an individual’s risk group. Under the new rules, a person who engages in frequent unprotected heterosexual intercourse could be treated as though he or she is at lower risk of transmitting disease than a man who has had single instance of protected oral sex with another man. That needs some explanation; if not unfairly discriminatory, it certainly seems counter-intuitive, and reflects a concern that simply placing all sexual contact between men, regardless of circumstance, in the same category is unreasonable. The Government is keen to make sure it does not discriminate unfairly against gay men, so it seems fair to suggest that these issues would benefit from greater scrutiny.
In summary, though, it is undeniable that the Government has made a step in the right direction. To a dying man, blood is blood. In due course, we hope, it shouldn’t matter who gives it at all.