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Kathleen McLaughlin on her book 'Blood Money', about the global trade in blood plasma

SCOTT SIMON, HOST:

The U.S. economy gets about as much money from selling blood products overseas as it does from soybeans - more than $24 billion in 2021. Much of the plasma used around the world comes out of the veins of Americans who sell it because they need money. Kathleen McLaughlin has written a kind of reporting odyssey that begins with her own personal experience of smuggling plasma into China, where she lived and reported for years. Her book, "Blood Money." Kathleen McLaughlin, a former Knight Science Journalism fellow at MIT whose reporting's been in The Economist, The Atlantic, on public radio and more, joins us from Butte, Mont. Thank you so much for being with us.

KATHLEEN MCLAUGHLIN: Thank you, Scott. I'm delighted to be here.

SIMON: And let us please begin with your personal story, the arrivals hall in Shanghai.

MCLAUGHLIN: Yes.

SIMON: Why were you smuggling human blood products into China?

MCLAUGHLIN: It all sounds very dramatic, doesn't it? About 20 years ago, I was diagnosed with a chronic illness that requires me to have periodic infusions of a medication that's made from other people's plasma. I had moved to China to work as a journalist. I very quickly learned, when I knew that I was going to China, that China had serious problems with its own blood supply. I knew I needed to bring my own safe blood products. And that was the only way to do it, was to stuff these bottles of medicine into my suitcase and lie on the customs form and essentially smuggle these products into China.

SIMON: As you note, China had learned in the hardest possible way about literally blood money in the Hunan province.

MCLAUGHLIN: Right. Hunan province decided to create something called the plasma economy. Poor farmers who'd never really had a chance to make a lot of extra money could sell their plasma to government-run clinics and some private clinics. And it would create a wealth that the province hadn't seen before. But the problem started when HIV snuck into the system. And at that time, the plasma economy was running so fast and so unsupervised that the virus spread like wildfire.

SIMON: We should explain. Unlike, say, what was happening in China, blood plasma in the U.S. is sterilized and screened, isn't it?

MCLAUGHLIN: That's correct. Given, you know, several years of reporting in the U.S. on this and having seen the inside of some of these facilities, I have very little concern or worry that something like what happened in China could happen here.

SIMON: Tell us about Randy - not his real name, not what we'd call destitute, but hard-stretched to pay his bills, right?

MCLAUGHLIN: Yeah. And this is something I found, really, in, I would say, every place I visited in the U.S. I had expected to find the poorest of the poor selling plasma. And that's just, for the most part, not the case. You know, the poorest of the poor are screened out by rules. Like, you have to have a permanent residence. You have to have the basic trappings of not being extremely poor. So people, like Randy, are doing it to supplement their income because wages have not kept pace with the cost of living in so many different places.

SIMON: How much can people like Randy make by selling blood plasma?

MCLAUGHLIN: It completely depends where you are, so it varies. And it also varies by how often you go. I would say a rough average, you could probably make somewhere around $40 per time. If you go more often, you get paid more. So the system is gamified, meaning that you get all sorts of incentives throughout the month. The goal of the center is to get you in twice a week every week until you can't do it anymore. If you want to donate plasma just purely altruistically and not get paid, you can go to the Red Cross. The Red Cross limits the number of times you can donate plasma to once every 28 days, and that works out to 13 times a year. If you go to a for-profit plasma center, where you do get paid, you can go 104 times a year.

SIMON: What do we know about possible long-term health consequences?

MCLAUGHLIN: The good news for plasma donors is that I haven't found any scientific indication that this is really bad for you long term. The negative health consequences seem to go away when you stop doing it. So I've spoken with a lot of people who feel greatly fatigued, nauseous. I've heard from people who've passed out after donating plasma. And then, there's just kind of - long-term donors will describe this, like, malaise, you know? You just feel tired. You don't have a lot of energy. The plasma industry will tell you that this is perfectly safe and there's nothing wrong with it. I don't think, to be honest with you, that there's been enough study of what it does to people.

SIMON: I've talked to some doctors about this over the years 'cause the U.S., as you noted, is one of just a handful of industrialized countries that permits the commercial sale of blood. And doctors have said to me that there are so many procedures in which plasma can be useful. They just can't rely on the generosity of donations. Now, you depend on blood plasma, too. Should it be prohibited?

MCLAUGHLIN: I don't believe that at all. No. I actually think that the issue here is we're not paying people enough. I don't personally have a moral problem with paying people for plasma because I think that's true. We need a lot of it for medications and other uses. My issue, I guess, is that I don't think we have sat back as a country and said, is this who we want to be? Do we want to be the kind of place where people are expected to sell pieces of themselves to get by? I don't think that most people know this goes on to such an extent, that there are probably millions of Americans who have sold their plasma. And I think that we should at least acknowledge it and have a conversation about what we think is ethical and moral and fair.

SIMON: Kathleen McLaughlin, her book, "Blood Money." Thank you so much for being with us.

MCLAUGHLIN: Thank you, Scott. Transcript provided by NPR, Copyright NPR.

Scott Simon is one of America's most admired writers and broadcasters. He is the host of Weekend Edition Saturday and is one of the hosts of NPR's morning news podcast Up First. He has reported from all fifty states, five continents, and ten wars, from El Salvador to Sarajevo to Afghanistan and Iraq. His books have chronicled character and characters, in war and peace, sports and art, tragedy and comedy.