Blood Donations

Adjourned debate on motion of Hon. T.A. Franks:

That this council—

1. Notes that since 1996 South Australia has had a deferral period for gay and bisexual men looking to be donors of whole blood, meaning they cannot donate blood unless it has been 12 months since their last sexual contact with a male partner;

2. Recognises that the Therapeutic Goods Administration (TGA) has recently approved an application by Australian Red Cross Lifeblood (Lifeblood), which proposes to reduce the deferral period for donors of whole blood to three months since their last sexual contact; and

3. Supports the removal of this restriction and calls on the Marshall state government to effect its implementation in South Australia so that more people can donate blood regardless of their sexuality or sexual activity.

(Continued from 1 July 2020.)

The Hon. I.K. HUNTER (17:51): I rise to make some brief remarks on the motion of the Hon. Tammy Franks. The issue of the blood ban for gay and bisexual men is one that has been strongly opposed by many in the community, particularly by the LGBTIQ community, for many years. That people who are in a long-term monogamous relationship cannot give blood, no matter how many times they test negative for HIV or other sexually transmitted infections, is quite bewildering to many people.

This is particularly true given that Red Cross Lifeblood is so often in need of life-saving donations, and many people who could safely give blood and want to are being denied the option to do so. Indeed, recent developments have also brought the so-called blood ban into further question. A 2015 report by Canadian Blood Services found that the risk of HIV transmission from infusion of contaminated blood was as low as one in 21.4 million donations, and blood services worldwide have put in place measures to successfully minimise the risk of infection spreading through donated blood.

Last year, it was reported by the Kirby Institute at the University of New South Wales that HIV diagnoses in Australia had reached an 18-year low at only 835 diagnoses. The institute attributed this in part to a drop in HIV diagnoses among gay and bisexual men by some 30 per cent over five years. Of course, the blood ban has long been rooted in discrimination, caught up in the homophobic panic around HIV and AIDS in the 1980s. The HIV crisis of that era took many lives, particularly of gay men, and was made all the worse by the stigma and fear created in the community.

Thankfully, the recent recommendation of the Therapeutic Goods Administration to reduce the deferral period from 12 months to three months is a step in the right direction, although it is only a small step. I note that there is an amendment standing in the name of the Minister for Health and Wellbeing to acknowledge that the TGA's new recommendation aligns Australia more closely with current clinical and scientific evidence. The opposition believes this is an appropriate acknowledgement and we will be supporting the minister's amendment, although for the reasons I will outline shortly, this is a practically meaningless statement.

It is important to acknowledge that scientific evidence evolves over time and we are beginning to see the start of this once again in this field. While Canada's blood donation deferral period aligns with our three-month approach that the TGA has just announced, the Canadian Chief Public Health Officer was quoted earlier this year saying, 'There needs to be an ongoing examination of science. We need to continue to look at this policy.' The article in the National Post goes on to say:

On its website, Canadian Blood Services says the three-month deferral period came in 'as an incremental step' towards changing the criteria. Since then, the work continues to evolve eligibility criteria based on the latest scientific evidence, as well as new developments in research into alternative screening methods.

That is a quote from the National Post of 13 June 2020.

I acknowledge that the current health advice recommends we adopt that three-month stance, but I hope the Therapeutic Goods Administration, the state government and the minister continue to keep a watching brief on this important issue, because this small step still does not mean that committed, monogamous, even married, gay couples are treated in the same way as heterosexual couples.

As for the immediate reaction to the announcement from members of the gay community—and this is just what I have gleaned from social media today—it can be best summed up as an action that is overdue. It is certainly a response, a partial response to community demands over the years, but it is one that is still discriminatory in its action. After all, heterosexual couples, married and unmarried, do not have to refrain from sex for three months before donating blood—they do not have to refrain from sex at all—yet a married gay couple in a faithful, monogamous relationship has to forgo sex for three months if one of them wants to donate blood. This is not equitable, and it is really not going to encourage too many people in this situation to actually become blood donors.

So yes, it is a small step, and for many who have commented today it is a tokenistic one. It will probably be ineffective and will probably not encourage an appreciable increase in blood donors; but the TGA is happy to make this small incremental change. I commend the Canadian experience, where they are looking at different ways of protecting the blood supply that treat donors, homosexual and heterosexual, in exactly the same way.

The Hon. S.G. WADE (Minister for Health and Wellbeing) (17:56): I would like to thank the Hon. Tammy Franks for moving this motion. The Marshall Liberal government acknowledges the generosity of donors who volunteer their time and their blood to help save lives. Every week, Australian Red Cross Lifeblood needs more than 29,000 donations to meet the constant demand for life-saving blood products.

Australian Red Cross Lifeblood is responsible for collecting blood donations in Australia in accordance with an agreement with the National Blood Authority, acting on behalf of all Australian governments, and the regulatory requirements determined by Australia's Therapeutic Goods Administration. Under these arrangements Lifeblood can be required to defer donors from giving blood when there is considered to be a high risk of infection being transmitted through blood transfusions.

The state government recognises that Lifeblood has been deferring donors who declare a history of male-to-male sex since the 1980s. In Australia there is currently a 12-month deferral period for a number of donor groups with sexual activity-based risk factors, including male-to-male sex. Changes to blood donor deferral policies in Australia are jointly considered by Lifeblood, the National Blood Authority and all Australian governments. Any changes must be in accordance with the regulatory requirements set out by the Therapeutic Goods Administration.

The state government acknowledges the decisions in April and July 2020 by the Therapeutic Goods Administration to approve an application by Lifeblood that proposes to reduce the deferral period for blood donors to three months since their last sexual contact. Sexual activity-based risk factors are defined in eight categories, including sex work, male-to-male sex, sexual contact with an injecting drug user (current or past), and sexual contact with a partner known to be infected with a blood-borne virus such as HIV.

Internationally, regulators are moving to reduce deferral periods. A three-month deferral for donors with sexual activity-based risk factors will bring Australia into line with the UK, the United States of America and Canada. In November 2017, the UK Blood Service, again incrementally moved from 12 to three months for deferrals for all sexual activity based risks, including male-to-male sex. On 2 April 2020, the United States FDA announced a reduction of deferral from 12 months to three months.

The application by Lifeblood was based on a comprehensive sexual activity deferral review, which began in 2017 and considered recently accumulating clinical and scientific evidence on sexual activity based risks. This evidence included epidemiological data and improved testing technology as well as the deferral practices in several other countries.

The safety and wellbeing of both blood donors and the recipients of blood products is foremost. The government would like to make it possible for as many South Australians as possible to give blood while ensuring the supply of blood and blood products continues to be one of the safest in the world.

The government supports an inclusive donor policy. The government strongly supports equitable arrangements for blood donor deferrals based on risk and supported by evidence. The state government recognises that this decision better aligns Australia's blood donation policy with the most up-to-date clinical and scientific evidence.

Lifeblood has proposed an amended national blood donor declaration form to reflect the approved changes and has requested each jurisdiction give effect to the changes in accordance with local legislation for national implementation from 31 January 2021.

I propose to put forward an amendment to the motion to reflect the fact that the TGA is part of a national process and that process is underway. The state government would not want to unilaterally action the TGA decision to reduce the deferral period for donor groups with sexual activity based risk factors. Accordingly, I now move to amend the motion as follows:

Leave out paragraph 3 and insert the following new paragraph in lieu thereof:

3. Notes that the TGA decision better aligns Australia's blood donation policy with the most up-to-date clinical and scientific evidence.

The Hon. C. BONAROS (18:02): I will be very brief and indicate SA-Best's support for this motion for reasons similar to those that have already been outlined by other honourable members, and I commend the Hon. Tammy Franks for raising this most important issue in this place.

The Hon. T.A. FRANKS (18:02): I thank those speakers who have made a contribution today—the Minister for Health and Wellbeing, the Hon. Ian Hunter and the Hon. Connie Bonaros—and for their support. I indicate that I am supportive of the proposed amendment made by the Minister for Health and Wellbeing. While it is not as strong as my original motion, I think that there is goodwill to keep working on this issue and not to let this great breakthrough, which I think Lifeblood must be congratulated on making through this new TGA decision, be lost in terms of momentum.

It is much-welcome news that the previous 12-month time period has now been changed to three months. While three months is not necessarily as far as it could go, it is in line with the TGA recommendations and both removes the stigma and follows the science when it comes to those men who have sex with men donating much-needed blood.

Lifeblood, it is unsurprising, have led this because they are at the coalface of having to ask those willing blood donors the personal question about their sexual activity and then in the unfortunate position of refusing that willing donation of blood not based on science but, indeed, based on stigma that is decades out of date in terms of the scientific requirements and the medical imperatives.

Indeed, while Lifeblood and the government do have a responsibility to ensure that nobody receiving a blood transfusion is infected by a preventable infection, more can still be done to allow particularly men who have sex with men to participate in blood donation even further and to increase our overall blood supply. This will need ministerial activism and leadership, however.

Indeed, community attitudes have shifted, and the community and willing blood donors would likely tolerate a much more detailed questioning of their activities in terms of not just casual sexual partners but, as the Hon. Ian Hunter noted, monogamous relationships that are long standing. This would be understood by the community and I believe will potentially further remove not just the stigma but increase that life-saving blood.

With that, I again thank all members for their contributions and the consensus that we have here today. It has been a long time in the making, and the work of Lifeblood is to be commended yet again, not just for the life-saving work that they do with blood donors but indeed for this destigmatisation they have led the charge on today. I hope that ministers around the country and our own Marshall government minister will continue this work.

Amendment carried; motion as amended carried.