Many of us believe that AIDS is only transmitted by a sexual
relationship. According to the 1994 statistics of HIV patients in
Japan, however, 1792 hemophiliac patients out of 2616 were
infected with HIV. Ryuuichi Hirokawa claims that seventy percent
of HIV patients in Japan used to have hemophiliac treatment (2).
Although there should be no connection between the hemophiliac
and AIDS, medical experts in Japan failed to prevent such a
tragedy. Japanese and American pharmaceutical companies were more
concerned with profits than with good medicine, and both Japan
and America government policy failed to protect the public. If we
do not learn from these mistakes, the tragedy of HIV in future
will be repeated again.
By pursuing profits over and above good medicine, the
companies endangered the lives of innocent people. The report on
the February of 1982 brought a crisis into America. The CDC,
national prevention of epidemics center, reported on their
magazine [MMWR] that hemophiliac patient in Miami was infected in
a disease that was later determined as AIDS (Hirokawa 25).
Likewise, The Washington Post, Wall Street Journal, Newsweek,
Time, and Mainichi-newspaper reported that such disease is
spreading through homosexuals, drug addiction, and hemophiliacs.
The disease had a symptom of breaking an immune system of human
body. In 1982, CDC named this disease as AIDS. Therefore in 1983,
pharmaceutical companies in the United States were urged by the
government to change to heated blood products. Though 10,000
hemophiliac people had been HIV positive in 1985 (Gutin 3).
During early 1980s in the U.S., pharmaceutical companies were in
panic; they had been collecting HIV contaminated blood [unheated
blood] through out the states. Because of the boycott by
hemophiliac patients, the sales of unheated blood went 30% down
(Hirokawa 26-28). Therefore, American pharmaceutical companies
tried to seek a market abroad, which was Japan. The number of
unheated blood products exported to Japan increased from 114,100
in 1983 to 158,400 in 1985. Even though the Baxter Travenol
company, for example, claimed the effectiveness of heated blood
treatments for the decrease of virus infection, other companies
helped to spread virus in else where other than their own country
(Hirokawa 35).
Pharmaceutical companies and doctors in Japan imported blood
from America to gain profit. Hirokawa points out that, “the
system of medical insurance creates medical addicted patient, in
order for a hospital to raise profits”(30). This is proved
by a system called “yakkasaeki” in Japanese. Even
when hospital or doctor stocks medical products in lower price
from the pharmaceutical company, the government will pay whole
charges of the product to a doctor (Hirokawa 31). It was possible
for them to gain a great deal of money by its cost balances and
therefore, making patient addicted to medicines (Giga 60).
Hirokawa points that blood created in Japan has very low wages of
cost balances when compared with ones imported from America.
Therefore, doctors and hospitals were eager to change into the
usage of blood that was created within their country (32).
Takeshi Abe, who used to be a vice president of the Teikyo
University in Japan, is one of the members who controlled the
whole HIV infection damages from behind. He overlooked at the
infection of his hemophiliac patients and chose to be on the
sides of pharmaceutical companies and doctors to earn profits
(Hirokawa 37). In 1983, he continued to convince hemophiliac
patients that, “ AIDS will only occur for one out of three
thousand. We should not stop importing blood from
America.”
Since hospitals and doctors’ have been treating virus
infection unwisely, many patients suffered to death. First of
all, Hirokawa admits that hospitals and doctors were urging their
patients for a mass use of contaminated blood and they continued
to tell their patients that their unheated blood is safe. Since
France stopped importing from America, patients suspected the
dangers of unheated blood. Though hospitals and doctors denied
the danger and they even suggested to the patients that such
worries will do no good to their body (Tokyo HIV lawsuit, a
plaintiff #12 12). Secondly, they were aware of their
patient’s HIV infection through out a CDC test [without a
patient’s permission] in 1984, but continued to not give
notification (Gutin 3). Therefore, the HIV infection did lead to
a secondary infection for people who had sexual relationship with
the unknowingly infected patients. Also because doctors have
continued the usage of contaminated blood, it was too late for
the infected patients to have any kind of treatments afterward
(Hirokawa 42-43). Thirdly, Hirokawa claimed that hospitals and
doctors refused to look at the infected patients, even though
they were the one who gave out the unheated blood (58). Fourthly,
even though the Red Cross in Japan had enough skills to make and
had a license to produce cryoprecipitate, doctors made a
downright lie that they can not use cryoprecipitate for their
hemophiliac treatments. They also had a know-how to produce
cryoprecipitate that was placed between cryoprecipitate and
concentrated blood. Eiichi Tokunaga, who was a head of the Red
Cross in Japan at that time, testified that it was possible for
the seventy Red Cross centers in Japan to produce such type of
safer blood with out any high ability or advanced facility
(Hirokawa 46).
Since pharmaceutical companies did not stop producing and
selling unheated blood, the infection spread widely. First of
all, pharmaceutical companies’ action caused a vicious
circle to this HIV contaminated blood matter. They continued to
give out unheated blood products to hemophiliac patients by
selling their products to hospitals. Most of the blood which they
have been selling to the hospitals in Japan was contaminated
blood exported from America (Hirokawa 35). Secondly, they
continued to import America’s blood because their highest
priority was given not to human life, but to profits.
Pharmaceutical companies assumed that if they have imported
heated blood, hemophiliac patients would no longer buy their
unheated blood. Also some companies, like The Green Cross Company
who shared seventy percent of unheated blood market in Japan, did
not have an enough skill to produce heated blood. Therefore, in
order for them to produce a safe blood, they had to earn time
selling out all unheated blood (Hirokawa 41). Thirdly, Hirokawa
assumed that pharmaceutical companies have been giving out the
safety declaration to the patients, which were not based on any
evidence (59). Pharmaceutical companies did not want to lose
their sales due to safe heated blood. At last, they did not
collect the unheated contaminated blood immediately, even when
the government urged hospitals to use heated blood in 1985. Hence
it was not until after all unheated blood had gone out, that the
companies finally started to claim that the hospitals should use
heated blood to avoid the virus infection (Hirokawa 50).
Also, the Ministry of Welfare and the government of Japan
itself failed to protect citizens who were having hospital
treatments under their law. Even though the Ministry of Welfare
had effective power to stop the infection through out the
country, they were also involved in this matter like doctors and
pharmaceutical companies. First of all, the Ministry of Welfare
and the government of Japan did not take an emergency measures to
prevent the AIDS infection. They should have stopped the usage
and import of heated blood immediately. Also, they were
responsible for urging hospitals to change hemophiliac treatments
to the usage of cryoprecipitate blood. Therefore, they should
have announced the usage of Red Cross’s safe
cryoprecipitate blood to hospitals. The lack of not taking
emergency measures had lead to a death of many innocent patients
(Hirokawa 59). Secondly, for a long time, they had hidden the
fact of infection to the society. This once again connects to the
hospitals and pharmaceutical companies, which earned profits from
selling contaminated blood. Companies and doctors were
controlling the government, by bribery, not to lose their market
share (Hirokawa 40). Thirdly, they did not urge the collection of
unheated blood after the approval of safe heated blood (Hirokawa
60). Therefore, hospitals and pharmaceutical companies continued
to keep unheated blood as a stock, which eventually got in hands
of patients. Even when the approval of heated blood usage was
handed out on July 1985, the government failed to stop The Green
Cross’s contaminated blood, which were used until 1990
(Data Pal 197). Fourthly, the government did not urge
hospitals to give out HIV infected notification to the
hemophiliac patients who have done the HIV tests. Since 1984,
hemophiliac patient’s blood was send to America and France
to be examined. The test results had proved that the one third of
patients’ were infected. Though hospitals and doctors
continued to hide the notification (Hirokawa 55). The government
should have been more responsible to the tests’ results, in
order for an immediate reconsideration of this matter.
In conclusion, we have learned about various concerns from this contaminated
blood matter in Japan. All doctors, pharmaceutical
companies, and the government must come up with
the new measure to face the future medical problems.
Also at the same time, we, the consumers have to
reconsider the present condition. When we think
about the medical supply industries in future, there
are many points that can be said. Here are five:
- First of all, the government should abolish
“yakkasaeki” by law, or make new regulations (Giga
60). Recently, regulations have been revised every two years, but
there are still unofficial announcements causing problems (Araki
78). In HIV matter in Japan, “yakkasaeki” played very
important role in sustaining the over usage of unheated blood. It
is important to establish a new medical reward in order for
medical institution to keep up its management and for not to
fully depend upon “yakkasaeki” (Araki 76).
- Secondly, medical products in Japan have tendency to mention
various good effects but only mention a few side effects (Giga
56). This is obvious to see when we compare a Japanese
explanatory note with an American note for the produced medicine.
Japanese companies should make a fundamental change because they
have a tendency of high priority for moneymaking (Giga 57).
- Thirdly, the Ministry of Welfare should react immediately
when an administrative auditor points out a blind part of law
(Giga 56).
- Fourthly, the government needs to glean internationalized
information (Giga 58). For example, Germany had had HIV infection
matter like Japan, though the government’s reaction was a
lot different. The Diet itself has laid down special institution
to investigate the infection and who was it responsible for
matter to happen (Yonemaru 39).
- At last, the government should open all medical information
to the public. Information of the medical products is one of the
most important facts that we must know. In this HIV matter, the
government failed to give specific notification of heated blood,
which caused many patients’ and peoples’
infection.
Most of the medical products are only being tested through
clinical demonstration (Beppu 82). Therefore, new types of
medical products have less information to the consumers. If the
government had a slightest information of danger to the new
medical product, they should announce and the consumers should
have a full right for its notice.
In addition, it seems that America has lead in finding a
solution to the above problems. In May of 1997, American
researchers were successful of producing AIDS DNA vaccine, which
was proved by chimpanzee examinations. Bill Clinton, the
President of the United States, have announced that America will
look forward to produce a new vaccine for AIDS, within next ten
years (Data Pal 198). Likewise, Japan is expected to
continue researching on the virus and on the matter. Though these
measures were not necessary if only medical doctors,
pharmaceutical companies, and the government had not failed to
over look the matter. Once again, this HIV matter in Japan had
showed great failure in Japanese medical systems that we depend
on. Further measures should be considered in order to earn back
our trust.
by Naoko Morita
Works Cited
Araki, Shigehito. "Duty for the workers of
pharmaceutical companies." Why Did the HIV
Contaminated Matter Happened in Japan? Eds. Nishi,
Saburou et al. Tokyo: Kiri Shoubou, 1996. 61-80.
Beppu, Hirokuni. "Duty of medical journals." Why Did
the HIV Contaminated Matter Happened in Japan?
Eds. Nishi, Saburou et al. Tokyo: Kiri Shoubou,
1996. 81-89.
Data Pal '98-'99. Tokyo: Shougakukan,
1999. 197-198.
Giga, Souichirou. "Economical Structure Improvement due
to pharmaceutical matters." Why Did the HIV
Contaminated Matter Happened in Japan? Eds.
Nishi, Saburou et al. Tokyo: Kiri Shobou, 1996.
52-60.
Gutin, JoAnne C. "The Red Stuff / From vitalism to
tragedy, the history of how humanity sees itself." http://www.newsday.com/nd1/more/bookbk06.htm (7
Jan.1999)
Hirokawa, Ryuuichi. HIV Contaminated Blood
Products. Tokyo: Iwanami Booklet, 1995.
Tokyo HIV lawsuit, plaintiff #12. "If only
patients' fears had been in focus . . . ." Why Did
the HIV Contaminated Matter Happened in Japan?
Eds. Nishi, Saburou et al. Tokyo: Kiri Shobou,
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