The taintedblood Timeline  -  what really happened...

The Lancet reports first UK case of AIDS in a homosexual.

A vaccine for Hepatitis B is licensed in the United Kingdom. The DHSS decides not to purchase any vaccine centrally, due to insufficient funding. Instead, each Region is to find funds from existing budgets for the purchase of HBV vaccines.

Note:
Perhaps the question should be posed as to whether the medical profession knew that haemophiliacs already had antibodies to Hepatitis B? Yet, the profession's desire to amass research through trials on PUPs (Previously Untreated Patients) prevailed.

In a DHSS letter of 16 July 1982, we read of an early awareness of research which fairly conclusively demonstrates that:

"....plasma taken from homosexual drug-takers contains a sort of virus which goes undetected when the plasma is tested because it is suppressed by the drugs. However, when used for Factor VIII, it becomes active again."

The DHSS letter states that information has been received from the American Bureau of Biologics (via NIBSC) indicating there may be considerable publicity in the next couple of weeks concerning the safety of American Factor VIII.

From the following comment, it appears the DHSS are complacent at this stage:

"In any case with our voluntary unpaid donor system we do not have the same problems as in the States where drug addicts are tempted to give blood simply for the money. However, about half of the Factor VIII bought from commercial companies is imported from the USA."

Note: In terms of knowledge in the United Kingdom, this is one of the earlier dates (16 July 1982) which demonstrates that the DHSS had advance "private" knowledge of the safety risks from US commercial factor VIII almost 10 months earlier than we previously thought. This DHSS letter went out 1 year prior to the infamous July 1983 CSM meeting (reported in the Guardian by Sarah Hall on Friday May 25, 2007).

This early knowledge by officials also pre-dates (by 2 months) our earliest known point of awareness of AIDS by the UKHCDO (which was in September 1982). We know that Dr Craske was tasked with looking into reports of the syndrome in 3 haemophiliacs from the United States.

A licensed Hepatitis B Vaccine will be available in the UK at the end of September 1982. This vaccine is to be offered to "priority patients" with haemophilia.

A trial is to be conducted at Oxford involving Haemophilia A patients, whereby the vaccine is to be administered by subcutaneous route.

At a meeting of Haemophilia Centre Directors in 1982, Dr Preston states that information regarding autopsies of all deceased haemophiliac patients will in future be collected by Haemophilia Centre Directors and returned to the UKHCDO for central analysis.

Note: The requirement of an autopsy is applied to ALL persons with haemophilia who have died. There is nothing in the minutes which indicates that the cause of death is taken into account.

In a Haemophilia Centre Directors' Organisation meeting in September 1982, there is not only knowledge of AIDS infecting haemophiliacs in the USA, but also, there is some understanding of the possible involvement of commercial blood products.

Dr Craske is tasked with looking into reports of the syndrome in 3 haemophiliacs from the United States. HCDO minutes state that: "It appeared that there was a remote possibility that commercial blood products had been involved."

A Lancet report by Dr Jones describes the link between AIDS and common cell immunity in haemophiliacs.

FDA requirements on blood donations introduced.

In an Oral Question in Prime Minister's Question Time on Tuesday 3rd May 1983, Mr Race makes it clear that Dr Gerard Vaughan, former Minister for Health, was warned 2 years earlier, circa May 1981, of the danger of contaminated blood supplies from the USA:

Mr. Race: "As the House of Commons' favourite own-goal merchant, the Minister for Consumer Affairs, was warned two years ago by his own Department of the danger of contaminated blood supplies coming from the United States, will the Prime Minister rectify that deplorable and disgraceful mistake by immediately authorizing the necessary expenditure within the National Health Service to make Britain independent in its blood supplies?" (see first column, para 9.)

Note: This Oral Question reveals that Dr Gerard Vaughan, then Minister for Health, knew sometime in 1981, possibly from as early as May, of the threat of contaminated blood supplies which were being imported from the United States. This is one of the earliest warnings that we are aware of so far and we are astonished to learn of how early this awareness was, and that so little was done. Clearly, we are not being told everything.

In a DHSS letter of 13th May 1983, it is clear that the DHSS has had sight of a letter from the CDSC (dated 9th May 1983), in which a recommendation that American FVIII concentrates should be withdrawn from use because of the risk of transmitting AIDS.

Nevertheless, the DHSS appear to take little notice:

"In my view this suggestion is premature in relation to the evidence and unbalanced in that it does not take into account the risks to haemophiliacs of withdrawing a major source of their FVIII supplies".

Note: Where were the DHSS obtaining their medical advice? The HCDO had already had 9 months to consider the problem of imported Factor VIII as Dr Craske had been specifically tasked by the HCDO with looking into reports of AIDS in 3 haemophiliacs from the United States - this was in September 1982. Dr Craske, at that time, had suspected a link to commercial Factor VIII and this was minuted.

At a Meeting of the Haemophilia Reference Centre Directors on 13th May 1983, the Directors decided that, on the evidence available, (and because of the benefits of treatment), that no restriction should be placed on imported Factor VIII concentrate.

The only exception the Directors made was to continue with their policy of only using NHS material for children under the age of 4 and for mild haemophiliacs.

Background: Why didn't the Directors of Haemophilia Centres try and do more to ban imported Factor VIII concentrate? They appear to have ignored the following warnings:

• Dr Craske had been tasked by the HCDO with looking into reports of the syndrome in 3 haemophiliacs from the United States a whole 9 months before (in September 1982) and he suspected a link to commercial Factor VIII.
• 5 months earlier, (January 1983) there had been an article in the Lancet by Dr Jones (also HCDO), where AIDS was linked to common cell immunity in haemophiliacs.
• The FDA requirements on blood donations had already been introduced on 23rd March 1983 - this was 2 months before this decision.
• On 6th May, (1 week earlier) the CDSC telephoned the DHSS to inform them that a 23 year old haemophiliac patient in Cardiff was now showing symptoms of an AIDS diagnosis after having been infused with US Factor VIII.
• On 9th May 1983, (4 days earlier), the CDSC had written a letter recommending that American FVIII should be withdrawn from use due to the risk of transmitting AIDS. The DHSS definitely had sight of this CDSC letter by 13th May 1983.

The Biologicals Sub-Committee of CSM recommends that very little is done about the threat of AIDS to haemophiliacs.

• The possibility is considered of withdrawing clotting factor concentrates from the market and replacing them with cryoprecipitate. It is concluded that this is not feasible in the UK on grounds of supply. (Minutes Agenda Point 5.3)

• The possibility is considered of withdrawing US preparations from the UK. It is concluded that this is not at present feasible on grounds of supply. Moreover, the perceived level of risk does not at present justify serious consideration of such a solution. (Minutes Agenda Point 5.4)

A letter from the Public Health Laboratory Service (PHLS) in Manchester, details the discovery of a batch of Factor VIII [Batch No. HL3186] that was made from pooled plasma where one of the donors was later confirmed to have antibodies to HTLV-3 (HIV). The letter also confirms that epidemiological follow-up studies are to be carried out on the recipients of that batch.

• We know that Dr Craske had detailed knowledge about the situation regarding AIDS in the USA, especially since he was tasked with looking into reports of the syndrome in 3 haemophiliacs from the United States in September 1982.

• Dr Craske even knew about the connection between AIDS and US commercial blood products.

• We also know that from October 1983, the UK Haemophilia Centre Directors had considerable, documented awareness of the risk of AIDS to the spouses of haemophiliac patients.

With this in mind, we strongly believe that the physicians involved in this BPL product recall were remarkably casual in their approach to dealing with it. The delays incurred in telling patients meant that their wives and partners were put at risk. We would suggest that this was because of directives from Dr Craske.

In an article in The Standard, it states that Dr Seale had been trying to alert public health officials to the implications of the threat of AIDS for nearly two years:

Dr John Seale: "I wrote to both Mrs Thatcher and the Public Health Laboratory Services to suggest blood transfusion policy changes then." (paragraph 4)

Note: This article shows that both Margaret Thatcher and the PHLS were notified circa November 1982 and could reasonably have been expected to know about the threat of AIDS to the Blood Transfusion Service and thus to haemophiliacs.