On January 16 a new directive came into place whereby Irish men who have sex with men will be able to donate blood for the first time since the dawn of the Aids epidemic… if they haven’t had sex in 12 months.

Some activists say the deferral period is unjust, but they may be fighting a futile battle, as Ciara McGrattan reports.

On any given day 17 to 20 percent of those who show up to donate blood are denied the chance to do so for a variety of reasons: from failing a haemoglobin test, to having traveled to malaria or Zika zones in the preceding months, or even having recently undergone acupuncture.

Until Monday, January 16, being a man who has sex with men (or indeed, a man who ever had sex with another man) was one of these exclusionary criteria. After that date, Irish MSMs will be able to donate blood for the first time – providing they haven’t had sex with another man in the preceding 12 months.

The lifetime ban on gay men and MSMs has been in place since 1985, when it was introduced in response to the burgeoning global Aids crisis. However, in the intervening decades, scientific advances in the treatment and cataloging of Aids and HIV have made the justification of a lifetime ban increasingly untenable.

This, coupled with increasing pressure from campaigners and a change in the UK’s policy in 2011 (excepting Northern Ireland), ultimately led to a long-overdue policy update.

Updated Policy

In a policy review released in January, 2015, the IBTS outlined three possible resolutions to the situation: remove the ban entirely, leave it in place or introduce a deferral period where gay men could give blood after a specified period of time. Then Minister for Health Leo Varadkar came out in favour of a deferral period policy, and in May 2016, current Minister for Health Simon Harris announced his department’s decision to replace the ban with a one-year deferral.

Not everyone is delighted by the change in policy. Campaigners like Galway-based Tomás Heneghan argue that the one-year deferral is “nowhere good enough”. In 2015, a then 23 year-old Heneghan – a regular blood donor since the age of 18 – was permanently ‘deferred’ from giving blood after disclosing a same-sex encounter at Dublin’s D’Olier Street clinic, despite having provided a copy of his most recent clear test results.

Heneghan, who was studying constitutional law at the time, was inspired by stories of ordinary citizens effecting change in the face on an indifferent political system. “You see all these cases where people have brought a case and managed to change something that the political side wasn’t willing to do themselves,” he says. “I always had that in my mind that change can be achieved. If the politics closes its door, you can still achieve change through the courts – or at least try.”

Discrimination

Heneghan then spent six months searching for a solicitor with the necessary mix of medical knowledge and a willingness to work pro bono. After securing legal representation he launched his case against the Irish Blood Transfusion Service (IBTS), arguing that the lifetime ban imposed on him was discriminatory, disproportionate and contrary to EU law.

After a year of interminable adjournments and legal back-and-forths, the case became moot when in May of last year Simon Harris announced the overturning of the lifetime ban in favour of the one-year deferral period.

Heneghan admits to being “heartbroken” when he heard of the decision. “From the very start of the court case I admitted that I wasn’t one of these people who would settle. Even if it takes a long time – whatever ‘it’ is – I see it through to the end. And I knew what I needed at the end, and it wasn’t a 12-month deferral. I knew I was right in pushing for a complete lifting of the ban too; I knew that the science and medical facts supported it.

“It had gone on for a year, back and forth, adjournment after adjournment and I was thinking after all these adjournments we might get a proper result.”

Individual Assessment

Campaigners say that a one-year deferral is little more than medically unjustified discrimination based on sexual orientation. UK LGBT activist Peter Tatchell argues that a three or even six-month deferral period would be sufficient, dependent on the risk factors associated with each individual donor. Heneghan agrees that individual assessment is the most appropriate policy to adopt.

However, Chief Executive of the IBTS, Andy Kelly is unconvinced about the efficacy of such a move. “I’ve heard that argument before,” he says. “Of all the countries who have looked at it, the only one who proposed going to a lesser [time frame] was Australia – about two years ago they proposed going to six months, but the regulator didn’t accept it. They reckoned the evidence wasn’t sufficiently strong to allow that change to take place.”

Emerging Infections

One of the justifications for the 12-month deferral policy is the spectre of ’emerging infections’– hitherto fore unrecognised infections with the potential to wreak havoc on public health.

“There’s a period by which somebody becomes infected and we can’t pick up the virus,” says Kelly. “Blood services are also concerned about the potential of an emerging infection and that they might not have time to respond, to put some action in place to stop it spreading within the blood system.

“It’s a precautionary measure. That’s why one year is deemed a reasonable period. I accepted that LGBT organisations like GLEN would argue ‘well one year is still too long’, but for the moment one year is what the international community think the evidence supports.

“We will keep it under review, like everything else, and I think it will be a few years before the data is sufficient for us to change.”

The Long Haul

But for men like Tomás Heneghan, nothing short of the opportunity to fulfil his civic duty to donate blood with the same freedom as his heterosexual counterparts will do. He urges those seeking further changes to the policy to get active.

“It probably sounds simple, but make sure your voice is heard. This case was about saying: this is not okay and it needs to change. Anyone can do that. One thing anyone can do is to write to your TD – and I’m not talking email, because odds are that will end up in their junk mail and it can be easily ignored. Write or type a letter, put a stamp on it, and make it known that you’ve done that. Call them out on Twitter, call into their clinic.”

However, since the policy on MSMs donating blood has only changed once in the past 30-odd years (despite being “under review” continually), campaigners like Heneghan might be in for a long wait.