The infected blood scandal has been described as the worst treatment disaster in the history of the UK's National Health Service.

In total, almost 30,000 people in the UK contracted HIV or hepatitis after receiving blood transfusions contaminated with the viruses back in the 1970s, 1980s and 1990s. More than 3,000 people died, and more continue to die every week.

A governmental inquiry published in May 2024 found evidence of large-scale cover-ups by health workers and ministers, which ignored, downplayed or denied the risks and damages caused by contaminated blood donations.

"It's not just the impact of the infection itself, the fallout has lasted for decades. It's huge. It affected the lives of people's families and friends. Lots of people in the UK had no idea this was going on — because people were being silenced," said Beatrice Morgan, senior associate solicitor at Leigh Day, a UK-based law firm which represented over 300 individuals during the UK infected blood inquiry.

Infected blood scandals aren't just restricted to the UK — many countries bought blood contaminated with infectious diseases.

But it's still not known how many people were infected with HIV , hepatitis B or hepatitis C from contaminated blood around the world. The total impact is unknown. People whose cases have been confirmed are still seeking justice.

What is the UK infected blood scandal?

In the 1970s, a new treatment for people with hemophilia became available which required donated human blood plasma. Many countries didn't have enough blood donations, so sourced much of their blood-related products from the US.

"They were collecting blood from prisons and active drug users, many of whom were known to have hepatitis. The blood wasn't screened properly. It takes only one contaminated donation with HIV or hepatitis to contaminate a whole batch, and a batch could contain up to 40,000 other donations," said Sally-Anne Wherry, a senior lecturer in advanced clinical practice at the University of Gloucestershire, UK.

There's huge evidence, added Wherry, that governments and drug companies involved in buying and selling US-based blood knew this was taking place.

In the UK, around 27,000 people with hemophilia were infected with hepatitis C.

A further 1,250 people were infected with HIV, including 380 children, of whom about two-thirds later died of AIDS-related illnesses. Some unintentionally gave HIV to their partners.

Wherry's father contracted hepatitis from blood transfusions aimed at treating his hemophilia. She said the trauma it caused was tremendous and multigenerational.

"Hemophiliacs and their families experienced unbelievable stigma around the time of the AIDS crisis. People's houses were vandalized, and hemophiliac kids were told to be taken out of school," Wherry said.

Which other countries were hit by infected blood scandals?

Blood is a globalized commodity, bought by health systems that cannot source enough blood for their patients.

"Any country that bought contaminated blood from the US in the 1980s was affected," said Wherry.

In Canada, 2,000 people contracted HIV and 60,000 people developed hepatitis C.

Australia saw more than 20,000 people affected.

And in France, more than 4,000 people contracted HIV.

In Germany, a scandal erupted in 1993 after government officials tried to cover up reports of HIV/AIDS in people given infected blood. Over 400 people died, and a third of the country's hemophiliacs (2,000 people at the time) were infected with HIV.

China also saw HIV infections from contaminated blood bought and sold internally. An estimated 300,000 people were infected with HIV through blood selling-schemes in the 1990s.

People are still being infected with diseases by contaminated blood products. In 2016, more than 2,000 people in India contracted HIV from contaminated blood transfusions, and an outbreak of bacterial infections from infected blood transfusions occurred in Turkey in 2021.

Contaminated blood remains a concern in any country where blood is not properly screened before use.

Cover-up of infected blood transfusions

A public inquiry in the UK began in 2017 and published its findings this past May.

The report summary described the UK blood scandal as "horrifying" and accused doctors, the UK's National Health Service (NHS) and every government dating back to the 1970s of repeatedly failing patients.

"We've been waiting for justice for such a long time, and it's still not here yet. There's been constant pressure for decades to have this issue noticed," said Wherry.

Following the report's publication, then-UK Prime Minister Rishi Sunak offered a public apology, highlighting the failures of successive governments and the NHS.

Sunak said people affected by the infected blood scandal would start receiving compensation by the end of 2024. The total cost of compensation is expected to reach billions of pounds.

What have we learned?

Rigorous testing of donated blood for infectious diseases is now routine around the world.

HIV screening became routine in 1985, while testing for hepatitis C began in 1991, 18 months after the virus was first identified. Testing is now routine for other blood-borne diseases, including bacterial infections.

Some countries also have rules about who can or cannot donate blood, aiming to reduce the chances of people transmitting infectious diseases. Until 2023, for example, gay men in the US were banned from donating blood due to discriminatory concerns about HIV. That has now changed. 

In addition, there's been legal action. A German court convicted three company executives for distributing contaminated blood. And in France, three former health ministers were charged with manslaughter; two were acquitted and one was found guilty of unintentional manslaughter but spared a prison sentence.

Morgan said it's unclear whether similar legal action would happen in the UK. "Because it's all so late, it's unclear whether it's in the public interest to prosecute individuals who may have criminal responsibility," she said.

Instead, said Morgan, people first want financial compensation.

Edited by: Zulfikar Abbany

Sources:

Infected Blood Inquiry Report 2024 https://www.infectedbloodinquiry.org.uk/reports/inquiry-report

Policy paper: Government Update on the Infected Blood Compensation Scheme: 16 August 2024 https://www.gov.uk/government/publications/government-update-on-the-infected-blood-compensation-scheme-16-august-2024/government-update-on-the-infected-blood-compensation-scheme-16-august-2024