A call to arms for plasma

Demand for life-saving plasma is growing at such a rate that New Zealand is falling further and further behind on its supplies, forcing it to pay millions of dollars every year for immunoglobulin from America, one of the few countries that pays people to donate.
Plasma is the yellow liquid component of blood that is needed to help the body recover from injury, distribute nutrients, remove waste and prevent infection. It is used to treat up to 50 illnesses, including cancer and autoimmune diseases. Immunoglobulin is a key protein in plasma.
New Zealand hospitals rely on donors – around 17,500 of them – who give plasma on a regular basis through the national blood service, Te Ratonga Toto O Aotearoa. It amounts to several tonnes a year but it is well short of what’s needed.
NZ Blood’s transfusion medicine specialist, Dr Richard Charlewood says New Zealand is at a tipping point.
“Unless we can get our plasma donation numbers up we’re going to get further and further behind. That’s not good for us in a financial sense, in that we have to buy plasma from other countries, it’s not good for us from a self-sufficiency perspective.
“When Covid hit and donation numbers went down in the United States they made it very clear to the world that it is a United States-first policy,” he says.
That means the US will not run out of intravenous immunoglobulin for itself – it will simply stop providing to other countries.
“As a small country with a small value contract we would probably be dropped fairly quickly,” Charlewood says.
It is called liquid gold because immunoglobulin is more valuable than gold. The global market for plasma is estimated to be worth more than $50 billion, rising to $75 billion by 2027. The US profits most from the global market because it is responsible for 70 percent of all the plasma on the world blood market.
Immunoglobulin or antibodies is one of several proteins contained in plasma, along with albumin and clotting factors. The immunoglobulins are in hot demand because they defend the body from infections, viruses and cancer cells. Charlewood says New Zealand is not alone in its struggle to collect enough plasma to meet growing patient need for immunoglobulin.
Peter Jaworski of Georgetown University in the US has gathered the data on the few countries that are self-sufficient on plasma and those that aren’t, like New Zealand and Australia.
The five countries that collect enough all allow commercial companies to assist in plasma collection, and either compensate or pay donors.
Jaworski, an associate teaching professor of strategy, ethics, economics, and public policy at Georgetown’s McDonough School of Business, estimates New Zealand now pays $10 million a year to import plasma.
“New Zealand and all other countries that ban commercial assistance or payment have trouble collecting enough plasma partly because we can only get 4-4.5 grams of immunoglobulin per litre of plasma.
“But mostly it is because demand for immunoglobulin has been growing at 6-8 percent every year (excluding Covid years) in high-income countries for over a decade.”
New Zealand was 100 percent self-sufficient until 2012, but until 2016 the amount of imported immunoglobulin was insignificant.
“In 2015, New Zealand was probably the only country in the world that was self-sufficient in plasma for immunoglobulin without help from the commercial sector, and without compensating donors,” Jaworski says.
Today The Detail takes a tour of NZ Blood’s Auckland facility with Charlewood to find out how plasma is collected and why it has to be frozen and sent to Melbourne for processing and packaged into products that are dispatched to hospitals.
Charlewood says several thousand more donors are needed to ensure that New Zealand can be self-sufficient again but he argues that paying for plasma is not the solution.
“It’s not something that we are really wanting to go down. There are a number of reasons for that, the first and foremost is plasma safety. If you are being paid for something you now have an incentive to be less than honest on your questions.
“The second aspect is the exploitation of people. If you look at American plasma donors, they are generally the poorest of the poor. To the rest of the world that feels somewhat exploitative and that’s not somewhere we particularly want to go which is why we would like to return to being self-sufficient.”
This week NZ Blood is highlighting the need for more plasma donors as it marks National Blood Donor Week.
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