Implicit Valuation of a Blood-exclusion Decision

Abstract

This paper presents an implicit valuation of Israel's decision to exclude blood donations from Ethiopian immigrants. The approach adopts assumptions that deliberately over state the public health effectiveness of this policy, for if such an analysis fails to justify exclusion on public health grounds, nothing will. Building on a recent (over)estimate of the number of infectious donations prevented by the ban, the analysis considers the cost of HIV-infectious donations entering the blood supply, the benefits of healthy do nations, and the cost of needlessly screening blood that will be discarded without regard to the test result. The analysis also highlights the social costs of excluding donors on the basis of ethnicity. The possibility of downstream HIV transmission from transfusion recipients infected from contaminated blood is also considered. All such calculations are made in a manner that deliberately favors the exclusion decision. In spite of such a one-sided analysis, the author concludes that the exclusion policy is not justifiable on cost-benefit grounds if the social costs of exclusion exceed $218,000 per year, or $3.63 per Ethiopian immigrant annually. Key words: public health; eco nomic analysis; policy; cost-benefit analysis; blood screening. (Med Decis Making 1999;19:207-213)