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Web-only Exclusives
November 30, 2000

From Our Correspondent: Hirohito and the War
A conversation with biographer Herbert Bix

From Our Correspondent: A Rough Road Ahead
Bad news for the Philippines - and some others

From Our Correspondent: Making Enemies
Indonesia needs friends. So why is it picking fights?

Asiaweek Time Asia Now Asiaweek story

JAPAN:

A Case of Delayed Justice
The Health Minister Admits to a
Government Cover-Up Over HIV-Tainted Blood

By Todd Crowell
and Murakami Mutsuko / Tokyo


JUSTICE WAS A LONG time coming. In the early 1980s, about 2,000 hemophiliacs in Japan were infected with HIV, the virus that causes AIDS. They contracted the virus through contaminated blood products -- hemophiliacs lack an agent in their blood that causes clotting, and must receive regular transfusions. They have long argued that their infection was no accident, but a result of government negligence. Over the years, various government agencies denied any wrongdoing -- until now.

On Feb. 16, more than 200 of the HIV-carriers, their relatives and attorneys crowded into the conference room of the Ministry of Health and Welfare. Minister Kan Naoto walked in and bowed deeply: "Let me sincerely apologize from the depth of my heart," he said. He admitted the government was responsible for their suffering, and pledged to do his best to provide them with medical and financial assistance. Then, as many wept, Kan, himself barely holding back tears, shook hands with each of the hemophiliacs and their families. At the request of a mother whose son had died of AIDS, he prayed before an urn containing the boy's ashes.

Japanese had never seen anything like it. Other ministries have been embroiled in scandals. Other department heads have resigned and apologized under pressure. But Kan had lifted the veil of secrecy on his own ministry, revealing a pattern of incompetence, insensitivity and dissembling. "Now I can live proudly and shamelessly," said Kawada Ryuhei, one of the few AIDS victims to allow his name to be published.

Kan admitted that the ministry understood the risk of HIV contamination of imported blood products in 1983, when it studied the issue. At the time it had considered recommending a switch to heated blood as a safer alternative. But it finally decided to allow the continued distribution of untreated blood. Only in 1985 was most unheated blood removed from the market. As a result of that delay, 40% of Japan's hemophiliac patients were infected with HIV. About 400 have since died of AIDS. "Every week, every day, some of us have been dying," laments Kawada. "It's not that we are dying like everyone else; we're being murdered."

Similar tainted blood scandals have surfaced in Europe. In France, four senior medical officials were convicted in 1992 of knowingly allowing hemophiliacs to receive blood-clotting plasma in 1985 that were contaminated with HIV. In 1993, Germany's federal health office was accused of covering up 373 cases of people who contracted the AIDS virus through tainted blood.

Some 190 Japanese hemophiliacs sued the government and five pharmaceutical companies in 1989 for allowing unsafe blood to be distributed to local clinics and hospitals. They have been only partly successful. Last October, lower-level courts in Osaka and Tokyo proposed that the government and five pharmaceutical companies pay $450,000 to each plaintiff. But the defendants have not agreed to a settlement, in part because they could not decide on who was to blame.

Then in January, Prime Minister Hashimoto Ryutaro took office and appointed Kan to head the Health Ministry. The new health chief promptly ordered an internal investigation. Within three days his team produced nine thick files on the case, including detailed records of the ministry's AIDS research team that was set up in 1983. Previously, officials had claimed that the documents did not exist or were lost.

The ministry's documents show that that in 1983 the government knew that untreated blood could be contaminated by the AIDS virus. At the time, most condensed blood products were made from blended U.S. blood. One HIV-infected donor was enough to taint the entire batch. Then U.S. scientists discovered that heating blood products during the manufacturing process killed the virus. In March 1983, the U.S. Food & Drug Administration certified heated blood safe for general use. Four months later, Japanese officials prepared guidelines advising clinics and hospitals not to use unheated blood. But one week later, the ministry reversed its decision. The still unanswered question: Why did it change course?

Gunji Atsuaki, then head of the ministry division in charge of AIDS research, recently issued a statement claiming that studies in the U.S. at the time indicated that only one or two hemophiliacs might be infected if unheated blood remained available. He said there was a "global consensus" that the benefits outweighed the risk of HIV infection.

Japan's national broadcasting station recently reported that the U.S. pharmaceutical company Trovenol (now Baxter Ltd.) had written Gunji in June 1983 warning of possible HIV contamination of its blood products and asked help for an urgent recall. The letter was ignored, said NHK. And investigative journalist Sakurai Yoshiko asserts in her book AIDS Crime that between 1983 and 1985 unheated blood imported from the U.S. was sold to Japanese drug companies at 40% to 50% discounts, who then sold it to patients at standard prices.

The head of the Health Ministry's AIDS research team in 1983 was Dr. Abe Takeshi, a leading authority on hemophilia. He had recommended allowing unheated blood to be used. A mother whose son died of AIDS filed a complaint with the Tokyo public prosecutor's office on Feb. 15 asking that Abe be charged with murder. She said Abe had treated her son with contaminated blood as late as 1985. Though he has not been indicted, Abe, now 79, resigned last week as vice-chairman of Teikyo University. He issued a statement saying that he stood by his earlier decisions.

It was Kan who put the investigation into overdrive. The new health minister is a member of the small Sakigake party. A liberal offshoot of the Liberal Democratic Party (LDP), it forms the smallest leg of the tripartite coalition headed by Hashimoto. Kan, 49, was an environmental activist before winning his Diet seat in 1980, and had taken a keen interest in the blood contamination problem even before assuming office.

Historically, Japanese government ministers have considered themselves beholden first to their departments, next to the industries those departments supervise and only then to the public. Little of the vast amounts of information they gather and evaluate is ever made public. Senior civil servants look forward to lucrative jobs in the private sector when they reach mandatory retirement in their mid-50s, and so are not inclined to make life uncomfortable for future employers.

An example is the Green Cross pharmaceutical company, Japan's largest maker of blood products. In the critical year 1983, its chief executive officer was the retired bureau chief for pharmaceutical policy at the Health Ministry. Four other former Health Ministry civil servants also held executive posts. Green Cross admitted on Feb. 27 that it had continued selling unheated blood as late as December 1986, with some products available well into 1987.

Minister Kan has made clear that he has bigger ambitions than just resolving the blood scandal. His goal is to "change the entire culture of Kasumigaseki," the Tokyo district where government ministries are located. In the more than two years since the political upheaval that ended the LDP's four decades of single-party rule, various self-styled reformers have talked a lot about making the government more accountable to the people. Kan may be the first politician to actually do it.


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