Life-saving plasma therapies are essential for many patients, but every year we flirt with a shortage. Plasma collected in the United States is the source material for more than 70 percent of the world's supply; humanity is nearly always one market disruption away from global catastrophe.
American dominance in this realm is explained by one simple fact: In the United States, it's legal to pay people for their plasma. Millions of Americans regularly give plasma in exchange for $30–$50 per donation. The average American donor gives 21.4 times per year. If you add plasma obtained from Germany, Austria, Hungary, and the Czech Republic—the other places where compensation is offered—paid plasma accounts for a staggering 89 percent of all the plasma used to make plasma therapies for the whole world.
Most foreign countries refuse to pay for plasma because of outmoded guidance from the World Health Organization. Its decades-old policy was initially motivated by the concern that payment would attract people from lower rungs of the socioeconomic ladder who are more likely to be carriers of transmissible infections. Those concerns no longer apply: There have been significant improvements in testing technology since the 1970s, and modern manufacturers now have the ability to use virus removal and inactivation techniques, rendering samples safer than ever. Yet the organization's guidance has not changed.
Some theorize that we don't have more volunteer plasma donors because we just haven't asked in the right way. But millions have been spent on TV, radio, and newspaper advertisements encouraging unpaid donation. Others say paid plasma is exploitative, but they don't explain how prohibiting compensation would help people who currently feel the need to sell their plasma. Countries that have made the switch to paid donation have not seen altruism pushed out. The Czech Republic legalized compensation for plasma donations in 2008. Within three years, total donations increased sevenfold, making the country self-sufficient in plasma therapies.
Due to the coronavirus, plasma donations have fallen 15–20 percent across the United States. Between the depressed supply of plasma and the possibility that demand will rise as new COVID-19 treatments that rely on plasma are developed, the world could well be heading for a devastating shortfall. The problem could be quickly and cheaply remedied if it weren't for irresponsible guidance from global health bodies and an unfounded bias against paid donation.