By ANDREW POLLACK, Published: December 5, 2009, Eagle Pass, Tex.
Michael Stravato for The New York Times
Patricia Hernandez, left, and Alejandra Baca donate plasma twice a week in Eagle Pass, Tex., a border town with 22,000 people and two plasma collection centers
WHEN the tips her husband earned as a waiter began dwindling a year ago, Esmeralda Delgado decided to help support her family.
Twice a week, Ms. Delgado, the mother of three young girls, walks across the bridge from Piedras Negras, Mexico, where she lives, to Eagle Pass and enters a building just two blocks from the border.
Inside, for about an hour, Ms. Delgado lies hooked to a machine that extracts plasma, the liquid part of the blood, from a vein in her arm. The $60 a week she is paid almost equals her husband’s earnings.
“This is like another income,” she says.
Hundreds, probably thousands, of Mexicans like Ms. Delgado come to the United States to trade their plasma for dollars. Eagle Pass, a town of 27,000 that bills itself as the place “where yee-hah meets olé,” has two such plasma collection centers. There are about 15 others in border cities from Brownsville, Tex., to Yuma, Ariz.
The centers are run by pharmaceutical companies that transform the plasma into life-saving but expensive medicines for diseases like immune deficiencies and hemophilia.
Some border centers are new while others have been around for many years. They account for only a small percentage of the plasma collected by the industry, with the rest coming from collection centers throughout the United States.
But they have stirred debate in recent years because they illustrate the workings of the $12 billion plasma products business, a fast-growing industry that has depended on the blood of people hard up for cash. Based on typical industry yields and prevailing prices, it appears that a single plasma donation, for which a donor might be paid $30, results in pharmaceutical products worth at least $300.
Away from the border as well, many plasma collection centers have historically been located in areas of extreme poverty, some with high drug abuse. That troubles some people, who say it might contaminate the plasma supply or the health of people who sell their plasma.
“Why in the United States do we have to depend on people who are down and out to donate?” says Dr. Roger Kobayashi, an immunologist in Omaha who uses plasma products to treat many patients. “You are taking advantage of economically disadvantaged individuals, and I don’t think you are that worried about their health.”
Dr. Kobayashi, who also teaches at the University of California, Los Angeles, says the collections on the Mexican border skirt the policy aimed at keeping plasma products safe from pathogens by prohibiting imports of plasma. “If you can’t import the plasma,” he says, “why not import the donor?”
But the plasma companies and federal regulators say the practice is legal, ethical and safe. There have been no known cases of an infectious disease being transmitted through plasma products for more than a decade. And since the body quickly renews its plasma, the process is considered safe for donors if properly monitored.
“It’s not like giving up a kidney,” says Dr. Jay Epstein, director of blood research at the Food and Drug Administration, which regulates the collection centers and the plasma products.
The industry says the same precautions are taken at the border as everywhere else. “I don’t understand the difference between having a center in El Paso and having a center in Columbus, Ohio,” says Bruce Nogales, who runs plasma collection for Talecris BioTherapeutics, owner of the center that Ms. Delgado visits. Nine of Talecris’s 71 collection centers, including four new ones, are on the border.
Still, the industry has made a lot of efforts in recent years to shed its skid row image by building some centers in middle-class areas and by promoting altruistic reasons for donating plasma. Companies say donors now come from various walks of life.
The United States is one of the few countries that allows plasma donors to be paid. (And even here the plasma industry says it pays donors for their time, not for the plasma itself.)
But many of the countries that prohibit compensation do not collect enough plasma. So they rely on plasma or plasma products made from the blood of people who donate in the United States, which supplies more than half the world’s plasma.
“The U.S. is the OPEC of plasma,” says Jim MacPherson, chief executive of America’s Blood Centers, a network of blood banks.
FOR the plasma industry, times have been good. Growth has averaged 8 percent a year over the last two decades.
Talecris, a leader in the business, just raised $1.1 billion in an initial public stock offering. The transaction represented a handsome return for Cerberus, the private equity fund. Cerberus acquired what is now Talecris from Bayer in 2005.
To satisfy demand for plasma-based medicines, the industry has increased the number of collection centers to 408, from 299 in 2005, according to the Plasma Protein Therapeutics Association, the industry trade group. Paid donations in the United States rose to 18.8 million in 2008 from 10.4 million in 2005.
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