KATSUMI OHIRA’S LIFELONG FIGHT FOR HIV-TAINED BLOOD VICTIMS
Katsumi Ohira, my long-time friend, passed away recently at 70. Two days before his demise, I called on him at his residence in Tokyo. He lay in his bed, obviously in great pain but I could tell from his reaction that he instantly recognized me and was happy to see me, which greatly relieved me. A female physician gently rubbing his chest to ease his pain told me:
“During his recent hospitalization at the National Center for Global Health and Medicine in Shinjuku, Tokyo, Mr. Ohira was adamant about not taking painkillers. He said they would make him dizzy and prevent him from saying so many things that he still has left unsaid as his parting message to posterity.”
Ohira, born with hereditary hemophilia, contracted HIV in the early 1980s when a doctor prescribed to him HIV-tainted unheated concentrated blood-clotting agents (hereafter, unheated agents) before going on his first trip abroad with his wife.
In March 1983, the US Center for Disease Control and Prevention (CDC) officially attributed HIV infections on the part of American hemophiliacs to unheated agents, urging the pharmaceutical industry to switch to heated agents in which the HIV virus had been killed.
Meanwhile, Japan was slow to take action: it wasn’t until July 1985, two years and four months behind the US, that the Japanese government approved the heated agents. Not only that. Even after getting government approval, five Japanese blood product companies, from Midori Juji Corporation down, gave priority to offering hemophilia patients unheated agents they had kept in stock in large quantity. Furthermore, in order to keep pace with Midori Jiji, which lagged in the development of heated agents, the competitors colluded with each other to adjust clinical trial dates required for government approval of their products until Midori was ready.
As a result, two years and four months were wasted, during which time an estimated 2,000 hemophiliacs in Japan contracted HIV. It was only very natural that a group of hemophiliacs sued the state and the drug companies to call them to account.
The first lawsuit was filed on October 27, 1989. Unprecedented in Japan’s court history, all of the 67 plaintiffs from 61 families chose to remain anonymous throughout the litigation.
Imminent Threat to Life
Ohira became a powerful spiritual pillar for the plaintiffs, although he was not initially a proponent of bringing legal charges against the government and drug companies. Born with hemophilia, a disease that causes the sufferer to bleed severely from even a slight injury, he was enjoying a happy and peaceful married life. He and his wife left in April 1983 for Europe. The month before, the CDC formally traced HIV among hemophiliacs to unheated agents, but the Japanese Ministry of Health and Welfare failed to take any action, with specialists continuing to administer nonheated agents to hemophiliacs.
During a checkup prior to departure, Ohira’s doctor gave him an injection of 750 units of unheated agents to prevent bleeding. Informing him that unheated agents would come in handy when traveling, the doctor gave him “22 or 23 ampules of 750 units of unheated agents,” which Ohira diligently injected into himself twice a day while in Europe.
Previously, Ohira had used a blood agent named Cryoprecipitate, commonly referred to as Cryo. Made from blood from a single donor, Cryo was considered safe against infectious diseases such as hepatitis, not to mention HIV.
Meanwhile, unheated concentrated blood agents were traceable to a pool of blood bought from an unspecified large number of donors—anywhere between 2,000 and 25,000. The danger involved would naturally be much greater.
Immediately after returning to Japan from a memorable trip, Ohira was shocked to read alarming articles in the Mainichi Shimbun with these headlines: “Danger of Infection Through US-Made Unheated Blood Agents”; “Fatality Rate Extremely High”; and “Hemophiliacs Face Danger of HIV Infection in Japan.”
“What should I do now?!” Ohira despaired. “I’ve used a lot unheated agents during my trip.” He could not but fear for his life. Meanwhile, the Ministry of Health and Welfare set up the Clinical Study Group for AIDS in June 1983, putting in charge Takeshi Abe, head of the faculty of medicine at Teikyo University in Tokyo.
Two and a half years later, in the summer of 1985, Ohira visited the university to call on Abe, who had by then been promoted to vice president. At the time, Abe also served as representative caretaker for a consortium of five major blood product producers—the Chemo-Sero Therapeutic Research Institute, Baxter Travenol Japan, Cutter Japan, Hoechst Japan, and Midori Juji.
Ohira had only one crucial matter to check with Abe. Japanese blood product manufacturers, which lagged significantly behind their American counterparts in the development of heated agents, had their own products finally approved belatedly and simultaneously in July 1985. By asking why the manufacturers had failed to win government approval on a first-come-first-served basis, Ohira was simultaneously pursuing Abe’s responsibility.
About a month before his visit with Abe, Ohira had called on Chemo-Sero to ask the same question. They admitted that they could have shipped out their heated agents much sooner, but that they were compelled to delay delivery to stay in line with Midori Juji’s slower development schedule. Ohira also had learned that Baxter Travenol Japan and Hoechst Japan had actually been ready for an earlier delivery.
After coming to grips with the progress of development at the manufacturers, minus Midori, Ohira told Abe pointblank:
“I have learned that the other makers, such as Travenor, were perfectly capable of providing the agents much earlier.”
Without accepting his liability, Abe blurted out: “This is why I don’t wish to meet people of your kind.”
It was some four years later that the HIV-infected hemophilia patients, including Ohira, filed a lawsuit for involuntary manslaughter against the government and the five blood product makers.
“Be Clever Patients”
Aside from this lawsuit, a criminal complaint was lodged against Abe, charging him with professional negligence resulting in deaths and injuries in connection with the HIV scandal. Abe was acquitted in the first instance, but died in April 2005 while an appeal hearing was in progress. He was 89.
Abe on his part had sued me and the Mainichi for libel, but in its decision the Supreme Court ruled against Abe.
Ohira was a large presence for the plaintiffs. He daringly raised pertinent matters and left many comprehensive testimonies, steadfastly playing hard ball with the Welfare Ministry, pharmaceutical makers, and hemophilia specialists, including Abe. To his last day, Ohira sounded warnings against the ministry depending on blood from overseas. After 1983, even when the US ceased to use nonheated agents domestically, its drug manufacturers continued to make them for sale in Japan. Japan was a ready market, which led to the tragedy. Ohira’s contention—that such a situation should never have been created and that the blood used by Japanese patients should have been managed with blood available in Japan—is absolutely correct.
Ohira took the situation of each HIV-tainted blood victim as his own, constantly offering supportive advice. Sharing with them every piece of information he had about the conditions afflicting them, Ohira harped on the importance of being “clever patients.” He untiringly encouraged those facing societal prejudices, urging them to never lose their fighting spirit.
I last had a meal with Ohira on Christmas Eve last year. I would regularly invite him and his colleagues to dinner at my home in Tokyo every spring or summer, but was quite busy last year and had to postpone the occasion until the yearend. I knew that the yearend wasn’t really an ideal time for a get-together like that, but wanted to still go ahead with it. Some even came from Kyushu to join us. Before heading for home after a fabulous dinner, Ohira said this to me with a smile:
“The dinner was great, but frankly I was expecting your delicious Thai curry today!”
As a matter of fact, Thai curry was exactly what I had initially in mind, but I eventually decided against it as that would take much time to prepare. So I told him: “Oh, sorry. You’re right. I promise your next meal here will definitely be Thai curry.”
We laughed and said good-bye, not realizing that was going to be our final farewell.
I understood from his physician that while in the hospital he took part in an on-line conference hosted by the Welfare Ministry. He fought to his last breath. So long, Ohira-san. I will always fondly remember you as my magnificent friend with a heart of gold! (The End)
(Translated from “Renaissance Japan” column no. 908 in the July 2, 2020 issue of The Weekly Shincho)