(instrumental music) - [Narrator] Welcome to the wonderful world of blood donation. Around the world, giving blood is seen as
a symbol of generosity, one of the noblest acts in modern society. But the reality is different altogether. - Health care is the perfect
moneymaking industry. Our willingness to pay for
available therapies basically, especially for our love ones, knows no bounds. - [Narrator] At the
heart of this business, plasma, a yellow liquid rich in proteins. It's the main component of blood. It's more expensive than oil. - I like a cow, but giving blood. - It almost killed me, so I
don't want to do that no more. - [Narrator] We decided to explore a little-known area within
the health industry, the blood trade. Our investigation took us to
France, Germany and the US. ( police siren whaling) - [Interviewer] They don't like
us to interview their donor. - Yeah man, you know why? They doin' something
they ain't doing right. They need to stop. Public want to know. (haunting instrumental music) - [Narrator] Today
Carlos is donating blood. Despite his busy job, he's a regular blood donor at the Red Cross center in Lausanne. Carlos sees his act as a sign of commitment to the community. More than 100 million donations are collected each year worldwide. In 2015, the Swiss Red Cross
registered 311,000 donations. The figure diminishes each year and they're constantly seeking new donors. Their message is clear: giving blood saves lives. - [Narrator] Blood is
a quite peculiar juice said Faust's devil with glee, but he's not the only
one to be interested. Health is also an industry and blood donations are subject
to the laws of the market. - [Narrator] Before giving blood, these Swiss donors must
complete a medical questionnaire and give their informed consent. In particular, there is one line at the end of the form, a sentence in small letters: I am aware that some
components of my donation may be used for the production of drugs. Only a few donors read this time. Though it's crucial, in reality, most of the donated blood is
sold to private companies, something the Red Cross doesn't advertise. - [Narrator] The plasma
fractionation industry. These are the pharmaceutical companies that buy 80,000 liters of plasma from the Red Cross each year. The humanitarian institution
makes nearly 10 million Swiss francs from this sale. Are the donors aware of it? - [Narrator] First discovery. The majority of the donor's blood is sold to pharmaceutical industries. The industry is so
interested in Carlos' blood for a specific reason, it's liquid part called plasma contains sought after proteins. They're used to make very
expensive and profitable drugs. Who are the players behind this industry? We decided to track the plasma trade. - [Female Narrator] Welcome to CSL plasma. Typically, 57% of our blood volume
is made up of plasma. Plasma is a strong-colored
liquid portion of the whole blood that transports water and nutrients to all cells in the body. It is composed of approximately
90% water and 10% protein. - [Narrator] The plasma industry is huge and a handful of companies
share the world market: Baxter in the USA, CSL Behring in Australia, Grifols in Spain, and the company Octapharma in Switzerland which we discovered through
these promotional films. - [British Narrator]
Octapharma's raw material is produced by the perfect bioreactor developed over millions
of years of evolution, the human body. - [Narrator] For these companies, plasma is nothing but a raw material and very lucrative too. The professional term is fractionation, the name of the procedure that transforms donors plasma into drugs. To do this, they collect, freeze, and mix thousands of
liters of human plasma. These companies control a market which is worth $17 billion
and growing steadily. Wolfgang Marguerre, the president and
co-founder of Octapharma. He's a very discreet person. Forbes estimates his
fortune at $6 billion. This is one of his very
rare public appearances. - How do you see the future developing? - These products are life-saving drugs and they will be required for some patient groups as a lifelong therapy. - Presumably, they're covered by most
insurance companies. - Yes, they have to be because
they're very expensive. But that is also the other
part of the same coin. There are many countries
who simply cannot afford to provide this kind of level of treatment to their population yet, at least. It sounds easy when you say plasma should be available enough. You just go to your
population, your country, you collect the plasma and then you will be in good shape and you make those products. It's not the case. - [Narrator] Now, a truly
global organization, Octapharma remains a family business dedicated to always going further to empower more patients to go further in their life of adventure. - [Narrator] Throughout the world, the lives of millions of patients depends on these treatments, Tamara is one of them. Today she's receiving her treatment at a hospital in Bern. Since childhood, she suffers from an immune deficiency that causes repeated infections. - [Woman] Hey, Tamara! - Hi (mumbles). Oh, I'm good. Yeah. - [Woman] Going? - Yeah. - [Narrator] Thanks to her
plasma-based treatment, Tamara's life has become easier, so much so that it would be
difficult for her to go without. - [Narrator] Where is her
life-changing drug from? Where is the blood in the drug from? From Swiss donors? - [Narrator] The plasma's
origin isn't public information. It's a trade secret. We decide to visit Swissmedic. This is the Swiss authority
in charge of drug control including their origins. These experts analyze
plasma samples each week, as well as the blood-derived products that are used in hospitals. - [Narrator] Cleveland, United States. We decided to travel there.
(plane engine running) (catchy instrumental music) West 25th Street, the address listed in
Swissmedic's register, some of the plasma used in the drugs sold in Switzerland comes from here. This blood collection center belongs to the Australian company, CSL. Donate plasma, save lives. Earn up to $200 a month. There are donor ads everywhere which tell says that the volunteers are paid for their blood. As opposed to most European countries, the USA allows compensation
for blood donations. This practice is legal. We enter the premises which
are under heavy surveillance, impossible to speak with the staff. - Yeah, you can't just
come and take pictures. You gotta do with the right way. - [Interviewer] I know. We (mumbles) from the outside, from the-- - Okay, across the street. Across the street, you can that way... You know? - [Interviewer] Yeah. - [Narrator] The center is in one of the city's poorest neighborhoods. Cleveland is a devastated city. The financial crisis of
2008 was a fatal blow. Pastor Lester Williams knows the reality of life in this neighborhood. Many of his church
followers sell their plasma. ♪ I can't live without you ♪ - [Woman] Come on, pastor. - [Pastor] Thank you. God bless you. Thank you. - [Man] God is good.
(congregation clapping) - I guess it all works out. It's legal, so I don't have a problem with that if that's what people decide to do. - But what is strange
is that the companies, they continue to call this a donation. But what is a donation
when you pay someone? - It's not a donation. It's not free. That's what a donation should be. It should be free. Evidently they're exploiting people in whatever their
condition is economically. So it's actually not a donation. They're actually paying for it. Now are they charging
to get 'em (mumbles)? Are they charging
Switzerland for the plasma? - [Interviewer] Yes. - So there making money
on it in both ways there. 'Cause the little that they're
giving to these people, it's not very much. - [Narrator] In Cleveland, all the market leaders are represented. CSL, Grifols, we also find Octapharma, the Swiss company which
produces Tamara's drug. - I like your tattoos. - Thanks. - [Male] Man, those are cool. - [Narrator] Mark goes there twice a week to sell his plasma. - I'm on a budget right now where I'm on 32 bucks for rent, $45 for the phone, $50 a month for my insurance, so, I'd have to say, I'm gonna ballpark around
two to 225 a month. And I found out that
I can with the plasma. That's a problem when
you're on tight budget, it's a fragile thing to know. - [Narrator] We wanted
to go inside with him to speak with the people in charge. This turned out to be impossible. The hostility increased the
closer we got to the center. - [Woman] (shouting) Please, those cameras please. (mumbles), can I have those cameras here? - [Man] All right. - [Interviewer] We're in public property. - [Female] This is private property. - [Man] That is not. - [Female] It is. - [Man] I'm just following my friend. - [Female] Okay. - [Narrator] So we
question donors outside, in the parking lot. - First, it was kinda
like an extra money thing, just to get a little money on the side to help me with bills and stuff. And then, I became a regular. At first when you first
start, you give $50, your first five times as a new customer. Then after that, on Tuesdays or Thursdays, any two days of the week, you get $20 and then it go up to $40. - [Interviewer] How long have
you been donating plasma? - Now for a year. It started last
- Every year? - Yup, two times a week. - [Interviewer] That's a lot. - Yes, but it ain't bad. It's cool. It help out. It's good for the families. It's good for my family too in the end. So one hand watch the other hand. - No one does it for any
kind of moral reasons. No one does it for the moral... No one does 'cause it helps people. It's just one of the side
effects is that it helps people. - [Narrator] The procedure
is well-established. As soon as the plasma bottle is full, the donor's credit card is credited. - Here we go, right here. Now, this is a blood bank card. It's almost like a regular visa card. They put the money on your card immediately after you get done. Sometimes they forget to put the money on your card and you got to call their
number on your card. Because if you don't call that number on your card and stuff, you're gonna be without money. (thumping instrumental music) - [Narrator] After the economic crisis, donations soared in the USA going from 15 million in 2007 to 32 million in 2014. Luke Schafer is a sociologist
at Michigan University. - When we look at the numbers of families reporting cash incomes below two dollars per person
per day in any given month, it's well more than doubles
over a 15-year period and when we look at the number of families who are on food stamps, it actually quadruples. Emergency food assistance
goes through the roof. So when all of these are
pointing in the same direction, so we walked into the plasma
clinic down the street and just ask people, "Why are you here? "What's going on?," people have lost their jobs, haven't been able to find work. In many cases, it's going to be the only income coming into the household. It's their only option. - [Narrator] We rejoined Mark
at the entrance to the center. It didn't work out the way he wanted. The center refused him because his blood pressure was too high. - I was unable to donate today. It's my blood and that's very important because I take my blood pressure medication and I think I ate bad yesterday. - [Interviewer] But then
if you can't donate, it's a financial issue for you. - It is, it is. Luckily, it's not life or death. It kinda has to do with not-as-vital stuff, so. But I might have to ask a
friend for a loan (chuckles) just for... I mean I'll take care of it soon and I'll be able to get my blood pressure straightened out. That's why it's good for
me to keep track of that. - [Narrator] We accompanied him to a small subsidized apartment that he's been living in for a year. - Make yourself at home. When I had my stroke, it was about three years ago. I went into the doctors. To be quite honest, I was drinking a lot. I was doing drugs. I was combining a lot of bad stuff. So the next day I went
to the Cleveland clinic, which is one of our really
good hospitals in Cleveland. And the word with people that
don't have a lot of money is you get rated and when you get rated, it means you can basically
go there for free and get health care. And as we are qualifying, the lady, she was like, "Oh, yeah, you're way
below poverty level." I'm like, "Way below?," there's below and way below. So that was an eye-opener. (lively instrumental music) There are times when for my own self-esteem, I don't want to accept help. I wanna be able to say, "No thanks, but no thanks." Doing Octapharma, it's kind of easy money and it's necessary, at least for me, it's necessary. (man singing) - [Narrator] For Mark
and many other Americans, blood is his last source of income. (acoustic guitar music) If he got sick, he could no longer donate. He'd have no income. But all these blood donations are affecting his health. David Margolius is a
doctor in one of the cities largest public hospitals. MetroHealth is the safety
net system for Cleveland. We take care of people, regardless of their ability to pay. For a lot of our patients and the people that we take
care of at MetroHealth, this is one of the few strategies that they can use to get money. - [Interviewer] What
does the literature say about the long-term
effects of donating plasma twice a week? - I couldn't find
anything in the literature describing what the effects were. I know from talking from
talking to my patients who do donate plasma that they're tired. So they get fatigued. They have headaches. But beyond that, all I know is the Red
Cross has one time a month and these guys are doing it twice a week. We talked to this
individual who's donating, my patient, he might not be able to afford
a cell phone bill or rent and that is more important
for his health potentially then the downside effects of donating because he doesn't have a cell phone, you can't get a job or he can't pay his bills then he'll freeze. So this is the dilemma that we're in. Yeah. - [Female Narrator] What
if you can earn extra money while doing something great for others? At Octapharma Plasma, you can. Not only are plasma donations vital to the treatment of rare,
chronic, and genetic diseases, you could also - [Narrator] The USA is the world's main exporter of human plasma with 70% of the world market. Their success is based
on a fool-proof recipe by building on this type of campaign, they nurture an image of a country with excellent sanitary conditions. (electronic instrumental music) The market is under the supervision of the Food and Drug Administration. The FDA stamp is a guarantee of quality, opening the doors to the
international market. Each week, frozen plasma is dispatched in shipments mainly to Europe. This is the other side
of the American dream, masses of poor people
willing to sell their blood. They provide an unlimited
pool of primary material. We wanted to understand the conditions in which blood is collected. 7 AM in Cleveland, in the parking lot of Octapharma. - I can't do it no more. Best to ask the other people. Meanwhile, I blacked out. I don't wanna do that no more. I just (mumbles) and I didn't eat before I went in, but it almost killed me. So I don't wanna do that no more. I got a job now. Praise the Lord. - It's worth it. I'm providing a product. I'm like a cow, I'm giving milk. - [Narrator] These stories
illustrate the industrial pace and inadequate checks. However, Octapharma assures that the authorities that there is strict donor monitoring. But if that's the case, why didn't the Swiss company let us enter? Why did they prevent us
from talking to the staff? How are its donor selected? To check, we had to go and see for ourselves with a hidden camera. This is what we discover inside. Machines interrogate the donors. The volunteers answer
the medical questions at electronic terminals. One single physical examination, measuring blood pressure. This is mainly to avoid
the donors fainting while donating blood, which would slow down the entire chain. Not a single chair in the room is empty, an empty stream of donors
with no time to recover after the donation. 12 hours a day, seven days a week. In view of such summary checks, everything is based on what people say. Paid donations entail a certain risk. They encourage donors to
lie about their health. Such compensation also
attracts a high-risk population that sometimes has secrets to hide. - Yeah, lying. (mumbles) doing that. That's where people (mumbles). Have you ever been to jail? You got to give them (mumbles). What do you get? (mumbles), weird question. But basically you are. You know, right? You know what I'm saying? - Yeah dude, this computer ask you. No, no, no. Who would say know if I was lying when I said my tattoos is over two years old? It looks like it's part of the bricks, but it actually ain't. It's what I missed and it blew the vein up. It make you look like you're
doing heroin or something. Just saying the entire no. People go over there, they getting the money, using it for drugs. But who am I to judge the next person? Last summer, the big thing around here is K2. So, it don't show up. Even if they was to test no for drugs, it don't show up anywhere. It's gonna give you that nice high for about three to five minutes and then you're chasing it again. So, you got to wait to
the next couple days, back to Octapharma Plasma. It's free money. I give up this plasma so I can get that fix. I feel everybody wins. That's the way I see it. - [Interviewer] Do people selling drugs, they are used to this? - They love it because, simple fact, that means while Octapharma is there, even if it's somewhere else, their clientele got somewhere to go every time to make some money. Okay, listen. You give me your card, you're Octapharma card, and I'll give you a bag of toon-see 'cause I know when you go, it's gonna get loaded on there. I'm gonna make sure that you go though because I'm not gonna
take no type of losses. I'm gonna drop you off in there, I'm dropping you off there and make sure that you get in, do your paperwork, and then I'm a lead 'cause I know I'm gonna get my money for sure. Now when you're done, you can come back again. We'll do the same process again. (hip hop music) - [Narrator] And this is
how the blood business attracts the drug business, and all that goes with it: trafficking, exploitation,
health risks for the donors. Is Octapharma aware of all this? We wanted to ask them if they noticed traces of drugs in their donors plasma. But it's still impossible to get access. Tensions rise. The security services asked us to leave, which we did. Why was our presence
bothering them so much? - They don't like us to
interview their donors. - Yeah man, you know why? 'Cause they all doing something that, they doin' something that
they ain't doing right. - Yeah. - Okay, I don't know what
the hell is goin' on, but for you guys to be out here professionally with your cameras to interview this place, I mean, what do you got to hide? (police sirens wailing) - We're doing a TV documentary about plasma and plasma donors. - Sir, they called and complained that they felt like you are harassing the donors coming out. - Management just advised
that they want you guys advised of trespassing, which means if you walk
onto the parking lot, they will have their security site charges against you guys for trespassing. - [Interviewer] Okay, that's fine, that's fine. Thank you very much. - [Policeman] Thank you guys very much. - [Interviewer] Thank you very much. - [Narrator] Back in Switzerland, there are many questions about
compensation, exploitation, and concern about donor's health. Does all this affect the drugs we use? What control do we have
over imported plasma? First of all, we wanted to see Tamara to show her our images. (man speaking) - [Narrator] The Swissmedic
experts reassured us that the plasma for Swiss drugs didn't come from paid donors. - [Narrator] In industry terms, the money paid to donors is compensation not payment, a play on words. In Germany, for example, donors may receive a small fee, which is limited to three times a month. But the fees offered in
the USA are much higher, enough to let the poorest survive. - [Narrator] The plasma masterfile, a several hundred page document in which the origin of
the plasma is listed, countless technical details, but nothing about the reality. Visibly, the Swissmedic experts don't know more about it. - [Narrator] Does it make
sense for the legislator to ask so few questions? The industry hides behind trade secret, keeping the authorities in the dark. The Socialist congressman,
Jean-Francois Steiert, as an expert in the Swiss health system. He finds the pharmaceutical
industry's lack of transparency unacceptable. - [Narrator] Opacity,
profits, lack of monitoring. To what extent is public health
at risk through the system? What threats does it post
to patients and donors? Jean-Daniel Tissot, Dean of the Faculty of Medicine
of Lausanne University, has long been head of
the city's blood center. Although he was generally reassuring, he pointed out the risks. - [Narrator] Zero risk doesn't exist as we are reminded by the scandal of contaminated blood that hit Europe, including the Swiss Red Cross and France. After the scandal, sanitation checks were
increased worldwide. The plasma pools are
now clean using methods that are said to be highly efficient. - [Narrator] Jean-Jacques Huart
is a hematologist in Lille. He's head of the blood center
for the north of France, the largest transfusion center in France. He's one of the people traumatized by the blood contamination scandal. - There's no climbing out of that and it makes no sense. They let people in. People are going in
there just to buy drugs and it's sad. - [Narrator] Today the checks
are considered effective, at least as known risks are concerned. But if there was a new
virus slipping through, it could spread more quickly
due to globalization. To reduce these risks, wouldn't the best way for each country to produce its own plasma? That would be preferable, according to the World
Health Organization. - Self-sufficiency is
definitely one of the aims that WHO promotes in terms of the goal that countries
are trying to get to. The goal is not self-sufficiency, solely for self-sufficiency sake. It's because systems
that are self-sufficient tend to be safer and tend
to provide better access. But there are many parts of the world that are not self-sufficient and have to depend on outside sources for blood donation. So for us it's an aim that much of the world
needs to work towards, but we're not there yet. - [Narrator] However
much the WHO might state the importance of self-sufficiency, the world market isn't following. The USA is exporting more plasma and soon Europe won't be able to do without this cheap raw material. - In many parts of the world, they've made decisions to, particularly in Europe
in several countries, some Scandinavian countries, France, are making decisions to basically privatize or to move
into a private management of these types of donation systems. - [Narrator] Despite the
checks being in place, the experts cannot rule out
the possibility of a new virus. This fear for health care is a main feature of the news in France. In July 2015, Octapharma obtained the
liberalization of the market. The Swiss market was
authorized to sell its plasma and the drugs derived from it to all French hospitals. Until then, the French blood Center had the monopoly. This intrusion is worrying
Michel Monsellier, the director of the powerful
Federation of Volunteer Donors. - [Narrator] Market liberalization, increased sanitation risks. What does Octapharma have to say in response to these fears? After many months of investigation and countless requests, the company still refuses any interview. We went to their headquarters
located in Lachen, in the Canton of Schwyz. - [Man] Would you mind stop filming please on all properties? - Well, the best thing to do, is if you could leave the
building at the moment, and then as Thomas said, we will consider your
questions and come back through the appropriate channel. - Okay, so you will answer my questions? - [Man In Blue Suit] We
will answer your questions - You just said that. You will answer our questions. - [Narrator] Upon the police's request, our camera men left the premises. The head of communications asked us to ask our questions in writing, promising us he pass them
on to the shareholders. Clearly, nothing is decided without
the approval of Marguerre, the founder and single
owner of Octapharma. The company doors closed to us once more. We had a long list of questions, not only with regard
to the sanitary risks, but also the company's methods. On the plasma market, Octapharma isn't the
most important player, but it's sales have already
reached 1.5 billion euros and are soaring. It's business practices have often aroused the authority's suspicions. - [Narrator] At the end of 2015, the former Portuguese prime minister was arrested for corruption. He allegedly received
funds from Octapharma when he was a consultant in Brazil, where the Swiss company was involved in a huge case known as
the Blood Vampire scandal. Octapharma is suspected of bribing Ministry of health officials. The case has still not been charged and the company continues
its activity in Brazil. Such political connections are worrying the French Donor Association. Monsellier has first-hand experience of the Swiss company's
sensibility over this matter. - [Narrator] When we
visited the headquarters, Octapharma promised
answers to our questions. A few weeks later, the head of communications informed us that none of them would be answered without explaining why. There was only one solution left, travel to Heidelberg, Wolfgang Marguerre's home. (doorbell ringing) - [Woman] Hello? - [Narrator] Wolfgang
Marguerre was incommunicado. He asked the police to let us know. - [Narrator] So our questions
will remain unanswered: the origin of the plasma, it's payment, the risks linked to donor property, drug detection, and the
likelihood of new epidemics. Why doesn't Octapharma provide any answers to the questions of Tamra and thousands of patients? (acoustic guitar music) (boy rapping) On Cleveland's sidewalks, these questions seem derisory. (police siren wailing)
Selling their plasma will always be a lesser evil to those with no choice for as long as people in Europe and elsewhere need plasma, the pharmaceutical industry
will meet their demand. - Just America, everything is a big corporation out here. And without money, nothing moves. You see when the market
crashes, everything shuts down. No government checks. So what can we do? Octapharma might still be running. Let's go get a couple of dollars out of them right quick. Tap this arm real good. Let's give them what they want, so we go get what we want. (horn blaring)
Oh, fuck. - [Narrator] Mark was relieved. He can finally give his plasma and he received $20. - [Interviewer ] How
was your blood pressure? - It was pretty good. I wrote it down. It was less than yesterday. So it was 129 over 82, which is pretty good. - [Interviewer ] What
are you gonna do now? Do you want to go home and rest? - Yeah, I'd pretty much
want to take it slow. I don't know. I was thinking about
maybe go home and regroup, might take a quick power nap, (chuckles) that kind of thing. - [Narrator] Mark and Tamara are connected by an invisible thread. The plasma industry means
their distress is inseparable. - [Narrator] The shift
is already a reality, the blood of the poor going
into the veins of the rich. ♪ Look at you, brother ♪ ♪ Grab your things ♪ ♪ We're not safe here anymore ♪ ♪ No one can deny the obvious ♪ ♪ Hey ♪ ♪ There are vampires in my borough ♪ ♪ There's a fever in the blood ♪
