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coming up ahead times. ok it's a deal one person's health is traded in exchange for another's. medical people scares me that this is my only steady income. illegal don't tell them at the border what you're planning to do or they might arrest you. is more about to sell or blood plasma. the united states exports blood plasma as a raw material one market germany. or no cost without plasma good be no medicine for us. to use is the us mexican border. the world's most committed plasma

donors are mexicans still has a dog trying pfizer to stop donating past my glass to. european and global pharmaceutical companies are conducting transactions bordering on the illegal. or strongly encourage people to not use their document for that for passerby. this is a film about people who save lives and about the risks that they are exposed to. be. to you. mean strange. for all. to. see. and his daughter hannah says are on their way to the

border from see it out why it is in mexico to el paso in the united states. with us but you know it's a normal day but today i'm feeling even worse than usual donating plasma wears me out i'm tired all the time and i barely manage to lift even light things like that because the best of my it up. a little it was indoors all the uses of the i'm not proud of being a donor. but we do whatever it takes to make ends meet. those who have been dishonest as i. did to be honest. now my hero and his daughter go there twice a week in spite of physical warning signs pharmaceutical companies lure them to the united states by offering dollars they accept donors with a visitor visa. but kinesis can feel that there's something wrong to let the cat or some border official. don't you through you know where to take away your visa when

you say you're going to donate plasma and that you can see if that makes me panic and it's very risky it's as well as it was. i got was. that. it's a trade at the borders of law and health but the father and his daughter are not the only ones our research shows that every week at least $10000.00 mexicans travel to the united states to sell their classmate. after donating they return to mexico. they leave their bandages in the u.s. to avoid attracting attention from border officials. and i want to pick i use the money to pay for university. and transport to travel expenses counseling to go to university tuition fees. they're just not tired but my pension is very small and i

still donate passement because it helps me get by you economy dot com you. donors need the money patients need the medicines made from donors blood. patients like looks at the opposite end of the supply chain some 1000 kilometers away every 3 days he undergoes the same procedure the infusion of plasma proteins takes several hours for her mom i mean for i got infections all the time i was in my life consisted of restrictions and sacrifices. or maybe when i started taking the medicine i got better i could live my life again and enjoyed the many lives for the. this change was only possible after looks was diagnosed with immunodeficiency he doesn't have enough antibodies. to give his body what it lacks he gets the infusions from god you don't mention i get antibodies from

a lot of people. when i take the medicine these parents brought is help boost my immune system and make me feel better i think i'm going but that's ok. it's not just patients with immune deficiencies who need these medicines doctors use them during operations for example to compensate for severe blood loss the medicines are also used to prevent hepatitis or rabies infections. in some situations we depend on plasma products to save patients' lives this but each of us might need a plasma product at some point in our lives the probability is almost 100 percent it was spoken due to get in. europe can't find enough donors the united states on the other hand can the us is the world's largest supplier of blood plasma there are more than 800 donation centers in the country donors are allowed to give plasma up to $104.00 times a year that's almost twice as often as

a lot in germany. the u.s. exports the commodity worldwide europe is the main consumer having used 18800000 leaders in 2017 the medicines are then sold worldwide. in germany alone 6000000 liters of u.s. plasma were made into medicine this last year. the 43 donation centers that the u.s. mexican border are the most productive in america they're mainly owned by the australian based company c.s.l. which has a german subsidiary c.s.l. bearing a spanish company grief holes and smaller entities such as b.b.l. which supplies the u.k. with plasma. the company is currently building 2 new centers. all of these companies declined requests for interviews. but during our yearlong investigation we spoke to dozens of former and current employees from phlebotomists right up to managers some let us record their interviews or allowed us to quote

them. the c.s.l. senators that are right on the border i would like to say i'm pretty confident saying 100 percent but let's say 99 percent of the donors cross from mexico. so the plan technically means more these companies set right next to the border because they know the locals need money they take advantage of that this was a poor. donors are paid and eligible for extra bonuses the companies use flyers radio spots and videos on social media to target their market. you can recruit as many friends for donations as you like the more frenzy recruit the more money you can earn donating plasma is an easy way to earn up to $400.00 a month as a new donor while saving lives. returning donors also see monthly bonus payouts and i get more points. only donors who give it the maximum frequency allowed by

u.s. regulators receive the full payment from mexican donors it's the equivalent of a small fortune but the payment is never referred to as such. big me when i 1st started posting history was that we accept donations of pocket money and we compensate people based on their hind end here because if we said that we bought it from the individual that's a form of prostitution it made me. how much of a grey area are we operating and we can't even we're giving you money. only grew fals provided us with a written response it says donors receive compensation for their time and their commitment as returning donors. for the company's business at the border pays off we gained access to internal documents from great falls that show that a center in the united states gets an average of $164.00 donations per day. the

centers at the border more than double that amount the most successful center in el paso registers more than $600.00 donors a day and this is the record breaking center run by a group feels most of the donors are mexicans but despite the large number of donors there is no public awareness about the blood plasma business at the border. we asked officials in mexico city the response was surprise the country band paid plasma donation in 1987 and all associated advertising. corner is the national council for self regulation and advertising ethics. that is in mexico it's illegal to sell one's blood no one is allowed to advertise a product that they're not allowed to sell us.

this morning on the outskirts of ciudad water is a city ravaged by mexico's drug war 44 year old grandma you know runs a gym here he needs to earn enough to provide for himself and his youngest daughter . so i always donate on wednesdays and on fridays or you have the women there today i'm going to do it with her he says. so they pay you right away so you yeah we get paid for every donation so they give you a debit card and then you go to an a.t.m. with it. they transfer money to the card too but at the end yes when you're finished donating the money is on your card and. the companies call it the compensation it amounts to 4 times what gummer yearns for his gym. with women filling your book in my little girl needs food toys fruit. thanks to the plasma i can pay for all these things. with the model no

a lot of those 1000 u.s. dollars are worth a lot here at the end of the day you're doing a good deed of saving lives go what if you will be this i'm. sure. a few kilometers away 21 year old here this is using the plasma money to pay her tuition fees. i'm studying to become a paramedic my job will be to look after patients on their way to the hospital. keep us but once something better i want to earn good money so that i can stop going to el paso. maybe to go shopping instead of going to this place now i'm a patient myself in the future i will take care of patients. as a trainer earns $100.00 a month but cost of living statistics show a $150.00 are needed per person per month to cover the bare necessities to secure

an extra bonus tries to win over his clients says donors as well. it's very interesting very tempting. there. the reason i'm hesitant is the question what are the side effects what is the live if it will if it doesn't. plasma is a blood component. the yellow liquid only becomes visible when separated from the rest of the blood. it contains valuable proteins immunoglobulins for example which protect against infections the plasma donation is different from a blood donation plasma is filtered from the blood and the other blood components are returned to the donor. plus the earth and the plus room is extracted. provided to the plasma company and made into medicines one. muser sold in pharmacies which is where i pick them up without. the

practice of paying donors is legal in germany but compensation sums of up to $25.00 euros are comparatively small. giving plasma isn't a problem as long as the donor undergoes a thorough health check. standards in the united states and germany differ greatly . when service was to close most in principle plasma donations in the us are also regulated and supervised by the author orators of all but tests of plasma protein levels are undertaken far less frequently than in germany and germany had stand the head of every faith donation in the us it started every 4 months. within 4 months the donor might have donated plasma up to $34.00 times without a single check on their level of critical plasma protein. you know. this can lead to deficiency symptoms in us dollars says professor. he conducted one of the few studies on the effects of long term plasma donation. the donor

doesn't notice this decline in his protein levels match the tricky thing to the lower the immunoglobulin to level the higher the risk of illnesses like pneumonia meningitis or urinary tract infections. you know it and soon going to be it's in fact and then you can die from that if it should because this is a very serious infection. in the us less frequent health checks translate into a higher risk for donors in gorge tunder german long every plasma donation has to be coupled with a donor risk and health assessment. in the top of forked. another regulation that doesn't exist in the united states instead of the mandatory presence of a doctor physicians only need to be on call 9 of them have onsite doctors and depending on the salary that you work at. your doctor my calm

once a week for 4 hours which is the minimum that they require too. many donors in the us have been giving plasma for decades with no adverse side effects. others suffer immediate symptoms. but continue donating anyway. come out my arms and legs go numb that's my vision turns black as if i'm about to faint i get migraines and that's usually how i feel about this one of us and. that was sometimes staffel than tast if you're still reacting but that's all they don't really pay a lot of attention to the people donating. the money they give me a rap a while but then nothing more. to some sympathy

and talking i feel like a guinea pig i mean like livestock but i enjoy them i'm more like a commodity than a patient or a donor they're in. chaos and don't want to. before it was more about numbers and i would compare it to like a factory type setting. although the majority of the people i work at telecoms aren't malicious and they don't home with molly in town they know that if this donor didn't state specifically that they passed out and we just say oh she just had her eyes closed and that they would have to look into it as much. p.p.t.a. is the trade organization that represents plasma producing pharmaceutical companies it's former president john bolt is visiting labs at the us mexican border.

i have nothing then good words to say about dissenters that i have seen on the border some just. dealing with mexican those. many mexicans cross the border on a temporary b. one b. 2 visa it allows for visits to the united states provided applicants apply the necessary documentation. one of the requirements is people do need to stab us the fact that they have a reason to return to mexico that they have a home or wife something like that there that they're not just using it to comments of their country and add to the us population and in a legal manner. under the trump administration border officers are focused on catching those entering the country illegally. but they usually try to slip in beneath the border bridges. the pleasant owners arrive the official way

holders of a valid visa are issued a border crossing card and are allowed to pass through. in order for a mexican donor to cross the border they need to have a us visa years feature is supplied by the us. government on a couple of conditions for that and they go and then donate the plasma. with this piece a mexican's register at the u.s. donation centers upon entering the country they're checked by u.s. customs and border protection officers. people using a b. one b. to be said to cross the border and earn money selling class what they could put that document at risk. and why is that. because the b. one b. 2 visa is not a document that allows someone to work or live in the united states simply document that allows them to enter for other reasons so the pattern offenders say it's not right it's a cop and they said i forage i want to force them to come on the left. but that's

your business. you know people are being compensated they're being paid. i each week thousands of dollars are paid by these centers apparently nobody has ever asked whether it's legal for mexican donors to be paid in the u.s. . the p.p.t.a. says plasma donors are not employees of donation centers. the u.s. state department issues their visa and confirms. generally an exchange of goods or services for remuneration in the united states is found to be inconsistent with permissible activities on the b. one b. 2 visa. technically under the trump administration there are strict rules for entering the country but plasma donors have been managing to get through for years b.p. all declined our request for a response c.s.l. angry falls wrote she also plasma complies with all laws in the countries in which

we operate. all donors regardless of where they come from must comply with all necessary health regulatory and legal requirements to donate there are no exceptions. some employees of donation centers offer precautionary advice. i told them at the border don't say you're coming to donate or you might lose your visa. i do know for you that we. all just don't hope you're coming to going to homecoming to your aunt's house or your cousin's house or you're going for whatever reason to the mom. it's the donors who carry the risk though they're largely unaware of the possible consequences. they went to new york and my understanding is that it isn't illegal but if you fall into the hands of an ill tempered officer they can

take away your visa because if they like it was so you better not say where you're crossing the border i'll do all i can or yell at a simple little. lady look at what i always tell them i'm visiting my aunt who lives in the city center. what are you carrying anything of a water bottle in my id. what do you do for a living but over that i work at a gym and an assembly plant. worker and take care of. 6. this. has been crossing for 9 years kinesis for 3 most of the blood plasma donated in the us is exported to europe the us and europe are the biggest global markets for plasma medicines. paula stringer is the head of an association of plasma producers that advocates unpaid donations unlike the p.p.t.a. we should be very happy that in the united states so much class most collected

because we need the plasma for the patients who are in need for the products however if you are becoming very dependent on one country and there is a monopoly there you see that the balance is not ok. leo test is one of several plasma processing companies in germany it makes medicine out of frozen blood plasma . in nearby marburg c.s.l. bearing process is blood plasma including from supplies harvested in the u.s. revenue in germany amounts to 2000000000 euros. the firm grip falls distributes the medicines in germany with sales of some 280000000 euros it also operates the commercial blood donation chain hamma. demand for blood plasma is growing more and more donation centers are opening in the united states in germany the number of donations has been stagnant for years. many european countries now rely on us

plasma germany is on course to such dependency experts are concerned. when there is an disaster in the past for supply united states for example because i knew that the chicken is being their taxes which cannot be inactivated then the whole passed by industry will collapse and europe will be. absolutely defective of that situation. 2 hours later each donor earned $40.00 today in return for $800.00 milliliters almost a leader of blood plasma. donors are weighed before every donation. i weighed one pound too little and is the minimum way to stiff to kilo's i tried to make myself heavier with my backpack but it wasn't enough and. messy until more or less i'm so mad i didn't even have my health to sell today and i think.

for the 1st was a good although there was a little it's like suddenly being unable to go to work and losing your source of income. so this was going ok you know i'm trading my health for many others apparently need the help of those donors more that's all right but what price are we paying. in fact it would be easy to protect donors even beyond national borders the german city of gurlitz on the polish border offers a case in point crossing one of the border bridges on foot takes just a few minutes on the german side there's a plasma center run by the same company that dominates the collection market at the u.s. mexican border grief holds the owner of germany's him

a donation centers. plasma donor tourism exists here as well. donors are paid 22 year olds compensation. i think is one of them ships over coffee this morning i told my wife i'm heading over to gurlitz to donate prize money but the panel run a few errands here in town pick up some things in the drugstore you know. the kids are taking it here donating plasma isn't a matter of survival it's a way to earn a little extra income in your clothes or both of you but with some donors you can tell they come here a lot. yes they're not turning their livelihood here but it is a small cash booth stolen by the suspects in most of them. after 4 visits donors are examined to determine whether they have enough antibodies to give plasma a 5th time. in the u.s. there's a greater willingness to take risks both on the part of pharmaceutical companies

because the law lets them and on the part of donors because they are poor. i would say you know. all a large number of them are probably have some kind of condition or something. they're maybe just not telling us about. donors often don't mention preexisting conditions they also receive little information about the possible long term effects of giving plasma. this willingness to take risks is based on ignorance and it begins with center employees. that the company actually educate bure about long term how rude they really don't even use an employee they don't tell you hey this is what might potentially happen with any of your donors whether good or bad. the pharmaceutical companies declined to comment on specific allegations. to donna

does not know what to do long short term or long term side effects are you i have a responsibility in medicine and this medicine all act in order to to be ethical in that regard. kinesis in gumma you know want to know if donating is affecting their health since the donation centers won't tell them we arrange a medical checkup based on the studies conducted by professor in. the check up at the laboratory in ciudad juarez is far more detailed than those carried out in u.s. donation centers. there are a fast test determines the amount of protein in the blood there isn't even a minimum value for the antibodies in assistant gamma you know we're both allowed to donate this week. i

feel fine i've always felt healthy since i started donating. and i can feel that i'm not in a good state of health i think they're going to confirm that. i just hope that i don't have an advanced condition really nothing more. that be enough. going to some i was. on. the list because i know i have you ever felt bad and i think it will remain in your chest trembling lips stiffness in your hands or legs and must be nice to see yeah that happens about twice a month and twice a month. so you know i also keep coming down with the flu i'm always having to take something how often approximately in. the last time was

a month ago. and it's coming back now. about meters. or shady 4.7 kilos. $48.00 kilos it's. not my will sometimes i don't see myself the way i am sometimes i think i'm too thin other times i think i'm too fat. when the bunker mariyam with water.

milk and i like putting on clothes like these i love them i like seeing them and touching them to me was funny doesn't hurt anybody and it feels very healthy to me . and it distracts me. waiting for the results. i. think that the welcome to have to pay my college exam fees to. how much is a. lie i think it's $140.00 that's expensive.

my brother fell victim to organized crime he was executed. according to the autopsy he was tortured 1st and then buried in the yard of some house. he was 28 years old . intentionally used. so i'd rather see when you see a stone a plasma then sell her body or smuggle drugs into the united states. is a bit less risky. in my culture results. if you look at it and it does your immunoglobulin level which we can see here is about $200.00 milligrams below the limit and. i get sick so often. yes you probably know fandango. he's good at your turtle

protein level is a bit too low as well this is definitely a consequence of your frequent plasma donations and that you're low on us when they . eat. these are your results look at your immunoglobulin g. level is also below that limit just slightly and yes and. i know this is my advice to you as a doctor is to stop donating for at least 6 months. and many. what is his message as they say it's very unlikely that you will recover if you carry on donating at this rate or impulses you could face more serious consequences with increasingly serious infections bronchitis for example or new monia because your body's defenses are too weak that if. you know because my family and you are in better health but i still recommend you reduce the frequency of your donations you currently did 8

times per month i would recommend a maximum of 5. stars or whatever on the one hand i'm relieved that i'm not sick. on the other hand it appears i'm pretty vulnerable. to that because i'm worried. about your health it's interesting. to start donating would be a luxury i can't afford. in the middle. i just feel it's very important that everything is ethically sound. that there are no shortcomings and people are not treated in ways that hurt them and.

it. when we show him our footage from the us mexican border the 59 year old can hardly believe it. there is something that this is of course totally unacceptable and shouldn't be allowed to happen in the midst of now after donors really should be taken better care of these are for this woman sake and for the sake of others who donate and i would wish to see a different ethical approach one that's more humane and means voting for. the father and daughter are not isolated cases studies have shown huge differences between american and european donors. spend on a considerable number of u.s. donors who we started also fell below the threshold values that apply in germany. we discovered that if you pull the plasma off the different groups that's the argy

level in the pay to donation group from the u.s. it was much lower and we can only find as a reason that the frequency of the nation is playing a role here. different standards apply in the u.s. and they can carry a heightened risk to donors health that's something that could be of concern to german officials who inspect donor centers in the u.s. officials in the state of hessen for example from the darmstadt regional council they inspect all centers that export plasma to has and. german medical association guidelines are not applicable to inspections in the u.s. . german standards are not relevant here the polar bear lake institute also monitors u.s. donation centers by order of the federal ministry of health in all the cases where the plasma is destined for the german or european market. good name

for we make on site visits we look at how donors that treated and selected we look at the quality of traceability systems the relevant e.u. regulations. these are all important aspects that are inspected on site. but german inspectors aren't interested in the protection of donors but rather for the protection of recipients things not relevant to recipients are not subject to review in all other cases german officials refer to us jurisdiction. this results have given her a clear picture we show them to the paul ehrlich institute. in our view in the case of the female donor the results do not comply with the threshold values which means her donations would not be purchased or accepted. in germany kinesis would not have been allowed to donate but that doesn't stop her plasma from entering the german market this creates a double standard one that benefits the pharmaceutical companies the p.p.t.a.

maintains that american laws are being observed and says donors do not even give plasma that frequently. in the united states legally you're allowed to donate twice a week which theoretically could mean their donor could donate whole of times a year away for when we look at their every change and we see every stone or donate about 7 times a year. but there are big differences between the national average and the centers of the border we've received an internal grief document that shows the majority of high frequency donors go to centers at the border. fences single male in. donate about $100.00 times a year. it's been 3 days since they got their test results. or what the doctor said i'll try to stop donating as soon as possible. i'm still

healthy and i want things to stay that way. but i'm extremely worried about your thoughts about how it's damaging you as the. prince of cause i don't think you should continue donating. must think it was you this is the same for that i can't stop it's my only source of income. you have so much you're young you're strong you're smart how are you doing. i mean find. your results tell a different story. of course i used to have nothing to eat now you're lecturing me about my health. that's not what this is about stop exaggerating you're not the victim here. i mean. to imply there's always a solution ok. ok. you better not say any more.

it plasma the plasma business is not the most honest one if they should tell the donors what could happen to them and often if they know you know they should take better care of us. that. brussels february 21000. the european union weighs in on the blocks dependence on plasma from the us. a group of delegates urges the commission to take action. well we import about 40 percent from the united states why because we do not have enough. material here to work on so what we need is more. plasma donation. but the problem in europe is that there are neither enough centers nor donors and the donors who do come don't come often enough. shrewish my hands i've had a smash and i wish people would donate more so the conditions would improve. as one

if conditions there were adjusted greys to match those in europe and there was a unified standard then donors over there would feel that they were valued. the hatchets all. can brussels do anything to protect donors. the e.u. sets the rules for plasma imports the laws are being reviewed says the german health ministry without being more specific. aligning standards is a topic that might be discussed. insiders would welcome such discussions in the us too. i think we can expect to milk our dollars for as much harder move we can dad of them and then not talk about any potential negative effects that they might have. but no one feels like it's their responsibility to initiate this conversation much less raise ethical concerns. this is it's not subject to

a regulator a control the ethical approach so to speak. insist on the if and when i dress up in costumes i like the way i look in. the see when i feel good. and i still know of your it's not a morally correct business. and to say i was long as there's a buyer there's a seller. somewhere just trading our health for dollars. and i have no choice.

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