这么多血
So Much Blood

原始链接: https://dynomight.net/blood/

《经济学家》杂志称,2023年美国血液制品出口占其商品出口总量的1.8%,此说法引发质疑。作者对此进行了调查,发现由于缺乏透明度,《经济学家》的数据值得怀疑。 通过分析美国贸易数据中的协调制度编码(HTS codes),特别是3002类别(“人血;动物血……”),作者发现这一大类商品占所有商品出口的2.05%。然而,这其中包含许多非血液制品,例如疫苗。 通过仔细分析子类别并咨询专家,作者估计,几乎可以肯定的是,约有0.53%的美国商品出口涉及人血。再考虑另外约0.16%可能与生产中使用的血液有关(例如疫苗的细胞系),作者最终推测,涉及血液的美国商品出口约占**0.69%**。这远低于《经济学家》报道的1.8%,后者可能被夸大或采用了更宽泛的定义。

Hacker News上的一篇讨论串围绕一篇题为“So Much Blood”(如此多的血液)的博客文章展开,该文章分析了美国的血液出口情况,并对一些常用的统计数据提出了质疑。用户认为文章标题具有误导性,并就Hacker News上优先使用原创标题而非更具信息量的总结的价值展开了辩论。 讨论深入探讨了美国血液出口背后的原因,强调了美国允许有偿捐献血浆的做法,这与许多其他国家不同。这引发了关于伦理考虑、潜在剥削以及对捐献者健康的影响的讨论。 评论者还涉及了相关的主题,例如血库的运作方式、啤酒销售的经济学以及更广泛的供应链脆弱性问题,尤其是在最近全球事件的背景下。一些人提到了进一步探讨血液行业的播客和文章,对该系统中的监管和剥削问题表示担忧。该讨论串展现了Hacker News社区的多元化视角以及对数据驱动讨论的偏好。
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原文

In a recent post about trading stuff for money, I mentioned:

Europe had a [blood plasma] shortage of around 38%, which it met by importing plasma from paid donors in the United States, where blood products account for 2% of all exports by value.

The internet’s reaction was: “TWO PERCENT?” “TWO PERCENT OF U.S. EXPORTS ARE BLOOD!?

Well, I took that 2% number from a 2024 article in the Economist:

Last year American blood-product exports accounted for 1.8% of the country’s total goods exports, up from just 0.5% a decade ago—and were worth $37bn. That makes blood the country’s ninth-largest goods export, ahead of coal and gold. All told, America now supplies 70% or so of the plasma used to make medicine.

I figured the Economist was trustworthy on matters of economics. But note:

  1. That 1.8% number is for blood products, not just blood.
  2. It’s a percentage of goods exported, excluding services.
  3. It’s wrong.

The article doesn’t explain how they arrived at 1.8%. And since the Economist speaks in the voice of God (without bylines), I can’t corner and harass the actual journalist. I’d have liked to reverse-engineer their calculations, but this was impossible since the world hasn’t yet caught on that they should always show lots of digits.

So what’s the right number? In 2023, total US goods exports were $2,045 billion, almost exactly ⅔ of all exports, including services.

How much of that involves blood? Well, the government keeps statistics on trade based on an insanely detailed classification scheme. All goods get some number. For example, dirigibles fall under HTS 8801.90.0000:

Leg warmers fall under HTS 6406.99.1530:

leg warmers

So what about blood? Well, HTS 3002 is the category for:

Human blood; animal blood prepared for therapeutic, prophylactic or diagnostic uses; antisera and other blood fractions and modified immunological products, whether or not obtained by means of biotechnological processes; vaccines, toxins, cultures of micro-organisms (excluding yeasts) and similar products:

The total exports in this category in 2023 were 41.977 billion, or 2.05% of all goods exports. But that category includes many products that don’t require human blood such as most vaccines.

To get the actual data, you need to go through a website maintained by the US Trade Commission. This website has good and bad aspects. On the one hand, it’s slow and clunky and confusing and often randomly fails to deliver any results. On the other hand, when you re-submit, it clears your query and then blocks you for submitting too many requests, which is nice.

But after a lot of tearing of hair, I got what seems to be the most detailed breakdown of that category available. There are some finer subcategories in the taxonomy, but they don’t seem to have any data.

So let’s go through those categories. To start, here are some that would seem to almost always contain human blood:

Category Description Exports ($) Percentage of US goods exports
3002.12.00.10 HUMAN BLOOD PLASMA 5,959,103,120 0.2914%
3002.12.00.20 NORMAL HUMAN BLOOD SERA, WHETHER OR NOT FREEZE-DRIED 38,992,251 0.0019%
3002.12.00.30 HUMAN IMMUNE BLOOD SERA 5,608,090 0.0003%
3002.12.00.90 ANTISERA AND OTHER BLOOD FRACTIONS 4,808,069,119 0.2351%
3002.90.52.10 WHOLE HUMAN BLOOD 22,710,898 0.0011%
TOTAL (YES BLOOD) 10,834,483,478 0.5298%

Next, there are several categories that would seem to essentially never contain human blood:

Category Description Exports ($) Percentage of US goods exports
3002.12.00.40 FETAL BOVINE SERUM (FBS) 146,026,727 0.0071%
3002.42.00.00 VACCINES FOR VETERINARY MEDICINE 638,191,743 0.0312%
3002.49.00.00 VACCINES, TOXINS, CULTURES OF MICRO-ORGANISMS EXCLUDING YEASTS, AND SIMILAR PRODUCTS, NESOI 1,630,036,341 0.0797%
3002.59.00.00 CELL CULTURES, WHETHER OR NOT MODIFIED, NESOI 79,384,134 0.0039%
3002.90.10.00 FERMENTS 361,418,233 0.0177%
TOTAL (NO BLOOD) 2,869,107,296 0.1403%

Finally, there are categories that include some products that might contain human blood:

Category Description Exports ($) Percentage of US goods exports
3002.13.00.00 IMMUNOLOGICAL PRODUCTS, UNMIXED, NOT PUT UP IN MEASURED DOSES OR IN FORMS OR PACKINGS FOR RETAIL SALE 624,283,112 0.0305%
3002.14.00.00 IMMUNOLOGICAL PRODUCTS, MIXED, NOT PUT UP IN MEASURED DOSES OR IN FORMS OR PACKINGS FOR RETAIL SALE 5,060,866,208 0.2475%
3002.15.01.00 IMMUNOLOGICAL PRODUCTS, PUT UP IN MEASURED DOSES OR IN FORMS OR PACKINGS FOR RETAIL SALE 13,317,356,469 0.6512%
3002.41.00.00 VACCINES FOR HUMAN MEDICINE, NESOI 7,760,695,744 0.3795%
3002.51.00.00 CELL THERAPY PRODUCTS 595,963,010 0.0291%
3002.90.52.50 HUMAN BLOOD; ANIMAL BLOOD PREPARED FOR THERAPEUTIC, PROPHYLATIC OR DIAGNOSTIC USES; ANTISERA AND OTHER BLOOD FRACTIONS, ETC. NESOI 914,348,561 0.0447%
TOTAL (MAYBE BLOOD) 28,273,513,104 1.3826%

The biggest contributor here is IMMUNOLOGICAL PRODUCTS (be they MIXED or UNMIXED, PUT UP or NOT PUT UP). The largest fraction of these is probably antibodies.

Antibodies are sometimes made from human blood. You may remember that in 2020, some organizations collected human blood from people who’d recovered from Covid to make antibodies. But it’s important to stress that this is quite rare. Human blood, after all, is expensive. So—because capitalism—whenever possible animals are used instead, often rabbits, goats, sheep, or humanized mice.

I can’t find any hard statistics on this. But I know several people who work in this industry. So I asked them to just guess what fraction might include human blood. Biologists don’t like numbers, so this took a lot of pleading, but my best estimate is 8%.

When looking at similar data a few years ago, Market Design suggested that that immunoglobulin products might also fall under this category. But as far as I can tell this is not true. I looked up the tariff codes for a few immunoglobulin products, and they all seem to fall under 3002.90 (“HUMAN BLOOD; ANIMAL BLOOD PREPARED FOR THERAPEUTIC, PROPHYLATIC OR DIAGNOSTIC USES; ANTISERA AND OTHER BLOOD FRACTIONS, ETC. NESOI”)

What about vaccines or cell therapy products? These almost never contain human blood. But they are sometimes made by growing human cell lines, and sometimes those cell lines require human blood serum to grow. More pleading with the biologists produced a guess that this is true for 5% of vaccines and 80% of cell therapies.

Aside: Even if they do require blood serum, it’s somewhat debatable if they should count as “blood products”. How far down the supply chain does that classification apply? If I make cars, and one of my employees gets injured and needs a blood transfusion, are my cars now “blood products”?

Anyway, here’s my best guess for the percentage of products in this middle category that use human blood:

Category Description Needs blood (guess) Exports ($) Percentage of US goods exports
3002.13.00.00 IMMUNOLOGICAL PRODUCTS, UNMIXED, NOT PUT UP IN MEASURED DOSES OR IN FORMS OR PACKINGS FOR RETAIL SALE 8% 49,942,648 0.0024%
3002.14.00.00 IMMUNOLOGICAL PRODUCTS, MIXED, NOT PUT UP IN MEASURED DOSES OR IN FORMS OR PACKINGS FOR RETAIL SALE 8% 404,869,296 0.0198%
3002.15.01.00 IMMUNOLOGICAL PRODUCTS, PUT UP IN MEASURED DOSES OR IN FORMS OR PACKINGS FOR RETAIL SALE 8% 1,065,388,517 0.0521%
3002.41.00.00 VACCINES FOR HUMAN MEDICINE, NESOI 5% 388,034,787 0.0190%
3002.51.00.00 CELL THERAPY PRODUCTS 80% 476,770,408 0.0233%
3002.90.52 HUMAN BLOOD; ANIMAL BLOOD PREPARED FOR THERAPEUTIC, PROPHYLATIC OR DIAGNOSTIC USES; ANTISERA AND OTHER BLOOD FRACTIONS, ETC. NESOI 90% 822,913,704 0.0402%
TOTAL (GUESSED BLOOD)   3,207,919,363 0.1569%

So 0.5298% of goods exports almost certainly use blood, and my best guess is that another 0.1569% of exports also include blood, for a total of 0.6867%.

Obviously, this is a rough cut. But I couldn’t find any other source that shows their work in any detail, so I hoped that by publishing this I could at least prod Cunningham’s law into action. Sorry for all the numbers.

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