Paper short abstract:

This paper discusses the evolution of sociotechnical imaginaries mobilized in the debate on MSM donor deferral in Belgium between 2003, the first Blood Directive, and 2017, adoption of 12 month deferral. It highlights the coproduction of EU epidemiological and national sociotechnical imaginaries.

Paper long abstract:

In the EU, successful blood procurement depends on the public trust in national Blood Establishments. Repeated criticism to the exclusion of Men who have Sex with Men (MSM), however, hampers that trust. In response, numerous member states relaxed their deferral policies. Previous research in Science & Technology Studies highlighted the sociotechnical nature of such controversies, and the sociotechnical lock-in that can result from attempts to surpass explicitly political claims through the use of epidemiological imaginaries. We aim to contribute to this field by exploring (1) the coproduction of imaginaries on the EU and the local/national level, and (2) lock-out strategies used by multiple stakeholders in the debate.

We developed a longitudinal, interpretive study of the paradigmatic case of Belgium, where deferral was recently relaxed from permanent to one year (MSM1). We studied the recurrent discursive elements mobilized by stakeholders between the implementation of the first EU Blood Directive (2003), and MSM1 (2017). Our data comprises Belgian newspaper articles; official communication by a Belgian BE; and policy recommendations of the Belgian High Council for Health, advisory organ to the Minister of Health.

We show how stakeholders shifted their argumentation on five emergent categories throughout the debate: policy aim, responsibilization, science-politics dichotomy, legitimizing, and challenging group-based deferral. We found four overlapping phases of debate: classic epidemiological imaginary, challenging key elements, open/contentious debate, and re-adjustment/-appropriation of the epidemiological imaginary. We found continuous (re)performance of the EU imaginary, although readjustment included localized, non-epidemiological argument categories, e.g. practicing citizenship through donation.