“An aging population is a double challenge for Canadian Blood Services. First, as large percentage of our population gets older, healthcare activity will increase and so will demand for blood and blood products as a consequence. Secondly, a large segment of our most loyal donors are at the age where they will soon move from being donors to users of the blood system.” – From the Canadian Blood Services (CBS) website
Last week’s surprise announcement of the closure of the CBS Thunder Bay plasma collection center raises numerous questions, including the credibility of the above statement from CBS.
If CBS is so concerned about its donations, why would it close the doors of its only dedicated plasma collection center in the country?
Donors in Thunder Bay are feeling betrayed, told there was a significant need for them to come and donate, then suddenly told it was all unnecessary. Some of their “most loyal donors” are now wondering if they were lied to.
CBS maintains it has a surplus of 10,000 units of plasma per year. Thunder Bay produces 10,800 units. CBS needs in excess of 220,000 units of plasma per year for both transfusions and for fractionation into blood plasma products. That’s not much of an oversupply, especially if you really are anticipating increased need from aging.
Thunder Bay is closing to eliminate 10,000 units, while CBS is accessing more than 20,000 “surplus” plasma units from the United States according to their 2010-11 annual report.
CBS says that over the past two years there has been a decline in demand from hospitals.
It’s true synthetic products have largely replaced the need for plasma for hemophiliacs, and new medical practices rely less on transfusions, but it doesn’t mean blood plasma products are no longer in demand.
One of the products, immunoglobulin, is given to cancer patients to restore the body’s immunity to bacteria and viruses and allows for more aggressive chemotherapy treatments. It is also used in bone marrow transplants. 75 per cent of the immunoglobulin used in Canada is made from American-source material.
Yesterday CBS issued a “customer letter” admitting that demand for immunoglobulin products increased by about 9 per cent last year. Canada is among the highest users of immunoglobulin in the world.
In 2003-04 CBS launched a “Canadian Plasma Protein Products Strategy” to increase the domestic content of immunoglobulin used in the country. Within three to four years 40 per cent of the content was supposed to be Canadian. At present it is 25 per cent, one percent higher than it was in 2003-04. While closing the Thunder Bay facility, CBS maintains it is once again trying to reach their goal while diversifying the source of their supply. CBS ships donations to U.S. manufacturers to be turned into plasma products that are in turn sent back for use in Canada.
Unlike Canada, the U.S. allows payment to blood donors. There is an incentive for those desperate for cash to lie on their screening forms to gain payment for their blood. That makes assessing risk much more difficult. U.S.for-profit companies maintain their screening process is sufficient to ensure there are no blood-borne illnesses transmitted through this product.
Yet the World Health Organization specifically recommends the collection of blood from voluntary non-remunerated blood donors at low risk of infections. The WHO specifically recommends elimination of paid donation.
CBS made this announcement just weeks after Canadians learned how vulnerable their health system was to the problems of another foreign multinational. Swiss-owned Sandoz Canada reduced their supply of injectable drugs this winter after the U.S. FDA raised concerns about the quality of product coming from their Boucherville, Quebec plant. When the production line slowed to fix the problem, this left Canadian hospitals scrambling for critical drugs. Many of these drugs were not accessible from another Canadian supplier.
The speed in which this closure is to take place is astonishing. The workers were told last Friday. Their last day will be April 12th.
CBS is not in financial trouble. They have run surpluses in the last two years. In 2010/11 it was more than $5 million.
Surely it would make sense to consult with the users of the product and address issues of supply security before throwing in the towel on the Thunder Bay collection center.
Thunder Bay’s City Council has already passed a motion asking for a reprieve – at least until November.
Thunder Bay-Superior North MP Bruce Hyer said the reasons given for the closure by CBS “didn’t match up.” Speaking to the Thunder Bay Chronicle-Journal, Hyer asked about the rush: “What was the need to have it close in two weeks? The answer was basically ‘well, we thought it was better for staff.’ Well, I think it was better for corporate CBS.”
Having just been burned by Sandoz, Ontario Health Minister Deb Matthews may very well want to pick up the phone and start asking some questions.