A major change in how we donate plasma

It was supposed to take place last fall. Now two private for-profit plasma collection centres are to open shortly in Toronto.

With approval from Health Canada it represents a major shift in how we deal with biological donations – the centres will be paying for plasma from donors contrary to the recommendations of both the Krever Inquiry and the World Health Organization.

Canadian Blood Services says they have nothing to do with the company, although they admitted to us last year that this is something they may reconsider in four or five years. The private company has no relationship with CBS’ counterpart in Quebec either.

Which raises the question of what this company is planning to do with all the plasma they are collecting? The most likely route is to sell it to fractionators in the United States to make intravenous products that could end up back in Canada.

Before Canadian Blood Services closed down the Thunder Bay plasma collection centre last April, plasma was getting shipped from northern Ontario to South Carolina for fractionation into something called Immunoglobulin, better known as IVIG. The IVIG was in turn sent back to CBS for distribution across Canada. CBS was supplying about 25 per cent of the plasma needed to make the Canadian supply of IVIG, the rest coming from American donors — many of whom would have got paid.

Demand for IVIG is fast on the rise – averaging about 9 per cent per year. Used to build up the immunity of cancer patients undergoing chemotherapy, at present there is sufficient global supply, but there are fears that if IVIG turns out to be the breakthrough drug for treatment of Alzheimer’s, there could be significant shortages.

There is presently no plant in Canada producing IVIG. All of it comes from the U.S., although CBS assures us if need be they would seek the product from Europe too. This is despite the fact that Canadians who have spent more than three months in Europe post 1980 are prohibited from donating blood at the CBS collection centres.

Sunday night CBC reported that the private plasma clinics will be paying $20 per “donation” here in Canada. For the students who are targeted by these companies, two donations a week equals a case of beer for the weekend. One of the donation sites is nearby a homeless mission.

As soon as you start paying for donations, numerous ethical questions come into play, including where do we stop? If it’s okay to pay for plasma, what about organs?

It also encourages donors desperate for cash to bend the truth when it comes to screening health issues that could affect the safety of the product. Fractionation does increase the safety of the product (versus fresh frozen plasma) but Canadian scientists are reluctant to say that such products will be absolutely safe under the circumstances. One of the longstanding claims is our blood system is safe precisely because we do not pay for donations.

Now all that is all changing.

It also raises questions about donors to Canadian Blood Services. Will people continue to donate blood products for free when a private company is willing to give them $20 on a pre-loaded VISA card?

We’ve heard that other cities could see similar clinics set up shortly. Will that put pressure on CBS to get in the game, or will CBS simply give up organizing donations and instead just write the cheques?

Last year we raised this question and few took interest. With weeks of seeing these new centres open in Canada, now the media is paying attention. The question is, will the politicians start asking questions now?

If we don’t debate this we might as well scratch “blood — it’s in you to give” and replace it with the new slogan, “blood – it’s in you to sell.”