Deb Matthews enters paid blood donation debate

Ontario Health Minister Deb Matthews has asked Health Canada to delay licensing of three new clinics that would pay donors for blood plasma.

The new clinics represent a fundamental change in how we treat blood donations in Canada and is contrary to the recommendations of both the Krever Inquiry and the World Health Organization.

Two private clinics have been set up in Toronto, and a third is planned for Hamilton. The three cannot open until they get licensing approval from Health Canada.

We first learned about these clinics almost a year ago when Canadian Blood Services announced it was closing its last remaining dedicated plasma collection site in Thunder Bay.

At that time we wrote to all provincial health ministers — including Deb Matthews  — as well as Federal Health Minister Leona Aglukkaq. The NDP’s France Gelinas asked questions for us on the floor of the legislature. We even circulated two petitions which were also introduced into both Federal and Provincial Parliaments. Outside of Thunder Bay, the media treated the story with indifference despite our efforts.

A year ago we thought it odd that CBS was telling us on one hand that there was an oversupply of plasma, while on the other hand a private company was setting up shop in the province to collect substantially more. CBS’ own annual report showed they were also increasing imports of American plasma.

CBS has always maintained the oversupply is in fresh frozen plasma, whereas the rising demand was for plasma fractionated into pharmaceutical products. The Thunder Bay donation centre used to collect for both, so it was a head scratcher as to why they simply couldn’t shift the balance of collections to be used where the demand was greatest.

Canadian Plasma Resources claims they are not the first to pay for donations in Canada. Winnipeg’s Cangene has been doing so for some time – although Cangene directly manufacturers plasma into pharmaceutical products itself. It is very much a niche operation and is nowhere on the scale of the proposed Toronto and Hamilton clinics. Nor is it a broker.

The new company has no such role. Where they will sell their plasma is unclear, although both Canadian Blood Services and Hema Quebec are not in a position to become buyers – at least not right now.

Being a private company, their operations are not subject to the same level of scrutiny as a public agency such as Canadian Blood Services.

It is most likely, given there is no Canadian market, that paid donations of plasma in Toronto and Hamilton will be destined for the U.S. Whether it comes back as finished product, such as immunoglobulin (IVIG), is anybody’s guess. Whereas CBS shipped plasma to U.S. fractionators as part of its supply chain of IVIG, there is no agreement that we are aware of that there would be any reciprocity from these clinics.

Given our recent experience with supply issues at Sandoz, it is remarkable that we would be so cavalier about leaving the security of our IVIG supply in the hands of another country.

This story got going several weeks ago when we were interviewed by Kelly Crowe and featured on CBC-TV’s The National. After learning about the new clinics, Crowe found our stories on the Diablogue. At OPSEU our phones have been ringing since and suddenly those Diablogue stories from last April are becoming must-reads.

Now the politicians are paying attention at both the provincial and federal level.

Nobody knows how the proliferation of private for-profit plasma donation centers will affect CBS’ ability to attract volunteer blood donors.

While CBS claims that fractionated plasma is safe, an expert panel in 2007 held out the possibility that given the large pools of plasma needed to produce IVIG, they could not be absolutely certain about its safety.

There are ethical considerations about how voluntary a biological donation is when money becomes involved. And where does this stop now that we are about to step over that ethical divide? For example, do Canada’s poor become a repository of organs for Canada’s wealthy?

One of the new clinics is located nearby a homeless mission. All the clinics appear to be directed towards student donations.

The Globe and Mail’s Andre Picard was gobsmacked by the news. Picard made much of his reputation from covering the Krever Inquiry into Canada’s tainted blood scandal. He even wrote a book about it.

In his March 4th column he was blunt: “If there is one lesson we can take from our inglorious history in blood collection and distribution it is that lax regulation and bureaucratic blandishments kill.”

Up until a few weeks ago nobody was talking about this. Now that we are, it’s clear that this whole issue needs a lot more consideration and public debate. It also requires a government in Ottawa that cares more about public safety and less about opportunities for private business.

Deb Matthews may be late to the party, but we’re happy she finally showed up.

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