Why is Health Canada aiding private blood firm?

As the snow begins to fall and the mercury begins to drop, Health Canada has found itself in some hot water. The trouble has been years in the making — since at least 2013. That was when Canadian Plasma Resources, a profit-seeking company that pays individuals for their blood plasma, sought to open its first location.

A recent media exposé has raised some troubling questions, not just about CPR’s business model and what it means for the health of Canadians, but also about the surprisingly close relationship this private firm has with Health Canada, the public agency tasked to regulate it.

Among its many roles, Health Canada is responsible for enforcing laws and regulations that govern the collection of blood and blood products. Canada’s blood supply is collected and maintained by the independent, non-profit agency, Canadian Blood Services. Voluntary donations are collected in the public interest and make their way back to patients in Canadian hospitals through life-giving blood transfusions.

Rather than collecting voluntary, unpaid blood or blood plasma destined for hospitals and patients in Canada, CPR is a private company that pays for plasma to generate profit. They do so by appealing to some of the most impoverished and vulnerable in our society. In Ontario, CPR tried to open clinics beside a methadone clinic and homeless shelters. In Saskatoon, they opened their first location in an area with a high concentration of pawn shops and payday loan stores.

Once plasma is collected and processed by CPR and companies like it, it’s sold to customers around the world. Clients include drug companies that incorporate plasma into pharmaceutical products that are sold to patients and hospitals at a profit.

No laws are being broken, but there are serious and significant concerns.

CPR’s paid donor model has resulted in declining voluntary donations for blood donations to Canadian Blood Services in Saskatoon, where CPR currently operates. CBS warned Health Canada about their compromised supply and asked for “a pause of support for commercial activity” while developing a plan to secure voluntary plasma donations. Health Canada chose to ignore this warning, and instead approved CPR’s application to open its second clinic in Moncton, N.B.

There are also well-founded safety concerns.

For-profit plasma collection is widespread in the U.S. and has been called into question. There have been reports of questionable adherence to screening guidelines, including individuals lying to pass medical tests. In one instance, a desperate paid donor reported, “I can’t eat if I don’t pass.”

In Canada, CPR has opened storefronts in communities stricken with poverty who already bear a high burden of illness, including bloodborne illnesses like HIV and hepatitis C. It’s reasonable to have safety concerns about this business model. The World Health Organization has said as much, recommending blood and plasma collection from low-risk, voluntary, unpaid donors.

Canada’s own tainted blood scandal and the resulting Krever Inquiry led to very similar conclusions, recommending that blood donors be unpaid except in rare circumstances.

Most Canadians would like regulators such as Health Canada to put the public interest first. So why, despite warnings raised by CBS, the WHO and the lessons of Canada’s blood scandal, did Health Canada approve CPR’s licence to operate?

An Access to Information request revealed that Health Canada officials communicated with senior lobbyists regarding the CPR’s business, expansion and even public-relations plans, including their challenges with Ontario’s proposed paid-plasma ban. CPR’s lead lobbyist also didn’t federally register as such until March 2016, a month after CPR’s Saskatoon clinic was approved.

All of this poses the question, what is going on at Health Canada and to whom do they consider themselves accountable? As the public regulator responsible for the nation’s health, it’s the well-being of Canadians that should come first, not the bottom-line of private enterprise.

Dr. Danyaal Raza is chair of Canadian Doctors for Medicare, a family physician at St. Michael’s Hospital in Toronto, assistant professor at the University of Toronto and an expert adviser with EvidenceNetwork.ca.