How a plasma maker landed in the Prairies
CLAIRE BROWNELL REPORTS ON CANADIAN PLASMA RESOURCES, A FIRM THAT SET UP SHOP IN SASKATCHEWAN AFTER BEING LEGISLATED OUT OF ONTARIO
Barzin Bahardoust didn’ t realize he was courting controversy when he started his business five years ago.
At the time, he was working on a PhD in electrical and computer engineering at the University of Toronto, but he wanted to become an entrepreneur. So he reached out to the Riahis, family friends with business experience in pharmaceuticals.
They listened to his ideas, but ultimately convinced him to come on board with one of their own. Canada, they said, has a huge and growing demand for medical treatments made from blood plasma, but depends on the U.S. for 80 per cent of it because of that country’s established network of pay-for-donation clinics.
The solution: Bring compensated plasma donation to Canada — reducing reliance on foreign plasma, adding $25 a week to donors’ income and offering shareholders a slice of a market estimated at close to $1 billion.
Things turned out to be a little more complicated. The company they formed, Canadian Plasma Resources, has put Bahardoust in the middle of a raging debate about the ethics of paying people for their bodily fluids and the safety of human material collected by private, for-profit companies.
Critics also question what kind of firm should take any paid plasma donations. Some have voiced concern about Canadian Plasma Resources’ complex ties to Iran, including companies linked to its nuclear program.
“We thought this was a good idea and this business was suitable for Canada,” said Bahardoust, who is now the chief executive of Canadian Plasma Resources. “Looking back at things, we underestimated some of the history that surrounds blood and plasma in Canada.” Blood plasma is the yellow fluid that remains once white and red blood cells and platelets are removed. It can be used in transfusions, although Canadian Plasma Resources is focused on providing plasma to make a variety of medical treatments, from helping people who have clotting disorders to some cancer medications.
Critics say collecting plasma from paid donors by private, for-profit clinics is a dangerous regression from the recommendations of the Krever Commission after the tainted blood scandal of the 1980s, when 30,000 Canadians were infected with hepatitis C and HIV through transfusions and plasma products. One of its recommendations was that donors of these products should not be paid.
As a result, Canadian Plasma Resources’ initial plan, to open donation clinics in downtown Toronto in 2013, was met with a public outcry.
Critics cited safety concerns over private plasma collection, and accused it of picking locations near homeless shelters to take advantage of the impoverished.
Bahardoust said Canadian Plasma Resources spent $9 million on real estate, equipment and staff in the Toronto area, only to have the Ontario Liberal government effectively drive the company out of the province by passing legislation in 2014 to ban paying people for their blood and plasma.
Quebec also bans compensated plasma donations.
But Bahardoust found a friendlier political climate in Saskatchewan, where Health Minister Dustin Duncan assured him the province has no plans to enact a similar ban. In February, Canadian Plasma Resources got a Health Canada licence to operate a collection clinic in Saskatoon and opened its doors two weeks later.
Duncan said he gave the green light to the clinic — which Bahardoust says is also supported by several other provinces — because he believes increasing Canada’s domestic supply of plasma and reducing its reliance on American donors is good for the country’s health.
“I understand that for some people it is a very emotionally charged issue and I respect that. Certainly we want to ensure that the system in Canada is highly regulated and that it is done in a safe manner,” Duncan said.
But he added he has a hard time understanding why bringing compensated plasma donations to Canada has resulted in such an outcry when most of the country’s treatments come from paid donors in the U.S.
Although one of the Krever Commission’s five principles to govern the Canadian blood system was that donors should not be paid, the inquiry also found a major factor in the tainted blood scandal was a failure to collect and manufacture enough blood and blood products domestically. That led to a reliance on U. S. donors, including prisoners, and a higher risk of infection.
Critics see things differently. On March 7, a group of blood supply activists opposed to Canadian Plasma Resources gathered to make their case on Parliament Hill.
About 50 people representing the spectrum of political parties turned up for the reception, hosted by Blood Watch, which counts such organizations as the Ontario Hemophilia Society, the World Health Organization and the International Federation of the Red Cross and Red Crescent Societies on its list of those opposed to paid plasma collection.
Also in the room was safe blood advocate Kat Lanteigne, who watched a close family friend fall sick with AIDS after contracting HIV from her hemophiliac husband and later wrote a play, Tainted, based on interviews with the major figures involved in the tainted blood crisis. She plans to visit all 10 provinces to lobby against private, for- profit plasma clinics in Canada.
Like critics of the large American plasma industry, Lanteigne is uncomfortable with the notion of paying people desperate to sell their bodily fluids, warning Canada would establish “blood farms on the backs of the poor” if we follow this approach.
She also cites studies showing compensated donors tend to be less healthy than altruistic ones. Critics are also concerned the lure of payment could introduce an incentive to lie about risk factors to get through the screening.
Bahardoust counters such criticism by pointing out Canadian Plasma Resources gives people a chance to discreetly indicate their plasma should be thrown out and still receive compensation.
Under Health Canada’s rules for clinics that collect plasma, the company must also subject new donors to interviews, a physical exam and proof of a fixed address, re-interviewing them every time they donate. The first two batches of plasma they donate must test negative for infectious diseases before they are considered qualified donors; each batch continues to be tested after that.
Health Canada itself says since the introduction of modern manufacturing processes more than 25 years ago, “there has not been a single case of transmission of hepatitis B, hepatitis C or HIV caused by plasma products in Canada.”
Derek From, a lawyer at the Canadian Constitution Foundation, also argues paid donations are necessary to meet demand.
He donated plasma for US$45 a week while he was a student in the U.S., but said he wouldn’t have bothered if it weren’t for the compensation, seeing it as a fair trade: he had something the clinic wanted and it was willing to pay in exchange for his time and trouble.
“What we’re doing right now is we’re begging people — ‘ Come in! Donate your time! Donate your fluids! Out of the kindness of your hearts, do this!’ ” From said. “And what results do we get? Very poor results. It doesn’t work.”
Convincing thousands of people to give up two hours a week so a machine can suck plasma out of their arms for free does sound like a tall order, but Lanteigne believes it shouldn’t be written it off as impossible without making a serious effort. She would like to see a national strategy to recruit altruistic plasma donors through Canadian Blood Services, rather than forfeiting collection to the private sector.
Beyond the debate on compensation for plasma donations, Canadian Plasma Resources has faced challenges over its ties to Iran.
In September, the Federal Court upheld a Canada Border Services Agency decision to deny a work permit for Ramin Fallah, a shareholder in Canadian Plasma Resources’ parent company, Exa Pharma Inc., who had been hired as an executive.
The CBSA claimed his former employer, Fanavari Azmayeshgahi, “has been identified in open sources and by allied governments as being an entity of (weapons of mass destruction) concern.”
The court found that Fallah did not raise any evidence to counter that allegation.
Another alleged link to Iran’s nuclear program is through Canadian Plasma’s business partnership with the German pharmaceutical company, Biotest AG, which has processing plants in the U.S. and Germany.
Biotest has a joint venture called Bio Daru with pharmaceutical company Darou Pakhsh, which is on a list of Iranian companies Britain considers at risk of using exports for weapons of mass destruction proliferation. Nasser Riahi, founder of Exa Pharma and father of its president, Yalda Riahi, is also a founder of Bio Daru.
Bahardoust said Nasser “severed his ties with Exa Pharma years ago,” and Yalda is now the only member of the Riahi family with an interest in Canadian Plasma Resources.
He also said Canadian Plasma Resources rescinded its job offer to Fallah as soon as the CBSA denied his work permit. He adds attempts to link Canadian Plasma Resources to Darou Pakhsh or anything else related to Iran’s alleged nuclear activities are ridiculous.
“While the majority of our shareholders are proud members of the Iranian Canadian community, including myself, Exa Pharma and Canadian Plasma Resources do not conduct business in the republic of Iran,” Bahardoust said. “Our sole focus is to collect plasma in Canada and manufacture it into products to be sold in the Canadian market to treat Canadian patients.”
He adds the company is currently only licensed in Canada and does not have regulatory approval to distribute products made from its plasma in any other countries.
But Lanteigne and Blood Watch are wary of the company’s stated plans.
Lanteigne adds its response to policy changes in Ontario — which have included threatening to sue the province — inspires little trust. “That’s not the kind of company that you want taking people’s blood,” she said.
For now, Bahardoust said the plasma being collected at the Saskatoon clinic isn’t going anywhere until the company builds a reliable donor base and finalizes a plan for processing and distribution, which he expects will take at least a year.
To follow through with its stated plan of selling products made from plasma collected in Canada, the company would have to compete through a Canadian Blood Services’ request for proposal process.
In an emailed statement, Canadian Blood Services said it does not have an agreement with the company, but wouldn’t rule it out in the future.
“If Canadian Blood Services determines in the future that purchasing more plasma is in the best interest of patients, we could consider products from Canadian Plasma Resources,” it said.
But as controversy rages over Canadian Plasma Resources and what it may do in the future with the plasma it collects in Saskatoon, another company is already distributing treatments made from compensated plasma donations at a clinic in Winnipeg.
For most of its 30- plus years, the clinic has focused on donors with the rare antiD antibody, whose plasma can be used to make a treatment to prevent stillbirths among women with rhesusnegative blood.
But under the clinic’s new owner, the Laval, Que.-based pharmaceutical company ProMetic Life Sciences, it has been increasing collection of normal plasma with the goal of making a broader range of treatments.
Bill Bees, ProMetic’s vicepresident of plasma technology, said he would like to see the Winnipeg clinic expand to 30 collection beds from 12 within five years. He would also like to open new centres — possibly in the U.S., given the political challenges in Canada.
Bees said he thinks the reason Canadian Plasma Resources has found itself at the centre of controversy while ProMetic’s clinic has mostly flown under the radar comes down to publicrelations missteps by a company that’s new to the industry.
Meanwhile, he said the outcry has been distressing for his donors, some of whom have been coming to the clinic in exchange for compensation for decades.
“They just didn’t understand it,” Bees said. “They’ve always been compensated and they were beginning to feel like there was something wrong with this. They were feeling like they were dirty.”
WE’RE IN THE 21ST CENTURY, LIVING IN MODERN COUNTRIES. I THINK THERE IS FREEDOM EXPRESSION IN CANADA. — ROGER RODE, FRONT NATIONAL