Pay donors for their blood

Canada buys the overwhelming majority of its plasma-protein products from American, for-profit companies that attract plasma donors by paying them. In 2016, Canadian Blood Services collected only 17 per cent of the total plasma it needs for essential plasmaproducts. To cover the shortfall, Canadian taxpayers spent $623 million buying just one of these products, immune globulin.

That’s why Canadian Blood Services (CBS) recently asked the government for $855 million in additional funding over the next seven years. They want to use the funds to open plasma collection centres that could collect more plasma that would be used to manufacture more of these products. And small wonder. Plasma-product pharmaceuticals treat a growing list of ailments, including life-threatening bleeding disorders, immune deficiencies, and infectious diseases like tetanus and hepatitis.

Despite this, when the Canadian company Canadian Plasma Services (CPS) stepped in to fill more of this need domestically — by using a paid donor model — groups like the Canadian Union of Public Employees, Canadian Health Coalition and others launched an aggressive campaign to stop them.

So far, their campaign has been very successful. Before CPS got a chance to operate a single clinic in Ontario, the Ontario government passed the Voluntary Blood Donations Act in 2014, which makes it illegal for any private company to pay plasma donors. Alberta did the same this year. Now, this coalition is putting pressure on other provinces to do the same. Their campaign makes misleading claims about safety, and is also hypocritical. It is not just short-sighted for governments to prohibit a model that would increase domestic plasma for plasma-protein products. It’s simply wrong.

The cornerstone of the opponents’ argument is safety. Their press releases and public statements refer to “the deregulation of blood safety,” claiming paid donor plasma “poses a serious safety risk to the security of our blood supply.” They also reference the Tainted Blood Scandal of the 1980s, where approximately 2,000 Canadians were infected with HIV and another 30,000 were infected with hepatitis C. The tainted blood came from paid, poorly-screened donors, who were primarily prisoners in the U.S.

But that scandal is not relevant to plasma donations; it was about blood used for transfusions. By comparison, CPS and companies like Cangene (which had been operating in Manitoba for decades) collect blood plasma only for plasma-protein products. Meanwhile, private clinics operate in exactly the same regulatory environment as CBS. There is no “deregulation.”

Both Health Canada and CBS have repeatedly said that plasma-protein products from paid donors are safe. Graham Sher, the CEO of CBS didn’t mince words in a YouTube video when he said: “It is categorically untrue to say, in 2015 or 2016, that plasmaprotein products from paid donors are less safe or unsafe. They are not. They are as safe as the products that are manufactured from our unremunerated or unpaid donors.” There is no additional “safety risk.”

If CUPE, the Canadian Health Coalition and other opponents really did think paying donors creates a safety concern, they’d presumably also object to the use of paid-donor, plasma-protein products made in the U.S. After all, if the problem is that compensating donors leads to unsafe plasma-protein products, what difference does it make if we compensate Canadian or American donors? It clearly doesn’t. Their claims are hypocritical.

So, too, are the opponents’ arguments against this particular business model. They worry about private companies operating for-profit. They say that blood plasma is a communal resource. Leaving aside the highly dubious claim that blood plasma belongs to anyone other than the person whose body harbours it, this argument also ignores the fact that others are already profiting from blood plasma. The relevant question isn’t whether someone should profit, but who should profit: American donors and companies, or Canadian donors and companies?

Canada has no plan to stop purchasing plasma-protein products from American, for-profit companies that pay donors. They probably never will. As a Health Canada Round Table discussion on compensating plasma donors concluded: “no country in the world has been able to meet their need for plasma with a solely volunteer model.”

Paying donors is the only way to ensure a safe and secure supply of blood plasma for plasma-protein products. While we will continue to pay American companies that pay American donors, let’s at least permit a few Canadian companies to pay Canadian donors as well. It’s the right thing to do.