While Canada buys 80 per cent of its blood plasma via paid-donor sources from the United States, there still remains an inexplicable reluctance from politicians and activists to pay Canadians for their blood plasma, the yellow liquid that houses red and white blood cells.
Last year’s announcement that Canadian Blood Services has contracted Grifols, a Spanish pharmaceutical company, to collect paid plasma in Cambridge, Whitby and Hamilton sparked pushback from politicians and anti-paid plasma activists, citing concerns around potential exploitation, a loss of altruism and concerns about safety.
While it remains illegal to pay donors for blood plasma in Ontario, Canadian Blood Services is exempt from this law, and so is the company it has contracted to carry out this work. Unfortunately, resistance to paying Canadians for plasma will continue to result in not only the continuance of Canadian reliance on paying the U.S. for its paid-donor plasma, but will continue to deny patients access to these life-saving plasma-based therapies.
Hamilton may not end up getting a paid plasma centre after all, since it recently declared itself a “paid-plasma-free zone” after a motion that was put forth by Hamilton’s Mayor Andrea Horwath passed in city council. This move will affect Canadians who rely on plasma products for medications to treat burn and trauma patients, those who need treatments for auto-immune disorders and those seeking treatment for hemophilia, as well as other bleeding disorders. According to a 2022 analysis, there is a risk to life without immunoglobulin treatment and there is no alternative therapy. The projection is that there will be a five to seven per cent increase in Canadians needing plasma-based therapies every year.
The voluntary route is simply not meeting this growing demand, as the same analysis shows that Canada is at only 15 per cent plasma sufficiency, while it receives more than 80 per cent of its plasma from paid donors in the United States.
Arguments made by Mayor Horwath and anti-paid plasma activists often centre on the morality of allowing people to commodify their bodies. But, strangely enough, they don’t have objections to Canada relying on the U.S. for plasma, where donors are paid.
A submission for Bill S-252 by 16 professional ethicists and economists to the Canadian Senate stated that “in Canada, donors are paid about $40-$50 Canadian per donation which takes approximately 1.5 hours. This amount is neither extremely low (it is well above the minimum wage), nor is it so high as to cloud a potential donor’s judgment about what is best for her.”
Even if a low-income person has made the decision to get paid for their plasma, it should not be the role of the government to paternalistically say what is best for them. As one of the signatories of the Senate submission, Peter Jaworski, puts it, the moral point of plasma collection is to collect enough plasma to meet the needs of patients, not the intentions of donors.
Of course, an argument for paid plasma should not be seen as an argument against altruistic plasma donations. In fact, voluntary donations should continue to be encouraged, and even the government of Canada has stated “there is no evidence that paying plasma donors compromises the safety or weakens a country’s volunteer blood donor system.” The United States has more than 400 paid plasma sites and the number of voluntary donations remains some of the highest in the world. Germany and Austria, which also have paid plasma donations, have voluntary plasma donation numbers much higher than Canada’s.
Another argument is that paid plasma is not as safe as donated plasma. Due to changes in how we collect blood and plasma, there haven’t been any safety concerns in Canada since the tainted blood scandal in the 1980s. We know that the safety claim is false, again, because we import 80 per cent of the plasma therapies we need from the U.S., where donors are paid. Companies collecting plasma are required to be approved and licensed by Health Canada, all plasma donors are thoroughly interviewed before donating and their plasma is additionally tested for infectious diseases such as HIV and hepatitis. A first-time donor’s plasma is never used until a second donation is made to make sure they were not in the early stages of infection, and all donations are traceable to donors with fixed addresses.
During the manufacturing process, plasma goes through a process called fractionation which eliminates a range of viruses using heat treatments, filtration, chemical cleaners, pasteurization and acid treatments, a process that is successful in detecting and eliminating West Nile virus from donations.
Alberta, Saskatchewan and New Brunswick already have operational paid plasma centres. Ontario’s centres should be welcomed given the obvious advantages to patients, especially when it is an option that can work hand in hand with voluntary donations.
A majority of Canadians seem to find paying for plasma as morally appropriate, according to a 2019 survey. There is overwhelming evidence reported by ethicists, scientists and officials that shows paid plasma donation has little to no effect on exploitation, altruism or safety. So why are politicians and activists stalling? The more politicians and anti-paid plasma activists slow down the process, the more time it will take for those needing life-saving plasma-based therapies in Canada to get better. Where is the altruism in that?
Originally published here
