Canada Blood Services helping Grifols open illegal private plasma collection sites in Ontario
In 2014, Ontario unanimously passed the Voluntary Blood Protection Act prohibiting for-profit plasma centers. Paying for plasma puts control of Canada's blood and plasma supply at risk.
In the 1980s, hemophiliacs received Factor VIII treatment that was contaminated with the human immunodeficiency virus (HIV) and Hepatitis C. For eight months the Canadian Red Cross Society (CRCS) delayed implementing the testing of blood and plasma being used in the U.S. For an additional eight months, the CRCS continued knowingly distributing contaminated blood products across Canada.
The tainted blood scandal forced the industry to re-examine mitigating risk to patients. That included reconsidering the practice of pooling large volumes of blood and plasma from different sources.
An investigation into the tainted blood and plasma supply culminated in the Krever Report (1997) with over 50 recommendations including invoking the Precautionary Principle. That report and its recommendations are still considered the gold standard around the world.
In his recommendations, Justice Horace Krever wrote, “The slowness in taking appropriate measures to prevent the contamination of the blood supply was in large measure the result of the rejection, or at least the non-acceptance, of an important tenet in the philosophy of public health: action to reduce risk should not await scientific certainty. When there was reasonable evidence that serious infection or diseases could be transmitted by blood, the principal actors in the blood supply system in Canada refrained from taking essential preventive measures until causation had been proven with scientific certainty. The result was a national public health disaster.” (Pg. 1049, Vol 3.)
Canadian Blood Services (CBS), a federal agency that operates at arms length from the government, became Canada’s blood authority in 1998 replacing the CRCS. The exception was Quebec who chose to establish the Hema-Quebec which operates separate and apart form CBS.
In 2022, CBS held backroom meetings with Grifols, a Spanish multinational pharmaceutical and chemical manufacturer and the largest worldwide producer of plasma products.
These discussions would eventually manifest into a private public partnership (P3) intended to privatize the Canadian plasma supply system. The deal would make CBS a major stakeholder financially profiting from the harvesting and selling of Canadian plasma.
In Canada, blood and its components, including plasma, used for transfusion is collected solely by CBS and Héma-Québec and only from volunteer donors. However, plasma used for the manufacturing of plasma products is also collected by private companies and from paid donors — just not in Ontario, British Columbia and Quebec.
During a 2022 interview I had with Kat Lanteigne, co-founder and executive director of BloodWatch.org, she stated, “fundamentally, the question is and has always been, should we privatize blood collection in Canada? And, should we be making a profit off of Canadian plasma?”
Lanteigne went on to say, “it’s an unconscionable act because they [CBS] are a charity. And, that’s getting missed in this discussion.”
CBS was, at that time, one of Canada’s largest national charities funded by Canadian taxpayers. It was responsible for the collection of blood and plasma from donors who receive no financial compensation.
CBS issued a statement in May 2016 stating, “Canadian Blood Services does not, and will not, pay donors.” That’s despite proof that CBS had been in secretive negotiations to privatize plasma since 2010 while formally admitting to have been in negotiations since 2015.
Blood is composed of red blood cells, white blood cells and platelets. Plasma is a straw coloured liquid that contains proteins that are medically, as well as financially, valuable.
Today, many hemophiliac medications are produced synthetically. Yet, plasma remains valuable because it’s used in the treatment of burns, immune disorders, and neurological conditions.
However, over 40 per cent of the intravenous immune globulin (IV Ig) that is used in the world has no clinical evidence for its use. That negatively impacts patients who have no other alternative medications.
This profitability has led to the an aggressive, for-profit plasma collection industry. Still, not everyone sees monetizing plasma as a positive step forward. Worldwide restrictions are increasingly limiting the expansion of paid collection centers and that is negatively impacting profits.
Restriction of market sources brought Spanish-based pharmaceutical corporation Grifols to Canada’s and the CBS’ doorstep. Paying for plasma is still illegal in Ontario, British Columbia and Quebec. However, CBS entered into a contractual agreement with Grifols claiming that CBS is exempt from Ontario’s Law and that by association, that exemption extends to Grifols who is acting as CBS’ agent.
Health Canada doesn’t regulate for-profit plasma collection companies, they just license them. That means restricting these corporations falls on provincial and territorial governments. In 2014, Ontario unanimously passed the Voluntary Blood Protection Act (VBPA) prohibiting for-profit plasma centers.
That same year, the Wynne Liberals prevented a total of three paid plasma collection sites from operating in Hamilton and Toronto.
There is no explicit or implicit agents clause embedded in the VBPA. That means it remains illegal to pay donors for their blood or its constituent parts, aka plasma, in Ontario.
The Hamilton Spectator recently reported that Health Minister Sylvia Jones confirmed that the proposed centres legally conform to Ontario’s VBPA. However, Jones has not provided CBS and Grifols with written confirmation of this apparent legal loophole. Perhaps, because as Lanteigne recently stated to the CBS Board of Directors, that’s because it is illegal in Ontario.
BloodWatch.org has confirmation in writing from Health Canada that should this illegal contract be carried out, the plasma collected at these sites could be sold on the international market by CBS or Grifols without violating either federal or provincial law. That would undermine the plasma supply chain in Ontario and potentially across Canada.
I encourage you to take 8 minutes to listen to Lanteigne as she addressed the CBS Board of Directors on June 16, 2023. Lanteigne cites breech of trust, contract law violations, the abandonment of ethics and the selling of Canadian blood donors to Grifols as reasons to remove CBS CEO, Dr. Graham Sher from his position as well as to prohibit private for-profit plasma centres to operate in Ontario.
Blood-Watch.org obtained documents that suggest Grifols plans to open a for-profit plasma collection centre at 2255 Barton St. E. in Hamilton by 2025. The neighbourhood is known for lower incomes and higher unemployment.
CBS has also approved new Grifols’ plasma collection sites in Cambridge and Whitby with an additional two Ontario locations yet to be determined.
Instead, CBS should be opening and operating donation centres in those locations rather than facilitating the monetization of plasma which ultimately leads to exploitation of marginalized communities.
Although there are no specific regulations regarding where a plasma collection establishment must be located, or not located, the regulations for plasma collection under the Food and Drugs Act are worded in a way that allows Health Canada to enforce special requirements on a case by case basis, if needed depending on the circumstances.
There is a regulatory requirement to be able to trace back any donation to a donor and to inform or contact the donor, as well as the reliance of plasma collection programs on repeat donors that should eliminate a transient or high-risk donor from participating in plasma donation. Those safe guards include showing valid photo identification; proof of residence within a certain distance of plasma collection sites; quarantining the first donation and destroying it if the donor does not return for follow-up donation and quarantining the donation for 60 days.
Dr. Kerry Beal, Lead Physician of the Shelter Health Network, in Hamilton, Ontario told Small Change, “If 'residence within a defined perimeter of the collection center is a way of eliminating transient or higher-risk donors, and we know that the area is one of the postal codes with the highest poverty rates in Canada, and we know that the social determinants of health do not favour that population to be healthy — [for example] they would fall into the category of higher-risk donors just on the basis of their underlying health issues — if you want to target young healthy donors, would it not be better to put your plasmapheresis center near the university or college?”
She added, “Looking back over the years - we have the tainted blood scandal where more than 1,100 Canadians, the majority of whom were receiving blood components derived from plasma, were infected with HIV and 20,000 were infected with hepatitis C. The risk of infection increased dramatically from products where plasma from multiple donors are pooled.”
Europe limits plasma donations to once every two weeks. CBS currently recommends donating no more than once every seven days. In the U.S. where folks can sell their plasma twice-a-week, over 80 per cent of the collected plasma is from vulnerable, poor and abject poor populations.
The side effects of plasma collection can include dehydration, weakness, fainting, and blackouts. These adverse effects stem from the use of sodium citrate, an anticoagulant used in plasma harvesting.
Frequent plasma sellers may experience higher rates of lower blood protein levels, increased risk of infection, and liver and kidney problems.
Individuals are typically paid $30 to $50 per transaction in the US for plasma that will net $300 in the wholesale market and is more valuable than gold when processed. Individuals are incentivized to sell their plasma more frequently and to refer friends.
Promotional materials portray sellers as altruistic folk who are ‘donating’ their plasma, when reality dictates that it is clearly not donating if you are being financially incentivized to sell part of your body.
The truth is, the for-profit plasma industry targets racialized and disadvantaged neighbourhoods. They draw from the ever-increasing pool of the those living with chronic poverty and those who are unhoused, as well as university students and middle-class families suffering economic hardship due to the rising cost of living. Selling plasma often becomes an important source of income that helps people make ends meet.
Currently, the blood system in Ontario is a voluntary system and cannot be a paid system. However, by cooperating with the paid plasma industry, Ontario is placing at risk the sustainability of the entire blood voluntary system and undermining its self-sufficiency. Plasma collection inherently needs to be based on patient need in order to ensure Ontario, and Canada, can manage its supply chain and become self-sufficient.
The Krever Report included establishing one national operator to collect blood and plasma on behalf of Canadians. It also recommended blood be deemed a public resource and that access to blood/plasma and blood/plasma products should be free and universal. Safety of the blood and plasma supply is paramount so sufficient amounts should be collected to avoid importation from other countries.
The World Health Organization (WHO) released the guide, Towards 100 per cent voluntary blood donation: a global framework for action (2010), reinforcing the need to make worldwide blood and plasma donations 100 per cent voluntary by 2020. WHO also believes every country should be working towards self-sufficiency under a national system.
The for-profit industry gaslights the public into believing the profit driven plasma industry is the only way to reach self-sufficiency. Yet, there is overwhelming agreement that non-profit blood and plasma collection makes for a safer collection system that can meet domestic needs.
Essentially, paid plasma collection is opening the door to the privatization of Canada’s blood supply which puts profits before patient needs in the market-driven global environment. Ultimately, that will remove blood and plasma from the social commons turning them into commodities to be bought by the highest international bidder.
Negotiating in the open market becomes increasingly difficult when the supply is impacted by events like the COVID pandemic. The US private plasma industry saw supply dry up when universities began working online. That stressed the US supply chain and impacted profits.
In Canada, blood products are provided at no cost to patients and have very few restrictions placed on them in terms of use. What is utterly astonishing is the fact that Canada doesn’t track the use of plasma products and even the auditor general of Ontario has determined that plasma products are being over used.
Germany, Austria, the Czech Republic and Hungary allow private plasma companies to operate, but they must be cost neutral. These centers are also prohibited from incentivizing the process by paying customers to bring friends, issuing prepaid credit cards, or offering trips to frequent donors. Those selling their plasma are limited to one transaction every 14 days.
Countries that ban for-profit plasma collection want to have control over their national supply because plasma is a finite public health resource that is part of the social commons. These countries want to ensure safety within the supply chain and maintain control around supply management.
Grifols is set to open a plasma product manufacturing facility in Montreal, and bought out Canadian Plasma Resources. That sets Grifols up to lead a national takeover of Canada’s entire plasma collection system, and I would argue, the entire blood system.
It’s ironic that the push for privatization is happening after CBS received $20 million in infrastructure funding to open 11 plasma collection centers during COVID. All plasma donations at these centres were made without financial incentives and the response was so overwhelming that CBS scheduled the opening of another 11 donation centers.
The five for-profit Ontario plasma collection centres set to open in Ontario are part of a plan to open a total of 24 additional paid collection centers across Canada.
But why enter into a P3 with a Spanish corporation at all when Canadians were donating plasma at rates that were driving new donation sites? And, where was the independent oversight to ensure there was no conflict-of-interest on the part of CBS’ CEO, Graham Sher, or board members?
Belgium, the Netherlands, New Zealand and Italy are almost entirely self-sufficient when it comes to plasma derived drugs. Australia is 67 per cent self-sufficient with a fully nationalized plasma collection system. Investment by government, coupled with responsible management and oversight within these countries made this possible within a three to five year framework.
“I trained as a lab technologist and worked in the field for about 15 years before I attended medical school - transfusion medicine was part of my advanced certification exams (ART). I was taught that Canada, unlike the United States, did not pay for donations in order to maintain the safety of the blood supply,” stated Beal via email.
“Canadian Blood Services claim that Canada has not had a single case of Hepatitis B, Hepatitis C or HIV transmitted by a plasma product in the last 25 years. While it would appear that the provinces have the ability to decide to pay donors for plasma, the feds are responsible for the safety of the blood supply through Health Canada,” Beal added.
The fact that Canada’s blood and plasma supply is finite and crucial gives the federal Minister of Health the authority to take measures to ensure Canadians will not experience shortages. Time for federal Minister of Health, Mark Holland, to step in and shut down this fiasco because someone needs to put the health and safety of Ontarians, and Canadians, ahead of profits.
BloodWatch.org has organized a letter writing campaign and is encouraging Ontarians to contact Health Minister Sylvia Jones, their MPP and MP requesting the Ontario VBPA be upheld.
They would also like to see a VBPA adopted in every province and territory upholding Justice Krever’s recommendations as well as establish CBS as the only national blood operator under a new non-partisan CEO and presumably a new board.
Take six minutes to hear from survivors who know exactly why Canada needs a moratorium placed on paying for plasma.
#nopaidplasma #InvestigateCBSBoardandCEO #KeepBloodandPlasmaInTheSocialCommons
Thanks for the article!