Wednesday, May 25, 2011

Buying Blood? The tale of why Canada really does pay people for blood.

A few disclaimers to start:
  1. I have nothing against blood donation or blood product transfusion- in fact I am very supportive of both.
  2. I do not disagree with the methods used by Canadian Blood Services to obtain blood products to meet the demands of growing Canadian need for said products
  3. I have volunteered with Canadian Blood Services, both as a greeter/guide on the blood mobile, and as a blood typer collecting blood samples from participants as part of promotional events aimed at increasing blood donation.
  4. I am a family member of an individual who has required several blood transfusions in their lifetime, and am grateful for CBS and Canadian blood donors.

In Canada, the Human Tissue Donation Act of 1989, section 15,subsection I, states that:

15.(l) No person shall buy, sell or otherwise deal in, directly or indirectly, any tissue, body or body part for the purpose of a transplant or for a therapeutic purpose, medical education or scientific research. (1)

And section 15, subsection 3, states that:

(3) A person who contravenes this section is guilty of an offence and liable on summary conviction to a fine of not more than $100,000 or to imprisonment for not more than 1 year, or to both. (1)

Sounds pretty intense...sounds like Canada believes that no one should buy or sell blood or blood products. You can't be paid for blood donation in Canada...let's examine, shall we?

Blood products (or plasma products) refer to concentrated or purified proteins fractions derived from plasma for therapeutic use, such as albumin or intravenous immune globulin (IVIG) (2,3). Canadian Blood Services (CBS) is responsible for collecting blood samples from Canadian donors that are used in the production of plasma products (2). Over the last 10 years, the net usage of IVIG alone in Canada has doubled to more than 3000 Kg/year (3). With this increased demand in plasma products, Canada is no longer (since 1994/1995) a plasma self-sufficient nation (3).

Self sufficiency can be defined as the collection of enough plasma from Canadian donors to meet the needs for manufacturing the product in highest demand (IVIG) (3). Canada is almost self sufficient at producing albumin, but only 20% of the IVIG used clinically in Canada is derived from Canadian plasma (3). The balance of IVIG is purchased as finished product from commercial manufactures (3) by Canadian Blood Services, who purchase the balance of hospital requirements for IVIG from international suppliers (2). In fact, a significant proportion of all plasma protein product inventories are purchased in U.S. dollars (2).
The US collects 3 million litres of recovered plasma (from blood donation) and 14 million litres of source plasma (for further manufacturing) from paid donors.

Like it or not, the blood/plasma products that are used here in Canada were obtained in such a way that would violate section 15(1) of the Human Tissue Donation Act of 1989 if it were done here in Canada. If The Act exists out of some sort of moral obligation to maintain the integrity of human tissues and organs by ensuring that they are not paid for, or sold...then The Act fails to realize that we are already paying people for blood donation, by proxy, for plasma products.

(1) The Human Tissue Donation Act

(2) Canadian Blood Services annual financial report

3) Dr. Willem K. Stevens- Blood Products Division, Centre for Blood & Tissues Evaluation, Health Canada. Production and Regulation of Plasma Products. Course BPS4102 Biopharmaceutical Regulation, Faculty of Science, University of Ottawa. March 21st, 2011.

1 comment:

  1. Hmmm, hope there is a solid loop hole for us to maintain our blood supply, at least until we can change our laws to allow blood to be an exception. Otherwise, we are susceptible to the media making a headline out of this and a kneejerk political reaction to get out of the headlines and block this supply. Lives depend on this and we need a solution before we could ever change.