Survivors of the tainted blood crisis of the 1980s are sounding the alarm about a proposal by Canadian Plasma Resources (CPR) to pay people for donations of blood plasma, saying it flies in the face of lessons learned 25 years ago when blood was collected from high-risk populations.
CPR, which has two clinics in downtown Toronto all but ready to receive donors, says its proposal is a safe way to secure the growing amounts of plasma needed for life-saving medications.
The company intends to pay people $25 to sit for an hour while blood is taken from their body. A centrifugal machine would then separate plasma (a fluid of mostly water and proteins) from the red blood cells and platelets, which would then be returned to the body. Regular donors would be able to sell plasma to CPR as often as once a week, according to CEO Barzin Bahardoust.
But before any veins are punctured, the clinics must be licensed by Health Canada, a process now entering its second year. Part of the delay has been a public consultation that Health Canada conducted last year at the request of the Ontario Ministry of Health.
The final report should be released early this year, but its significance remains up in the air, since Health Canada spokesperson Blossom Leyung stresses that it's up to each province to decide whether to let companies pay donors for plasma, as opposed to collecting it from volunteers.
When asked for its position on pay-for-plasma collection, a spokesperson for the provincial ministry of health would only say that they are mindful of both public safety and the supply of blood products and they continue to "monitor the issue and consider appropriate options."
Andrew Cumming understands the need for a bountiful blood supply he has been taking blood-derived medicine for hemophilia most of his 54 years. He's also been taking anti-virals to counter his HIV infection and has had a liver transplant to counter the effects of the hepatitis C he contracted in the 1980s.
"Something as essential to the collective health of society shouldn't fall into the hands of a commercial interest," says Mr. Cumming, who spent decades on Bay Street as a derivatives trader.
"I'm a capitalist. I know that private companies minimize input costs," he says, arguing that market forces will push any paying company to find the cheapest blood it can, a process which led to the company making Canadian hemophilia medicine in the 1980s to source plasma from places such as prisons in Arkansas.
Quebec prohibits paid collection, making it the only jurisdiction to have acted on the second recommendation made by the Krever Commission, the four-year inquiry that looked into how 1980s contamination of the blood supply was allowed to infect up to 2,000 Canadians with HIV and up to 20,000 with hepatitis C.
In his 1997 report, Justice Krever argued that blood from unpaid donors is safer because paid donors "may have an incentive to donate even when they know they should not."
Lawyer David Harvey represented patient groups at the Krever Inquiry. He calls Justice Krever's recommendation against paid donations "one of the most fundamental in the report."
Paying for plasma is, in his view, "purely a business transaction – paying donors for plasma, which is then sold at a great profit."
Mr. Bahardoust doesn't deny that the relationship would be one of business, but touts a strict testing regime that he says is designed to weed out undesirable donors. Donors are only paid retroactively, after two donations are tested and found to be safe, to eliminate those who show up thinking they can get paid before their blood is found to be carrying a virus, bacteria or parasite.
"You need to have an expectation of having clean blood to be paid," Mr. Bahardoust said.
Besides, he says, paid collection is the basis by which the bulk of medicinal plasma is collected around the world. Much of the medicine used in Canada contains plasma products collected at paid clinics in the U.S.
Canadian Blood Services is the not-for-profit organization established after the Krever Inquiry to manage blood supply in Canada, outside Quebec. Spokesperson Marc Plante acknowledges that paid donations are an important part of the processed blood products used in Canada and have proven to be as safe as volunteer collections. CBS has made it clear, though, that they will not be buying plasma from CPR and prefer that their volunteer system of collection not have paying rivals.
Dr. Graham Sher, CEO of CBS, told a panel audience at an October production of Tainted, "Would I be happy if they never opened their doors here? Never did business here? Absolutely."
Mr. Cumming says the profit motive puts paying collectors on a collision course with high-risk users who need a cash infusion. And while he's reassured the current testing regime screens for the diseases that have already infected his body, he's worried about the next diseases to come along.
"They can only test for the pathogens that they know exist. For five years they had no idea what HIV was. Was it viral? A germ? How do you test for it?" he asks.
Janet Conners was living in Nova Scotia in the 1980s when her husband Randy was infected with HIV. Ms. Conners was diagnosed in 1989, five years before Mr. Conners died. She formed a national group of secondarily infected victims and achieved standing at the Krever Inquiry.
She says Canada did the right thing in establishing the inquiry, but wishes politicians had done more to implement its findings.
"Somebody has to not allow this to happen again," she says. "We've learned a lesson."
Or at least, she says, we should have.
"I think people forget. They don't mean to, but they do. For me, this will never go away until it kills me."