It is “disturbing,” “risky” and “dangerous,” according to critics, that Canadian Blood Services is exploring a partnership with a private company to introduce paid plasma donation across Canada.
Paying for plasma would put the safety of our blood supply in jeopardy, they proclaim.
It would cut down on voluntary donations! Take advantage of the poor! Compromise the integrity of our altruism-based donation system! Introduce privatization where there should be none!
No, these critics insist – critics that include the federal NDP, the Ontario Public Service Employees Union and the Canadian Health Coalition – the status quo must be maintained. And that status quo is one of … imported paid plasma donations that, through the magic of cognitive dissonance, somehow do not put the safety of our blood supply at risk, do not exploit the poor and do not compromise the integrity of our system through privatization.
Voluntary donations currently supply only around 15 per cent of the plasma Canada uses to make immunoglobulins for patients. The remainder is purchased from companies mainly in the U.S., where American donors are paid. It follows, then, that Canada is already in the paid plasma business, except we are procuring our supply through a middleman and can’t actually see the transactions.
The result is that Canadians get to smugly protest against the paid plasma industry, while at the same time financing and making use of the paid plasma industry. Indeed, this arrangement allows us to delude ourselves into thinking we run a system based entirely on altruism simply because we don’t see the icky stuff happening in front of our faces. Maybe paying donors for plasma is only morally repugnant if the recipients have Canadian addresses?
The introduction of paid plasma clinics would actually only be novel in some provinces. Alberta, Saskatchewan, New Brunswick and Manitoba already have private clinics that financially compensate donors, and doing so is permitted elsewhere throughout Canada, with the exception of Ontario, British Columbia and Quebec. The current legislation in B.C. and Ontario, called the Voluntary Blood Donations Act, prohibits offering compensation for blood products, but it carves out exemptions for Canadian Blood Services. That means that, barring a legislative change, CBS would have to be in charge of running paid donation clinics, even if it partners with private businesses.
The safety concerns about paid donations stem from the tainted blood scandal of the 1980s, but they are largely without merit in 2022. A 2018 report published by an expert panel assembled to evaluate Canada’s procurement and production of plasma noted that multipronged changes implemented since that time ensure the safety of all donations – whether volunteer or paid – and that there have been no confirmed cases of disease transmitted through plasma-derived products in more than two decades.
The greater concern in terms of safety for Canadian patients is one of acute shortages stemming from our overwhelming dependence on the U.S., which is subject to production shutdowns and political actions such as executive orders. As the pandemic-induced scramble for vaccines and personal protective equipment so clearly illustrated, in times of crisis many countries look to protect their own first, leaving those that depend on imports of essential materials to fend for themselves. Former U.S. president Donald Trump had no problem with using trade as a cudgel with which to hammer Canada into submission during the NAFTA/USMCA renegotiations, and there’s no reason to believe a similarly hostile president wouldn’t do the same, even with lifesaving materials such as plasma. That’s why self-sufficiency – or at minimum, getting closer to self-sufficiency – is so important.
Those who oppose paid plasma donation argue that Canada should redouble its efforts on voluntary donations. It’s a nice thought but, as it stands currently, the only countries that produce enough plasma to be considered self-sufficient are those that financially compensate donors – countries that include Germany, the Czech Republic, Austria and, of course, the United States. Canada is currently grappling with a rather desperate shortage of blood donors, and we’d be foolish to believe there’s something special in our national character that would allow us to buck this trend.
The status quo in Canada is currently the worst of both worlds: We carry that moral responsibility of financing a system that some people argue exploits the poor (which is a debate in and of itself), without the safety and security of a self-sufficient system. But because, in some provinces, we don’t actually see people leaving donation centres with fistfuls of cash, we feel okay about the current arrangement – in the same way we might feel okay about wearing fast fashion because we don’t see sweatshop workers sleeping on factory floors. But whether we see it or not, Canada is already in the business of paid plasma. We might as well start paying Canadian donors and get closer to self-sufficiency while we’re at it.
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Robyn Urback