Raise the Hammer

As a regular blood donor, I too am troubled by this. The potential safety risks are of grave concern, but there are other things that are hopefully going to be carefully considered and discussed by Health Canada, provincial health ministries, Canadian Blood Services, health professionals, and the Canadian public (donors, recipients, and others).

I believe it's better to have one agency running the system. Will this company operate under the direct supervision of Canadian Blood Services? Or will they become a "competitor"? Plasma is just one component of whole blood, but will the new company eventually want to collect whole blood and platelets?

What will this do to the existing pool of donors? Will it cause a portion of them to decide it's not worth donating their blood unless they're paid to do so? Will many of them switch to donating plasma for money instead?

Are there better ways to encourage people to donate?

David,

I am unsure how the potential of paid donors of plasma puts the blood system at risk as a paid donor can lie as easy as someone who donates for free. I would also direct you and anyone reading this to a commentary written by Dr. Graham Sher from Canadian Blood Services here: http://www.thestar.com/opinion/commentary/2013/03/13/prohibiting_payforplasma_would_harm_patients.html

I would also direct you to the following Opinion article as well:

http://www.thestar.com/opinion/commentary/2013/03/18/thousands_of_canadians_depend_on_plasma_from_paid_donors.html

That last article is by the Canadian Hemophilia Society Blood Safety and Supply Committee. From what I read they are not concerned about any possible contamination from this and Hemophiliacs certainly have a reason to be concerned due to the tragedy of tainted blood from 20 years ago.

I don't agree with everything that has happened since the recommendations of the Krever Inquiry came out but I think that the Blood System and the techniques, fail-safes and redundancies used to protect it are strong. There is nothing wrong with wanting to make sure we don't forget what has happened in the past but I think condemning potential changes without providing all the information is wrong and a bit too agenda driven.

Thank you Hipgnosis for posting this articles. It helped me understand and view this paid plasma donation differently. I do believe, this private company will follow the tight regulation of Health Canada. Considering the fact that we need a lot of Plasma to make one medicine to save life, I believe that compensating the time of the donors will be a good idea.

I juste whould like to know what is the plasma thing all about .

Good piece about a bad idea.

The Star covers this here :
http://www.thestar.com/life/2013/04/12/should_federal_and_provincial_regulators_allow_plasmaforprofit_clinics_to_operate_in_canada.html

The background to this story, which lies in the HIV epidemic ( and its hepatitis C shadow) is provided by Jacques Pepin in The Origin of Aids (Cambridge 2011). This is among the best works of history I have ever read. Pepin is professor in the Department of Microbiology and Infectious Diseases at Sherbrooke. He recruits and considers many kinds of evidence to produce plausible hypotheses of the emergence of the viral agent of the disease, its amplification in its human hosts and its eventual worldwide transmission. Many of Pepin's conclusions are probabilities only, though well supported. This is not the case with most of his chapter on the Blood Trade, in which he explains that the infection of haemophiliacs was only a portion of the problem. Also infected were the donors whose plasma had been processed to supply them.

Stated with maximum simplicity, this situation arose because of the development of a process called plasmapheresis, by which plasma - valuable for its many proteins - is separated from whole blood. The blood cells are returned to the donor along with fluids. This enables the donor to give plasma again within a few days or a week. However, this also meant that infectious agents could be transferred not only to the recipient of some part of the plasma, but also between donors if there was any lapse in equipment cleaning procedures. Accordingly, Pepin reports

"The first well-documented epidemic of HIV-1 among paid plasma donors occurred in a poor suburb of Mexico City where, in 1986, 281 donors were found to be HIV-infected, especially those that sold plasma ten or more times each month. Re-utilisation of blood collecting material was blamed. At the time there were thirteen plasmapheresis centres in the country, mainly in Mexico City and in states near the Texan border. Most donors were young men living in the per-urban shanty towns. They could sell their blood as often as every two to three days. By the time that the sale of plasma was prohibited nationwide in 1987, 7% of 9,100 paid donors were HIV-infected. In one of the plasmapheresis centres, HIV prevalence increased form 6% in June to 54% in November 1986. Other outbreaks among paid plasma donors were reported in Valencia, Spain and Pune, India...These outbreaks...were dwarfed by what happened in China in the early 1990s...There were several hundred plasma collection stations set up by blood product companies. In the most heavily affected provinces...approximately 250,000 paid donors acquired HIV. "

Yes, you read that right. 250,000.

Meanwhile, back in Haiti, a plasmapheresis centre operated by American investors and Luckner Cambronne, the head of the Tontons Macoutes, Duvaliers private militia, was exporting a maximum of 6000 litres a month to the U.S. from May 1971 to October 1972. When Cambronne was forced into exile by intrigues in Baby Doc's court, some of the shortfall in the supply was taken up by an outfit owned by Nicaraguan dictator Anastasio Somoza, which became the largest plasma collection facility in the world, processing up to 1,000 donors a day.

According to Pepin, "During the heyday of the plasma trade in the early 1970s, plasma was bought in at least twenty-five developing countries to be exported to pharmaceutical companies in the industrialized world. Apart from [Mexico, Haiti, and Nicaragua] the list included Belize, Brazil, Colombia, Costa Rica, the Dominican Republic, El Salvador, Guatemala, Puerto Rico, Taiwan, Thailand and even African counties such as Lesotho."

This is the crux, I think. Reportedly, Canada gets some portion of its current plasma needs from the States. What can this mean? Since living conditions are very similar in both countries, presumably the U.S. has the same per capita plasma needs as Canada, so how can there be a U.S. surplus for export? Because payment allows it to be tapped? But who is being tapped, and what happens to them if something goes wrong? What if plasma demand in the States goes up, and increased payments are not enough to maintain the exportable surplus? (This is pretty much a sure bet. Better option your plasma futures today. The income stream will allow you to purchase your health care services in the future. Ain't capitalism wonderful?) Suppliers will of course be seeking approvals to collect from wherever there are probable sellers.

Apart from the secondary problems of safety and security of supply arising from error and fraud, there is the primary question of responsibility. Shouldn't Canadians be responsible for our own health care, rather than outsourcing the supply of parts? If Americans or Mexicans or Haitians or whoever are shipping out plasma rather than using it within their own health care systems, doesn't it mean that there is something wrong with those systems?

There is a need for this because not enough people donate. I see nothing wrong with being paid. People can lie without being paid, with this program there will be more donors that is so desperately needed common sense.