Skip to content
Join our Newsletter

Editorial: Don’t pay plasma donors

The province’s health minister, Adrian Dix, has introduced legislation to ban payment for donations of blood and plasma. His objective is to prevent private collection centres springing up, as they have in Saskatchewan and Manitoba.

The province’s health minister, Adrian Dix, has introduced legislation to ban payment for donations of blood and plasma. His objective is to prevent private collection centres springing up, as they have in Saskatchewan and Manitoba. Donors at these for-profit clinics are paid about $25, in the form of a tax credit or a gift certificate.

The minister’s concerns are understandable. Yet there is an atmosphere here of the road to hell being paved with good intentions.

Raw plasma is the straw-coloured liquid remaining after the white and red cells are removed from blood. As with whole blood, it is used in transfusions. It can be extracted at regular donor centres, though the process takes longer than a straight blood donation.

However, plasma can also be broken down into subcomponents such as immunoglobulin. The process is called fractionation. These protein-rich fragments were originally used in treating bleeding disorders, such as hemophilia. But increasingly they have become a weapon in the fight against cancer and genetic disorders.

Canada is mainly self-sufficient in blood. Partly that’s due to new surgical techniques that reduce the need for transfusions during operations.

But demand for plasma components such as immunoglobulin is soaring. And here is where the dilemma arises. Canadian Blood Services, which manages Canada’s blood-collection and distribution system, gathers only about 20 per cent of the plasma we require.

A major reason is that there are no donation centres in several provinces, B.C. among them. Dix might want to attend to this.

In addition, there are no fractionation plants in Canada. As a result, most of the raw plasma we need, and almost all of the fractionated components, are imported from offshore companies, most of them in the U.S. But Americans are paid for donating plasma.

The irony is apparent. The B.C. government will not compensate domestic donors, but it has no problem being dependent on American donors who are paid.

Dix does have a defence of sorts. He says once we start paying for plasma, the volunteer system will suffer.

There might be some truth in that.

But all of this is beside the point. If we believe, as a matter of principle, that payment for plasma products is wrong, why not boost our own collection efforts? That would remove the necessity of relying on a U.S. system whose ethics we believe are compromised.

It’s important to be clear about the issues at stake. So far as safety is concerned, there is no problem buying fractionated plasma components from the U.S. or elsewhere. These are merely pharmaceutical products that have to meet rigorous quality standards.

The ethical issue revolves around buying American plasma that comes from donors who were paid. By purchasing these products, we become complicit in a practice we consider morally wrong.

Ideally, the solution would be to make ourselves self-sufficient in the collection of raw plasma. It would still have to be fractionated in the U.S., but there are no ethical concerns with that.

Canadian Blood Services has asked for approval to spend $855 million over seven years to finance 40 new plasma-collection sites. That should bring us to 50 per cent self-sufficiency. Presumably, full self-sufficiency would double these numbers.

That’s an enormous challenge. But if Dix and his colleagues across the country are serious, merely barring the door to for-profit firms won’t do. The only real solution is a co-ordinated effort to increase plasma donation.

And the matter is urgent. As countries such as China and India upgrade their health-care systems, the demand for plasma could soon outgrow the supply. At that point, we cannot count on offshore purchases.

Canada has to become self-sufficient in these lifesaving blood products.