Blood plasma in Canada: should compensation for donors be banned?

I am one of the signatories of a long letter arguing that Canada (which imports most of it's blood plasma products from the U.S.) should not ban the compensation of Canadian plasma donors.

Here's the letter:
Ethicists and Economists express concerns about banning compensation for plasma donors with regards to ensuring the security of a safe Immune Globulin Product Supply.
Submission to the Expert Panel on Immune Globulin Product Supply and Related Impacts in Canada

Here's the press release:
Ethicists and economists express concerns about banning compensation for plasma donations

Bleeding (and more) for Canada

Peter Jaworski in USA today discusses Canadian repugnance for paying for blood or sperm.

If it weren’t for America's free-market ways, more Canadians would have trouble getting pregnant.

"Canada used to have a sufficient supply of domestic sperm donors. But in 2004, we passed the Assisted Human Reproduction Act, which made it illegal to compensate donors for their sperm. Shortly thereafter, the number of willing donors plummeted, and sperm donor clinics were shuttered. Now, there is basically just one sperm donor clinic in Canada, and 30-70 Canadian men who donate sperm. Since demand far outstrips supply, we turn to you. We import sperm from for-profit companies in the U.S., where compensating sperm donors is both legal and normal.
...
"Canada has never had enough domestic blood plasma for plasma-protein products, such as immune globulin. Our demand for those products, however, is increasing. Last year, we collected only enough blood plasma from unremunerated donors to manufacture 17% of the immune globulin demanded. The rest we imported from you, in exchange for $623 million, or $512 million U.S.

Reliance on your blood plasma looked like it might change a little bit when, in 2012, a company called Canadian Plasma Resources announced plans to open clinics in Ontario dedicated to collecting blood plasma. The trouble is that its business model included compensating donors. Almost immediately, groups such as the Canadian Union of Public Employees and the Canadian Health Coalition began to lobby the Ontario government to pass a law to stop CPR from opening clinics. Ontario obliged in 2014, passing the Safeguarding Health Care Integrity Act, which among other things made compensation illegal.

When CPR shifted attention to Alberta, so did the groups opposing them. Just this year, the Alberta government introduced the Voluntary Blood Donation Act, which would prohibit compensation.

British Columbia’s government is just now looking at options to ban it as well.

What persuaded these governments? The anti-compensation groups argued that blood plasma from compensated donors was less safe, that people should donate blood plasma for free rather than for money, and that there is something wrong with having a for-profit business model in health care.

The latter two concerns are strangely specific. They don’t seem to apply to you Americans. If they did, the groups would have lobbied to make importation of anything other than products made from unremunerated donors also illegal. But they didn’t.

Instead, they object to a Canadian for-profit company compensating Canadian blood plasma donors in Canada, but American for-profit companies compensating American donors in America does not appear to register on their moral radar. Like the importation of sperm from for-profit U.S. companies that compensate donors, it has all the appearance of moral NIMBYism. It’s fine if it happens in your backyard, and we’ll happily buy the products, but we object to it happening in our backyard."

************

And here, in Canada's National Post:

Peter Jaworski: Canada needs blood plasma. We should pay donors to get it

Canada buys the vast majority of its plasma-protein products from American companies that attract plasma donors by paying them. Yet we ban the same practice here

Paying for (imported) blood products in Britain

Yesterday's post about paying for blood plasma in Canada reminded me of this story that The Guardian ran earlier in the year:
Blood money: is it wrong to pay donors?
"In some countries, people get paid for giving blood. And in the UK, we have to buy in plasma. But is safety compromised when money changes hands?"

"A recent black-and-white documentary, Blood, about a mobile blood collection unit in rural Russia, shows scenes familiar to many: dusty halls, anxious donors queuing to register, the occasional struggle to find a vein. Cups of tea, too, albeit just for the team.

Then there are the differences. Donors sit upright on uncomfortable, hard chairs. Some have just come off night shift; others have no money for food. Staff are concerned about how many units will test positive for blood-borne viruses. Potential donors worry about being accepted. A woman without an up-to-date residency certificate is turned away. A man insists he should be allowed to donate; he is broke and desperate for the 850 roubles (£8.85) payment. It is clear that most donors come for the money: for some, it is a lifeline.

Russia isn’t alone in paying donors – the US, China and Germany do, too. In Britain, however, we donate 2m units a year, with no payment – following the World Health Organisation recommendation that blood donation be voluntary. This is not only for altruistic reasons, but also for safety. “The safest blood donors are voluntary, non-remunerated donors from low-risk populations,” says the WHO.

...

"Nevertheless, thousands of NHS patients receive blood plasma from paid donors. This contains clotting factors and antibodies. Thousands of individual donations go into each dose of clotting factors – used to treat haemophiliacs who are bleeding – or immunoglobulins (antibodies) used to treat people with autoimmune diseases, severely damaged immune systems, or some serious infections.

After the outbreak of bovine spongiform encephalopathy (BSE), known as mad cow disease, some recipients of UK plasma products developed the fatal brain disease variant Creutzfeldt-Jakob-disease (vCJD). As there is as yet no adequate screening test for this, British plasma has not been used since 2002, when we began to import it from the US."

**********

HT Alex Nichifor

Bleeding for Canada: plasma exports from the US to Canada

In the HuffPo:, Peter Jaworski begins his rant about the blood supply with a good line about food:  Commodifying Blood Donation Could Solve Canada's Shortfall

"Many people think blood is special in a way that means it shouldn't be "commodified," or bought and sold on a market. It is a basic human need. It's not like the latest gadget or a pair of shoes; it is to be revered, not remunerated.

"I'm glad we don't think food is special in this way. If we did, imagine how many people would die of starvation, or would suffer from hunger.

This past December, the Ontario legislature preserved the sanctity of the exchange of blood through Bill 21, entitled the "Safeguarding Health Care Integrity Act." Schedule 1 included provisions from Bill 178, the Voluntary Blood Donations Act", which prohibits paying and receiving payment for blood, either directly or indirectly. With this bill, the legislature has made the giving and receiving of blood a sacrament.

*************

Of course Canadians don't have to pay other Canadians for blood plasma. If you look at the Harmonized Tariff Schedule (HTS) administered by the U.S. International Trade Commission (USITC), you find that HTS number 3002100210 stands for Human Blood Plasma, and in 2013 Canada had imports $29,274,584 worth from the U.S., where of course we compensate plasma donors.

HT: Josh Penrod