Preserving Ontario's Voluntary Blood Donation System
Ontario is taking action to maintain the integrity of the province's voluntary blood and plasma donation system with the introduction of new legislation.
The Voluntary Blood Donations Act, 2014 would, if passed, prohibit payment to donors for blood or blood constituents like plasma, including reimbursement of expenses or other forms of compensation.
The Voluntary Blood Donations Act, 2014
The proposed Voluntary Blood Donations Act, 2014 would, if passed:
- Create prohibitions against, either directly or indirectly:
a) Providing payment to any individual in return for giving blood or blood constituents
such as plasma.
b) Offering to provide payment to any individual in return for giving blood.
c) Accepting payment in return for the giving of blood.
- Provide for inspection and enforcement powers.
- Amend the Laboratory and Specimen Collection Centre Licensing Act (LSCCLA) to authorize regulations that would make clear that the activity of blood and plasma collection is required to be licensed under the LSCCLA.
- Amend the LSCCLA to give the Minister of Health and Long-Term Care authority to consider the principles set out in the Voluntary Blood Donations Act, 2014 when deciding whether it is in the public interest to issue a licence to a lab or specimen collection centre.
- Amend the Trillium Gift of Life Network Act (TGLNA) to clarify that the legality of paying for blood in Ontario would be governed by the proposed legislation and not by the TGLNA.
The proposed legislation, if passed, would exempt Canadian Blood Services and its donors to allow Canadian Blood Services to pay donors in rare circumstances. This is in line with the recommendation from the Krever Commission.
The Krever Commission
The proposed legislation is consistent with the 1997 report of the Krever Commission, a Royal Commission of Inquiry on the blood system in Canada in response to the tainted blood scandal in the 1980s that left thousands of Canadians infected with HIV and hepatitis through blood transfusions and plasma products.
The Krever Commission report recommended that:
- Donors of blood and plasma should not be paid for their donations except in rare circumstances.
- The blood supply system should be publicly administered by a national blood service.
- The core functions of the national blood supply system must be performed by a single operator in an integrated system.
Plasma is the yellow-coloured liquid that makes up about 55 per cent of total blood volume. Plasma can be obtained from either a regular whole blood donation or through a process called plasmapheresis, where blood is collected from a donor. The plasma portion of the blood is then separated out, and the red blood cells and formed elements from the blood are returned to the donor.
Plasma can be used as a direct transfusion to treat patients who are bleeding severely or need plasma to help their blood clot. Canada is completely self-sufficient in transfusion plasma.
Plasma can also be used to manufacture drugs referred to as Plasma Protein Products.
Canada does not have the manufacturing capabilities for the large-scale production of Plasma Protein Products. The Krever Commission recommended against Canadian Blood Services operating its own fractionation plant or being bound to use a domestic fractionator because of the significant capital investments required and the benefits of contracting with several international plants.
Plasma collected by for-profit clinics would likely not directly increase the availability or supply of Plasma Protein Products in Ontario. The plasma collected by for-profit clinics would likely be sold for a profit to international fractionation companies with the capacity to manufacture plasma into Plasma Protein Products for the international market.
Canadian Blood Services
Ontario's blood system is managed at the national level (outside of Quebec) by Canadian Blood Services, which was founded on the key principle of voluntary donation. Canadian Blood Services does not purchase plasma directly from donors, nor does it purchase raw plasma that is sourced from paid donors.