Evidence of meeting #36 for Health in the 42nd Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was donors.
A recording is available from Parliament.
Liberal
John Oliver Liberal Oakville, ON
To the Department of Health and Catherine Parker, are we doing enough to promote and encourage alternatives to blood transfusion? There is risk in it. Some of the new technologies and the new strategies, and even the autologous donations, seem to have less risk.
Director General, Biologics and Genetic Therapies Directorate, Health Products and Food Branch, Department of Health
In addition to regulating the blood supply, we are also responsible for the regulation of pharmaceutical and biologic drugs. I can confirm that there has been a great deal of development in the drug field in products that can be used as alternatives to blood, not just in developing new products, but in reformulating currently available drugs to make them more suitable for certain populations, such as the Jehovah's Witnesses, who do not want to have any trace of blood products at all. I would say that there's an extreme amount of development in that area.
Liberal
NDP
Don Davies NDP Vancouver Kingsway, BC
Thank you.
I want to follow up on my earlier question on plasma to make sure I really understand that.
Dr. Sher, you said, if I understand correctly, that the transmission rate is low for recipients of plasma products because of virus removal and “inactivation”. Does that mean that residual risk of virus transmission is not influenced by the incidence rate of infection in the donor population for plasma products? In other words, it doesn't matter, in the donor population, whether they're infected or not. You're saying that the testing and processing of the plasma will eradicate the risk. Is that what your testimony is?
Chief Executive Officer, Head Office, Canadian Blood Services
It's a little bit of yes and no, Mr. Davies.
What I'm saying is that when you look at residual risk of the finished product, there is absolutely no difference between plasma products made from remunerated donors and plasma products made—
NDP
Don Davies NDP Vancouver Kingsway, BC
Dr. Sher, I'm going to interrupt you. You've said that already and I understand that. I'm delving deeper than that.
I'm trying to find out.... What I think you're saying is that the way that plasma is processed eliminates the risk, which would then logically say that it doesn't matter if donors walk in and are infected, because you're saying that it will be caught through the process. That's what I'm trying to understand. Is that what you're saying?
Chief Executive Officer, Head Office, Canadian Blood Services
What I'm saying is that if you look at the paid plasma system and the unpaid blood system, the donors coming in may indeed have different seroprevalence rates for hepatitis and HIV.
What we cannot say categorically is that it's simply because you're paying them. They collect in different markets. They have a slightly different set of questions. They have slightly different processes. Is it the act alone of paying that is causing that raw seroprevalence data to be slightly different? We don't know that for sure.
The only abundantly clear evidence, which I keep coming back to, is the finished product. What you're asking me is whether the act of paying, in and of itself, raises the risk of HIV in the donors coming in. What you have to recognize is that the way the paid plasma industry operates—where it sets up clinics, how it recruits donors—is markedly different from what the not-for-profit unpaid blood system does, so you're not comparing like for like. That's the important distinction I'm trying to make.
NDP
Don Davies NDP Vancouver Kingsway, BC
Let me ask Health Canada. I'm still not getting my answer, I don't think.
The reason we need to have the one-year ban on MSM, we say, is that there's a window period where you don't know if that blood is infected or not, so you want to ask the question, and obviously the testing is not 100%. Yet when it comes to paid plasma, we're saying that we can accept elevated risk in the process by paying people, thereby creating an incentive to be dishonest, perhaps—I think that's just logic—because the process will catch it down the road, whether it's by freezing the plasma or otherwise.
I'm trying to find out for sure: is the different attitude towards paid plasma and the MSM ban because of the technology of dealing with the plasma versus whole blood or not? Ms. Parker, can you help me with that?
Director General, Biologics and Genetic Therapies Directorate, Health Products and Food Branch, Department of Health
Yes, I hope so. I'd like to clarify that plasma donors in Canada are very strictly regulated. Plasma donation is strictly regulated. Plasma donors, whether they are paid or not, go through a very rigid screening process.
Director General, Biologics and Genetic Therapies Directorate, Health Products and Food Branch, Department of Health
No, but it's equally rigid. There are various aspects of the plasma donation process designed to try to eliminate people who may be there just to collect the small payment. They need to provide proof of a fixed address and things like that. The donor screening and the donor testing are very rigid as well.
As I said earlier in my remarks, with blood safety, we're looking at overlaying rings of steps. The same is true with plasma donation. There is rigid regulation of the collection and the donor eligibility. There is also rigid regulation of what happens to that plasma after it is collected. It goes somewhere and it is made into plasma products. For those plasma products to come back into Canada, they must go through a whole separate drug authorization where every aspect of the viral inactivation, all the steps taken to address any contaminants that may be in the plasma, are—
Director General, Biologics and Genetic Therapies Directorate, Health Products and Food Branch, Department of Health
It's a different situation, because the plasma is processed, and it's actually processed into commercial drugs. There is that whole processing step.
NDP
Don Davies NDP Vancouver Kingsway, BC
You're saying it's that step that provides the certainty that the final product will—
Liberal
The Chair Liberal Bill Casey
That's all right.
That completes our rounds of questions. I thank the presenters very much.
I have a question, though. A few years ago, I went to donate blood as usual, and I was told I couldn't donate blood because I was too old. I had to have a doctor's certificate because I was over 65. That really screened me out from donating blood. Is there any other group that is discriminated against besides seniors? Is it a national standard or is this a local standard?
Chief Medical and Scientific Officer, Head Office, Canadian Blood Services
You'll be glad to know that you're welcome back. Health Canada has granted us approval to remove the upper age limit, so come on back.
Chief Medical and Scientific Officer, Head Office, Canadian Blood Services
No, but we have other reasons why people would be deferred. It depends on where you take your warm vacations in the wintertime. That could get in the way. If you spent certain amounts of time in Britain during the mad-cow era, you'll be permanently deferred. We have a long list of other reasons why we defer donors, but ageism is no longer one of our problems.
Chief Medical and Scientific Officer, Head Office, Canadian Blood Services
It was eighteen months or two years ago.