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
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
I couldn't agree more. I remember finding out from people 20 years ago that insurance companies would refuse to insure them if they simply had an HIV test.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
That was simply because, well, if you had reason to get an HIV test, you're obviously doing something that puts you at risk, so we're not going to take a chance on you and insure you. That was reality back in the 1990s.
I think a good piece of news is to show a piece of very faulty data that was out there. You probably heard the recent announcement in the last couple of months about the infamous “patient zero”, the Air Canada flight attendant who was basically blamed for the introduction of HIV to North America. It turns out that it was all based on faulty data and based on assumptions. On further review of that data, it turned out that it was completely wrong.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
It was completely false that this patient was responsible for the introduction of it in North America. He was just one of the first that they found out about.
December 8th, 2016 / 9:25 a.m.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
All right.
Thank you very much for coming.
Conservative
Len Webber Conservative Calgary Confederation, AB
Thank you, Mr. Chair.
First of all, I would like to begin my time by saying thank you to my fellow committee members for allowing this study to happen. I think it's long overdue. I appreciate your support for my motion back months ago.
Without question, our priority is a safe blood supply here in Canada. I know that our second priority is the expansion of the donor base for that blood system.
The government announced in June that they would reduce this ban from five years down to one year, and it showed me that science supported a reconsideration of our donation policies here in Canada. Is this one-year ban now based solely on science? Is the ban still somewhat arbitrary? That is what I was hoping to get from you here today. You've provided a lot of answers, and I appreciate that.
I do have some questions, and my first one is for Ms. Parker; I don't know if it's “Dr. Parker” or “Ms. Parker”. Of course, Canadian Blood Services and Héma-Québec submitted their research to Health Canada in early 2016 in asking that the deferral for men having sex with men be dropped to one year. That was done in June, but you have not divulged the research to back up this decision. I know that others couldn't get this research through access to information, ATIP, and I suspect that most of this research was done with taxpayer dollars. Will you, or CBS, or Héma-Québec provide that supporting research to this committee?
Director General, Biologics and Genetic Therapies Directorate, Health Products and Food Branch, Department of Health
Thank you for the question. The decision to authorize the reduction to one year was based on data that was submitted to us by CBS and Héma-Québec in a submission. We did in fact publish a summary of the research that we reviewed and how we came to the decision. That is on our website. I'm not familiar with why you would not have received additional information through an access to information request.
What we based our decision on was our scientists and statisticians reviewing the research data that the two blood operators provided to us.
Conservative
Len Webber Conservative Calgary Confederation, AB
That's interesting. Okay.
I have a question for the Canadian Blood Services. You mentioned in your presentation that in 25 years there has been zero transfer of HIV in blood transfusions. That's fantastic.
How many blood donations get rejected for testing positive for HIV? Can you give me some idea of the numbers?
Chief Medical and Scientific Officer, Head Office, Canadian Blood Services
It's a handful. It's less than a dozen a year, typically.
Chief Medical and Scientific Officer, Head Office, Canadian Blood Services
Our screening system is quite effective with the questionnaire.
Conservative
Len Webber Conservative Calgary Confederation, AB
Do you take information from that, such as demographic information, or where this blood is coming from or from what clinics?
Chief Medical and Scientific Officer, Head Office, Canadian Blood Services
We do contact every donor who has a positive test result for anything we test for. For the HIV-positive donors, we ask them a whole series of questions in trying to understand whether they were engaged in behaviours that would put them in a risk category, or whether they simply had no idea that they were HIV positive when they donated, or at risk of being HIV positive.
Conservative
Len Webber Conservative Calgary Confederation, AB
Okay.
I just want to talk a bit about your testing procedures. You have this antibody testing, this nucleic acid amplification testing, to test blood for HIV. Can this not be done with all blood that comes into your system?
Chief Medical and Scientific Officer, Head Office, Canadian Blood Services
Every unit of blood that's donated to CBS is tested with all of those tests. In this country, we don't have any blood that's not tested.
Conservative
Len Webber Conservative Calgary Confederation, AB
Okay. Why is it necessary, then, to go through that initial screening with the questionnaires for those individuals who are wanting to donate blood? From there, you assess.... If you're testing it anyway for HIV, why would you even ask?
Chief Medical and Scientific Officer, Head Office, Canadian Blood Services
The philosophy behind the maintenance of safety of the blood supply is a layered safety process. The first layer is the questionnaire. What we're trying to do in that process is to have only people come in to donate who are the least likely to test positive in any of the tests we're doing. Why do we do that? We do it in part because of this window period that Dr. Sher was speaking about. We do it also because none of our tests are completely perfect. We know that there can be errors in a test when it's conducted, because there are humans involved in the process. We also know that the pathogens themselves—the viruses, parasites, or bacteria that we're testing for—are living organisms, and their DNA mutates. They may mutate to the point where they're not picked up by the test, and we have actually seen that phenomenon happen.
All blood operators start with this screening process initially in trying to get donors who are least likely to be positive in their testing. That's the philosophy behind the screening assessment.
Conservative
Len Webber Conservative Calgary Confederation, AB
All right. That's interesting.
Let's talk a bit about this window period. Pardon my ignorance with respect to blood; I'm not a doctor or anything. On this window period, if you collect blood from somebody and you have no idea whether they have HIV or not, can that blood be stored for those 10 days, or whatever that window period is, to see whether or not that blood mutates, and then have it go through the testing in order to determine whether it has HIV in it?
Chief Medical and Scientific Officer, Head Office, Canadian Blood Services
What you're talking about is a process that is used in some countries, not for whole blood donations, but for plasma donations. It's called “quarantine and retest”. A donor would give a plasma donation that is frozen immediately. We freeze that anyway as part of the normal production. It then sits in the freezer for four or six months. The donor then subsequently comes back and gives another donation. If the donor tests negative on that second donation, then you're allowed to release the one that's been in the freezer for four to six months. That's the one place in which one can hold blood products for release.
For the fresh components, it doesn't work, because platelets only live for five days and you don't have enough time to wait.
NDP
Don Davies NDP Vancouver Kingsway, BC
Thank you, Mr. Chair.
Thank you to all the witnesses for being here.
For Health Canada, who initiated the reduction on the ban on the MSM population from donating blood from five years to one year? Was it Health Canada or was it Canadian Blood Services and Héma-Québec?
Director General, Biologics and Genetic Therapies Directorate, Health Products and Food Branch, Department of Health
It was Canadian Blood Services and Héma-Québec. They have the responsibility to initiate the process to amend their approved conditions. They did that through a submission filing to Health Canada.
However, they had been in communication with us well before that point. We had been meeting and consulting together on their plans to submit that actual application.
