Transcript
Speaker: I'm Jane Williams, this is the Red Eye Podcast. You can hear our live broadcast on Saturday mornings from 10 till noon at 100 .5 FM in the Lower Mainland. In today's episode, Lorraine Chisholm speaks with Michelle Brill Edwards about why we need to step up and defend the Canadian blood supply.
Speaker: Canadian Blood Services has signed a 15 -year deal with a for -profit plasma corporation to privatize plasma collection in Canada. Protests are taking place today, December 1st, at the CBS headquarters in Ottawa. Bloodwatch, CUPE, and the Ontario Public Service Employees Union are calling for the CEO and board of Canadian Blood Services to step down, following what they're calling a violation of public trust.
Speaker: They say the paid plasma scheme goes against recommendations from the Crever Commission and would negatively affect voluntary collection efforts. I'm joined by Dr. Michelle Brel -Edwards. Dr. Brel -Edwards is a longtime board member of the Canadian Health Coalition, a former Senior Health Canada regulator, and a whistleblower on drug and blood safety. And she joins me now from Ottawa. Hello, Michelle. Hi there, Lorraine.
Speaker: Thanks so much for joining me. I understand that you were at the demonstrations this morning in Ottawa. What was happening there on the ground? Opsu, the Ontario union whose employees are involved with a provision of Canadian Blood Services work, we're demonstrating against the recent deal secretively made by Canadian Blood Services with the
Speaker: giant plasma company called Griffels and it was really quite amazing. I, you know, not someone who often goes to these kinds of events and I thought of very invigorating and I would say almost inspirational to see how committed the frontline workers of the Canadian Blood Services are and what worries them about the deal is that we are in essence giving up
Speaker: the CBS mandate to collect voluntary donations of plasma. CBS is partnering with a private firm to do paid collection. And in the end, that will diminish voluntary collection of both blood and plasma. So this is very serious stuff. And they were making the point that the CBS has not really been trying
Speaker: to round up to get in to invite voluntary donors in the last few years. The efforts have diminished and they feel it at the frontline end of things. So they're calling on blood services to really get back to their mandate of voluntary collection. Well, let's dive into some of the specifics here. But first, it would be great if you could tell us what is plasma and why is it so valuable both medically and financially?
Speaker: Plasma is the liquid portion of blood. So whole blood is the red stuff, and it contains both solid components like red cells, white cells, platelets, and the liquid component, which contains proteins. So this is like a straw -colored liquid that looks like a chicken soup, and it kind of is like a chicken broth in the sense that it's water and proteins and, of course, other immune components, but
Speaker: It's very different from the solid part of blood. So the red cells are very delicate. The chicken broth, the plasma, is actually quite versatile. It can be frozen, it can be heated, it can be cleaned up in a bacterial sense by adding all sorts of heat or solvent detergents, chemicals that will clean it up. But you cannot do that with the actual solid blood components like the platelets and the red cells. So why is it important
Speaker: Well, it has become important over the last roughly four decades since we were first able to separate out plasma from the solid components, the red cells and all the rest during the collection process. So that has enabled us to collect a lot more plasma than we ever could before to gather it into industrial vats, separate out the different proteins and turn them into what are
Speaker: Medically and commercially exceedingly valuable products. Medically, a lot of the immune components, the proteins that help the immune system, are very life saving for people whose immune systems are in trouble. Commercially, ounce for ounce plasma products, the finished products that are sold around the world, are worth more than gold. Individual treatments are in the thousands of dollars.
Speaker: And the companies who transform plasma into these very valuable products are like, was it Rumpelstiltskin that spun a straw into gold? That is what they're doing. And it's extremely lucrative. And so they push the market and want us to use more and more and more of these products now for quite questionable uses at times. And what this means for Canada is just that we are
Speaker: the second highest user of plasma products in the world with no evidence that that is actually a wise use of these plasma products. We probably need somewhere around 50 or 60 % of what we really are using. The rest we are probably using excessively. Well, how does then that
Speaker: Well, maybe I would say inflated demand. I don't know if that's an act. Yes, that's a good term. Yeah. So how does that then commercializing of plasma put the voluntary blood system in jeopardy? It's a twofold problem. First of all, when you start paying people to provide their plasma for money, the chances are that the people who
Speaker: voluntarily donate plasma are going to say, well, hell, I'll go and just might as well get paid that $30 rather than give it for free. So you start losing voluntary plasma donors. That's bad enough. But the worst part of it, the second part of it is suddenly receiving payment for donation becomes the norm. It becomes the standard. It becomes okay. Yeah, that's what we'll do.
Speaker: And then the blood donors, the donors of whole blood, right, who are providing those very important cellular components, red cells, platelets, things that keep us alive at times of emergency, those donors say, hmm, why don't I just go get paid too? And you cannot pay people to donate blood as opposed to plasma. It's agreed around the world that that is unsafe. No one anywhere.
Speaker: including in the US, no one says that it's a smart idea to pay people for blood. It is controversial as to whether you should pay people for plasma, but it's not controversial about blood. You must not pay people for blood. That's unsafe. So what we are risking is not just that we won't have voluntary plasma in sufficient quantity. We are running the very serious risk that we won't have
Speaker: enough blood sufficiency, enough blood supply. That can't be replaced. If you don't collect enough voluntary blood by donation, you aren't going to have sufficient blood supply. So that's why we are very committed to this notion that CBS has to do everything in its power to maximize voluntary donation. And that includes not partnering with paid plasma companies.
Speaker: Now, I understand that the CBS has itself built dedicated voluntary plasma collection sites. Is it true that the for -profit system can operate more successfully and efficiently at collecting plasma and that people won't donate that for free? That's a myth. That's what the industry would have you believe, that the voluntary system cannot work. We know that's not true.
Speaker: For example, in Quebec, where there is a ban on paid plasma since the 1990s, they have doubled their plasma self -sufficiency just since 2016 by building these special centers that collect only plasma, a dedicated plasma collection. The technical term is plasmapheresis. Don't worry about the terms. It's just a wise way
Speaker: to encourage people to donate plasma voluntarily. Australia, a country roughly comparable to Canada in terms of our populations, our governance, they have improved their plasma self -sufficiency to somewhere between 50 and 60%. But in Canada, we have, by comparison, stayed since 2016 at roughly the same very insufficient
Speaker: plasma sufficiency of about 12 to 13%. That's unacceptable. We weren't trying. We built the units where plasma collection could be done more efficiently, but the CBS has not pushed that. For example, we have one of those new units right here in Ottawa. I have yet, and I'm a person who's very interested in this matter, I have yet to see any public exhortation by
Speaker: CBS to encourage citizens of Ottawa to go use that new center and give plasma voluntarily. So there are a lot of people that would help that would give, but they're not even told that there's a problem and here's what to do. We've also heard that plasma corporations target and exploit vulnerable populations to collect plasma. What are the ethical reasons for maintaining a not -for -profit blood collection system?
Speaker: The ethical issues are very long standing since the beginning of collection of plasma for manufacture into plasma products. That has been an issue. When you pay people to provide their plasma, usually you are going to have people who need the money. And very often, they are giving plasma often enough that it's damaging their own health.
Speaker: but they need the money, for example, for the groceries for the kids. So they will give as much as twice a week, even though their health is suffering. There are regulations to try and curb that, but people will give excessively and harm their own health. That's problem number one. Problem number two is that people sometimes feel compromised and will not tell the truth about illness because they want
Speaker: to be able to get the money for their plasma. That introduces infectious issues for the plasma supply. And we know that to be true. It's a matter of research that people who are paid to give have a higher incidence of infection in their blood and plasma than those who are giving voluntarily. Yes, we can clean plasma up, but we can't clean blood up.
Speaker: And that's, you know, that's a big part of the second part of the problem is the infectious risk to the system by payment. Now, some commentators in support of paid plasma say we're already reliant on the for -profit system based in the U .S., so that critiquing a private system is hypocritical. How do you respond to that? I think that's a very important point because it's a half truth.
Speaker: It is true that much of the world's plasma products are sourced from the United States. Roughly about three quarters of the world's supply comes from a paid system. What is the difference between paying Americans and paying Canadians? America, when you pay Americans, you are not putting at risk the Canadian blood supply.
Speaker: When you pay Canadians, that is exactly what you're doing. You're putting at risk the continuance of a voluntary system for collection of not just plasma, but blood as well. That is very serious. The Americans have for many years gotten away with a paid system. In fact, even in America now, their blood system is in trouble. They have had shortages throughout the pandemic and they are continuing now
Speaker: And so it's not simply the pandemic, it is that more and more people are expecting payment and we can't do payment for blood. So why is paying Canadians different? Because that affects Canadian blood and plasma supply. Where does the overall responsibility for the problem of a safe and accessible blood system lie and what do they need to do to ensure that?
Speaker: You know, the true answer is that everyone is responsible for the blood supply. Even Canadians as citizens, we have to speak up and protect the blood supply when it's in jeopardy. But if you look at the legislative authority, it really rests with the ministers of health. They are, in essence, the owners of the Canadian blood supply and they own
Speaker: the system on behalf of citizens. This is not a private company, Canadian Blood Services. This is a manufacturer of blood and plasma that is owned by Canadians for Canadians. And the ministers of health have a duty to ensure that that organization serves the public interest, not the interests of the pharmaceutical plasma industry.
Speaker: What actions can Canadians take? It just seems like a critical moment. What actions can Canadians take to oppose a for -profit system and to protect our public system, which I think a lot of Canadians really value? Actually, Lorraine, you're absolutely right about that. When I speak with people who need the system or who don't, who are kind of new to the issue, there is tremendous generosity of spirit amongst Canadians for running
Speaker: a voluntary system that serves everyone. It's really part of our public Medicare service. What people can do specifically is write to your provincial Minister of Health and say, keep the system voluntary. Do not allow CBS to privatize plasma collection. The key
Speaker: I think is for citizens of Ontario and British Columbia to do that. Both those provinces have bans on paid plasma. The bans are subject to reversal. Alberta had a ban as well, and it was reversed by a very unwise government during COVID in Alberta. We don't want that to happen in Ontario and British Columbia.
Speaker: just to help you see the importance of those two provinces. Together, Ontario and B .C. constitute 50 % of the Canadian population. That's 50 % of our plasma supply. We know that Griffiths is eager to go into those provinces, even though it is illegal to do so. There are bans in those provinces. There are exemptions for CBS, but not for Griffiths.
Speaker: If we can protect the bans in those two provinces, we are securing 50 % of the Canadian plasma supply for voluntary plasma donation. I should add that Quebec also has a ban and has had for a long time. It's a very secure ban that would be very hard to overturn. That constitutes 25 % of Canada's population. So that means together,
Speaker: Those three provinces give us 75 % of plasma self -sufficiency. That's important. That's what we have to fight for. Some people think that because a deal has been signed between Canadian Blood Services and Griffels, that this issue is over. It's not. We citizens have to hold the line. We have to say, not another step. Keep what we do have secure
Speaker: because that's the only way that we will have self -sufficiency in plasma in Canada. Well, such an important issue, and I really appreciate your joining me today to explain it to us, and I hope people will take it seriously and make their views known. Thanks so much for your interest, Lorraine.
Speaker: I've been speaking with Dr. Michelle Brill -Edwards. Dr. Brill -Edwards is a longtime board member of the Canadian Health Coalition, a former Senior Health Canada regulator and a whistleblower on drug and blood safety. The Red Eye podcast is produced at the studios of Vancouver Co -op Radio. You can support us by supporting Co -op Radio.
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