Despite its potential for positive change, paid plasma donation has negative ethical implications.
In 2022, Canadian Blood Services (CBS) announced a partnership with a private Spanish firm called Grifols to open plasma collection centres in Canada. Grifols pays its donors, and currently has one operational Canadian location, in Winnipeg at the University of Manitoba.
In Ontario, Quebec, and British Columbia, it’s a federal offence to pay people to donate plasma—this restriction is set out by each province’sVoluntary Blood Donations Act. While CBS is exempt from this rule in exceptional circumstances, it currently operates on an entirely voluntary basis in these provinces. Yet Grifols plans to open its first Ontario location this year, with a total of 15 Canadian centres by the end of 2025.
This move into Ontario is worrisome as it could undermine the current voluntary nature of Canada’s existing donation system. As paid plasma donation centres become more widespread, donors will migrate away from voluntary systems toward compensation.
Some plasma is frozen and transfused directly to patients with major traumatic injuries or undergoing surgery. However, the majority goes towards creating plasma-derived medicinal products (PDMPs) such as immunoglobulins or coagulation factors, which are used to treat various conditions, including immune deficiencies and bleeding disorders. Canada’s plasma supply only satisfies about 13 to 14 per cent of its immunoglobulin needs.
Currently, this missing supply of PDMPs is imported from American pharmaceutical companies, who pay their plasma donors.
Increasing compensated donations could increase Canadian plasma supply and would result in less reliance on American donors.
For-profit plasma donation centres are known to exploit individuals living below the poverty line, and those with low or unstable incomes, including university students. Plasma donation centres in the US are often concentrated in states with lower minimum wages, and in cities where more people live under the poverty line. Companies target these areas where they know they’re likely to find people looking for extra sources of income.
A study in Cleveland revealed over half of paid plasma donors to be unemployed and 57 per cent of paid donors to earn at least one third of their monthly income from plasma donation. Individuals who donate too frequently can risk developing anemia. Frequent donation can decrease the quality of plasma because of our bodies’ limited capacity to regenerate essential proteins. Yet those dependent on plasma donation as a source of income may be more inclined to ignore warning signs or lie during intake assessments.
I worry similar predatory practices will become commonplace in Canada should provincial governments allow private companies such as Grifols to establish themselves here.
While banning private firms in Canada would protect people from exploitation, it ittedly wouldn’t solve the issue of Canada’s insufficient plasma supply.
Other possible solutions include non-monetary incentives or educational campaigns. Hema-Quebec successfully initiated a public education campaign and established several new donation centres. Their efforts increased voluntary plasma donation, nearly doubling the amount of plasma they received.
Regardless of the path forward it chooses, Canada must consider what it’s willing to sacrifice for its plasma supply.
Violetta is a fourth-year Health Sciences student and one of The Journal’s Business, Science & Technology Editors.
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Pierre Delecto
The author believes lower income people should not have the option to earn additional money by doing something that benefits others. She would rather Canada have less plasma available domestically for those who need it AND eliminate a way for lower income people to earn more money. That’s certainly an interesting position.
If it’s unethical to pay people for plasma donations, shouldn’t we stop importing most of our plasma from the US? As the author points out, we get most of our plasma from paid donors in the US. Is it okay to “exploit” low income Americans, but not Canadians?
Zedrick Serson
Can we get a context check on how much money the family of the writer of this incoherent screed makes? I’m getting major “I got mine, fuck you” vibes from the article
Cassandra Prim
Please fact check your opinions prior to providing a simplistic view of an extremely complicated challenge. This article does not truly reflect the challenge of Canadians becoming less reliant on US paid donors. Moving towards more collection of plasma in Canada under tight Health Canada regulation allows for every bit of Canadian plasma to come back to benefit Canadians. The alternative to more regulated collection within Canada is actually spending millions of dollars to fuel US paid plasma industry by purchasing the valuable medications made from plasma on the open market. Any type of collection site in Canada will need to abide by Canadian regulations which limit the amount of plasma being collected from each donor. The danger here actually is not the companies like Grifols with contractual obligations and tight regulation, rather external non-contracted private enterprises that will take Canadian plasma out of the country and sell it on the open market, thus removing the option of benefiting Canadians. Canadians need life saving medications made from plasma and making these from Canadian plasma is going to benefit us more than sticking to the current strategy where we bleed our tax dollars.