TORONTO – British authorities opened the door Thursday by allowing some gay men to donate blood, a move Canada’s two blood collection agencies hope to follow.
But concerns about the safety of the blood supply that stem from the tainted blood scandal of the 1990s may lead Canada to adopt a more restrictive policy than the one Britain announced, some figures involved in the debate suggest.
“We’re not totally closed to change at this point, but we need to go carefully,” David Page, national executive director of the Canadian Hemophilia Society, said from Montreal.
On Thursday, Britain joined South Africa, Australia, New Zealand, Japan and several other countries in doing away with the now controversial lifetime ban on blood donations from gay men.
Starting in November, gay men in Britain who haven’t had sex with other gay men for at least 12 months will be eligible to give blood. In South Africa the deferral period is six months; in New Zealand it is five years.
Toronto lawyer Adrian Lomaga, who has been fighting for this type of policy change in Canada, welcomed the news.
“Given the research I’ve seen to date, I think a 12-month deferral period is reasonable. I’m comfortable with that as being a deferral period in Canada,” said Lomaga, who filed a lawsuit against Quebec’s blood agency, Hema-Quebec, when he was a student at McGill University.
“I don’t think it would increase in any significant way the risk to the blood recipients in Canada.”
Lomaga, who is gay, was to see his case go to court in April of this year. But he withdrew it after his legal team was told by lawyers for Health Canada that the Canadian policy was under review and might be changed within the year.
When asked for comment, Health Canada said via email that the department was aware of the British decision. It said it would not approve changes to blood collection operations which increase risk to the recipients of blood products. It did not clarify if it believes a 12-month deferral policy would increase risk nor did it confirm whether the government is open to altering Canada’s policy at this time.
However, spokespeople for both Hema-Quebec and Canadian Blood Services – which operates the blood donation system in the rest of Canada – acknowledged the agencies feel that it’s time for a change.
“Our hope is that we move away from a permanent ban to a timed deferral,” said Dana Devine, vice-president for medical scientific and research services for Canadian Blood Services.
“I can’t tell you now what the number will end up being. But to change the paradigm from infinity – from forever – to something which has a beginning and an end is really what we’re trying to do.”
Marc Germain, Devine’s counterpart at Hema-Quebec, said his agency applied to the Canadian Standards Agency in 2009 to drop the lifetime ban in favour of a deferral.
The standards agency would have to study and recommend a change to Health Canada, which has the final say. The standards agency has started work on the file.
Initially Hema-Quebec suggested a 12-month deferral, but after experiencing push-back from some government experts and from groups representing people who need frequent blood transfusions, it is now recommending a five-year deferral.
“In our case, we’re absolutely certain that going from a lifetime deferral to a five-year deferral or even a one-year deferral – because that’s what we were promoting a couple of years ago – would absolutely make no difference in terms of the risk of HIV (transmission),” Germain said in an interview from Montreal.
From the point of the science, a five-year deferral isn’t warranted, suggested Greta Baeur, an epidemiologist and biostatistician who teaches at the University of Western Ontario. Baeur was an expert witness in the case of Kyle Freeman, a gay man from Thornhill, Ont., who defied the ban by giving blood.
Freeman was sued by Canadian Blood Services and was eventually fined $10,000 for negligent misrepresentation. Bauer was an expert witness for Egale – the acronym stands for Equality for Gays and Lesbians Everywhere – which had legal standing in the case.
She points to a study done in Australia, where the number of units of HIV-infected blood that were detected through mandatory screening was tracked annually for the five years before and after Australia moved to a 12-month deferral policy. The numbers before and after were virtually identical, discounting the claims that lifting the lifetime ban would lead to an increased number of donations of HIV-infected blood, Bauer said.
“We make a claim to evidence-based policy and evidence-based medicine and yet we say: “Well, the evidence is in, but we just don’t feel that that’s right,'” she said.
Germain admitted science isn’t the only thing factored into this decision. The people who rely on the blood system need to feel confident that any change wouldn’t put them in harm’s way, he said.
The shadow of Canada’s tainted blood scandal looms over these discussions. In the 1970s and 1980s, before HIV-AIDS emerged and then before the Red Cross started testing of donated blood for the virus, hundreds of Canadians were infected with HIV and-or hepatitis C.
In the aftermath of the affair, the Red Cross was stripped of responsibility for Canada’s blood supply; Canadian Blood Services and Hema-Quebec were set up to take over the task.
“Our Canadian psyche is marred by the tainted blood scandal and we carry that with us in how we look at this issue,” Devine said.
“And it’s a very important thing to make sure that we keep top of mind. So from our perspective, the blood safety thing really is Job 1.”
Neither Germain nor Devine could predict whether or when a change to the Canadian policies would come, but Germain said the movement in Britain gives him hope more countries will gain the confidence to make this type of change.
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