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Saturday, June 2, 2018

Bans on paying for plasma put supply at risk

Bans on paying for human blood distort a vital global market - The Economist:

May 10, 2018 - "A willing buyer in a market with plenty of willing sellers, Barzin Bahardoust is finding life surprisingly hard. For years he has been trying to pay Canadians for their blood plasma — the viscous straw-coloured liquid in blood that has remarkable therapeutic powers. When his firm, Canadian Plasma Resources (CPR), tried to open clinics in Ontario in 2014, a campaign by local activists led to a ban by the provincial government on paid plasma collection. Undeterred, he tried another province, Alberta — which also banned the practice last year. Then, on April 26th, when CPR announced a planned centre in British Columbia, its government said it too was considering similar legislation. CPR has managed to open two centres, in far-flung Saskatchewan and New Brunswick. Even these have faced opposition.

"The global demand for plasma is growing, and cannot be met through altruistic donations alone. Global plasma exports were worth $126bn in 2016 — more than exports of aeroplanes.... But Canadian reservations about paid plasma are shared across most of the world. America, China, parts of Canada and some European countries are among the few places that permit it....

"Only countries that pay for plasma are self-sufficient in it. (Italy, where donors are given time off work, is close to self-sufficiency.) Half of America’s plasma is shipped to Europe — 20m contributions-worth. Canada imports 80% of its plasma products from America....

"Exported plasma is used to manufacture pharmaceuticals.... Pharmaceutical plasma ... has all manner of uses. If blood fails to clot properly, as in haemophiliacs, a plasma product helps. A plasma product can restore an immune system weakened, for example, by chemotherapy. A complication known as Rhesus disease, in which the blood type of a fetus is incompatible with the mother’s was responsible for 10% of stillbirths in America as recently as the 1960s. These days plasma products can save the child.

"Plasma today is mostly collected via apheresis, a process where whole blood is extracted, spun in a centrifuge, and the plasma is skimmed off. Red blood-cells are then mixed with an anticoagulant and transfused back into the donor.... Plasma donors can give up to 800ml of plasma — and in America are allowed to do so twice a week.... In a year a plasma donor could give over 80 litres of the stuff, compared with just 1.6 litres from a whole-blood donor. Mr Bult says paid repeat donors, who have been intensively screened, help keep plasma products safe.

"But a stigma about paying for blood lingers.... Some data, for example, lend weight to the suspicion that it preys on the poor.... The other worry ... is that paying for plasma may lead to a reduction in whole-blood donation. But Peter Jaworski, of Georgetown University, is sceptical, suggesting that, anecdotes aside, the evidence shows paid plasma donation 'does not crowd out voluntary blood-donation'. Americans, for example, continue to donate as much voluntary blood per head as do Canadians.

"The aversion to paid-for plasma carries its own risks... the geographic imbalance puts supplies of plasma products at risk. At the plasma industry’s main annual conference, held this year in Budapest in March, over-reliance on imports from America was a hot topic. Representatives from several countries (including Canada) recognised they must do more to diversify their supplies. Making it legal to pay for plasma is an obvious first step."

Read more: https://www.economist.com/international/2018/05/12/bans-on-paying-for-human-blood-distort-a-vital-global-market
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