Question Period Note: Blood Donor Deferral Policy and Related Research – Men Who Have Sex with Men (MSM)

• When will the government eliminate the blood donor deferral for gay men?

• Canada has one of the safest blood systems in the world.

• I’m proud that our government has been working on reducing barriers preventing MSM from donating blood by:

o authorizing Canadian Blood Services’ and Héma-Québec’s proposals to reduce the deferral period for donation from five years to 3 months;

o committing $3 million to Canadian Blood Services, starting in 2016, and in collaboration with Héma-Québec, to further advance research on this issue, and

o providing a further $2.4 million over three years, starting in 2019–20, for additional research specific to reducing barriers to the donation of plasma.

• The goal of the Canadian Blood Services MSM research grant program is to generate adequate evidence to inform alternative approaches for blood and plasma donors, which could evolve the current eligibility criteria for men who have sex with men.

• Health Canada remains open to assessing future changes to the MSM donor deferral policy, including its elimination, provided that submissions are received from the blood operators and are supported by scientific evidence.

• The department continues to monitor the progress of the research programs, however research cannot be expedited, especially given the impacts of the COVID-19 pandemic on research projects.

In Canada:
There are no regulations prohibiting MSM and other groups from donating blood. Donor deferrals are policy decisions of the blood operators. However, under Canada's Blood Regulations, CBS and H-Q are required to make submissions to HC for any changes to their processes. HC must evaluate and authorize any changes before they can be implemented. HC has no authority to mandate that a donor screening criterion be changed due to perceived discriminatory aspects.

The first MSM deferral in 1984 prohibited a man who had engaged in sex with another man even once since 1977 from donating blood. On May 22, 2013, HC authorized a request from CBS and H-Q to change its MSM deferral criteria to a five-year deferral period and on June 16, 2016 HC authorized subsequent proposals from CBS and H-Q, to change the blood donor deferral period for MSM from a five-year to a one-year deferral period. On April 30, 2019, HC authorized a submission from CBS and H-Q to further reduce the MSM deferral period to three-months.

There are two main blood donor deferral strategies used internationally to address the risk of HIV and other disease transmission. The first and most common is a time-based deferral based on the higher-risk activities of specific populations, such as the MSM deferral currently applied in Canada. The second is an individual-based deferral that looks at higher-risk activities on a donor-by-donor basis. This is often referred to as a behaviour-based deferral and usually includes questions on new partners or multiple partners of either sex.

In 2016, the Government allocated $3.0 million for research to strengthen the evidence base supporting a non-discriminatory approach to blood donations. Results of these research projects are expected to be available in 2021, to inform future blood donation policies. Budget 2019 further provided $2.4 million over three years, starting in 2019–20, for additional research specific to reducing barriers to the donation of blood plasma. Among the funded studies, alternative donor eligibility questions and criteria are under evaluation for MSM.

International trends:
There is no international scientific consensus regarding donor deferral periods for MSM. Some countries, such as Austria and the Ukraine, maintain indefinite deferral periods, while other countries, including France and Australia, have one-year deferral periods. Others have adopted a 3-month deferral including England, Scotland, Wales, and United States. Some countries, such as Spain and Italy, do not have MSM-specific deferral periods. For example, in Italy the donor screening includes a face-to-face interview in a private and confidential location by a trained physician who is responsible for donor selection.

SYNOPSIS

Health Canada funds research that could inform future changes to blood donation policies. This funding supports blood operators to generate the scientific data required to support a submission to Health Canada for regulatory authorization. Canada’s blood system is internationally recognized for its high safety standards. It is, and will continue to be, one of the safest blood systems in the world.
IF PRESSED…

• Health Canada and the provinces and territories cannot mandate a policy change to donor screening requirements.

• Canadian Blood Services and Héma-Québec must make submissions to Health Canada demonstrating the change’s potential benefit and safety based on up-to-date scientific data. Without this evidence, the current screening policies cannot be changed.
If pressed on the Karas’ Human Rights complaint:

• This matter is presently before the court and further details of Canada’s legal position will be provided to the court.

• Cette affaire est actuellement devant le tribunal et des détails supplémentaires sur la position juridique du Canada seront communiqués au tribunal.