Question Period Note: Organ Donation and Transplation

N/A

• Every year, approximately 250 Canadians die while waiting for an organ transplant. As of December 2021, 4,043 Canadians were waiting for an organ transplant, yet only 2,782 received one.
KEY MESSAGES
• Our Government recognizes the value of federal, provincial and territorial collaboration in organ and tissue donation and transplantation, and role of the Conference of Deputy Ministers of Health in supporting government priorities and government-wide policy coherence.
• Health Canada is currently engaging with provinces and territories, Canadian Blood Services, and key stakeholders under the Organ Donation and Transplantation Collaboration to develop a pan-Canadian governance framework for better accessibility, responsiveness, quality, sustainability and accountability of Canada’s organ donation and transplantation system.
• Budget 2019 provided $36.5 million over five years, with $5 million ongoing starting in 2024, for the creation of a pan-Canadian data and performance reporting system for organ donation and transplantation, with provincial and territorial partners, including Quebec, for improving consistency and quality in data across jurisdictions.
• Since 2019, Health Canada has made strategic investments of over $5 million in initiatives that support a better performing organ donation and transplantation system and improves equity in care and access.
• Health Canada also regulates the safety of the system through a national regulatory compliance and enforcement program for minimally manipulated human cells, tissues and organs for transplantation, which includes monitoring serious adverse reactions to transplants.
IF PRESSED ON THE GOVERNMENT’S COMMITMENT TO SUPPORTING ORGAN DONATION AND TRANSPLANTATIONS …
• Since 2019, federal and provincial ministries of health have dedicated efforts to improve the organ donation and transplantation system through the Organ Donation and Transplantation Collaborative, which received endorsement from the Federal, Provincial and Territorial Conference Deputy Ministers of Health. The Collaborative will continue to receive support and direction from Deputy Ministers for pan-Canadian items requiring decision.
IF PRESSED ON THE PRACTICE OF SCREENING MEN WHO HAVE SEX WITH MEN (MSM) AS POTENTIAL ORGAN DONORS …
• Everyone can be considered for organ donation in Canada. Neither the Safety of Human Cells, Tissues and Organs for Transplantation Regulations nor transplant programs will prevent any Canadian from becoming an organ donor based on sex, gender, race, age or sexual orientation.
• Donors are assessed for a variety of risk factors connected with infectious disease transmission. If a potential donor has a risk factor, which could include men having sex with men, the regulations allow for their organs to be used based on the judgment of the transplanting physician and with the informed consent of the recipient. This is included in the Regulations due to the life and death circumstances which make transplantation the only option, and the limited number of donors available.‎
IF PRESSED ON THE NEW COMPLAINT FILED WITH THE CANADIAN HUMAN RIGHTS COMMISSION …
• Health Canada is aware of media reports indicating that a complaint has been filed against multiple agencies including Heath Canada, Canadian Blood Services and Nova Scotia Health Authority alleging discrimination against an individual on the basis of sexual orientation.
• Heath Canada is not aware of the specifics of the complaint and cannot comment further.
IF PRESSED ON EQUITABLE ACCESS TO ORGAN DONATION AND TRANSPLANTATION …
• Health Canada recognizes that there are access inequalities in health services across Canada based on geography, socio-economic status and race/ethnicity.
• The pan-Canadian data and performance reporting system will allow collection and analysis of standardized data from both donors and recipients across the country (including standard socio-demographic variables). This will address current data limitations and facilitate understanding of which population subgroups may be experiencing barriers for accessing high-quality services.
• Health Canada provided $900,000 to an initiative led by Providence Healthcare to improve equitable access to living donor kidney transplantation in communities marginalized by race and ethnicity.
IF PRESSED ON THE WORK OF THE CANADA REVENUE AGENCY OR BILL C-210 …
• While Health Canada defers comments to the Minister of National Revenue on this matter, we want to recognize efforts to leverage the tax and benefit systems to further advance organ donation in Canada. The government believes this arrangement will serve to increase the supply of organs for donation and transplantation, which should further reduce wait-times and save more lives in the process.

The Organ Donation and Transplantation Collaborative (the Collaborative) was launched in early 2018 in collaboration with Canadian Blood Services, various stakeholders, and provinces and territories (Transplant Quebec participates as an observer). The purpose of the Collaborative is to inform thinking and facilitate action and collaboration on improving Canada’s organ donation and transplantation (ODT) system performance. The priorities of the Collaborative are based on comprehensive stakeholder engagement. Membership aims to reflect the spectrum of functional (clinical, administrative, research, patient advocacy), jurisdictional, and geographic stakeholders.
The Collaborative is focusing on two main foundational pillars that includes the development of a pan-Canadian ODT governance framework that identifies decision-making and accountability mechanisms for ensuring timely, effective, and equitable access to ODT services. Ongoing consultations are an important element of this work, and will serve to validate and refine the framework, which includes roles and responsibilities of a Governance Committee, Stakeholder Advisory Committee, Patient/Advocate Advisory Committee and CBS.
The other priority is related to the modernization of a pan-Canadian data system that will support decisions, avoid missed organ opportunities, and improve patient care. Budget 2019 provided Health Canada with $36.5 million over five years, starting in 2019–20, with $5 million per year ongoing, to develop a pan-Canadian data and performance reporting system for ODT, in collaboration with provincial and territorial partners. The Canadian Institute for Health Information (CIHI) and Canada Health Infoway are advancing this work and providing annual updates to the Conference of Deputy Ministers of Health.
Between 2015-16 and 2019-20, the Canadian Institutes of Health Research (CIHR) invested over $110 million in donation and transplantation research, with over $25 million invested in 2019-20 alone. In June 2018, an additional $3.3 million was invested by CIHR and its partners ($2.4 million from CIHR) to support for the Canadian Donation and Transplantation Research Program. This funding has sunsetted.
In May 2023, media attention shed light on an organ donor in Nova Scotia whose offer to donate tissue was rejected due to the individual’s sexual orientation (MSM). It is not apparent if this is a stand-alone matter or if this is more widely spread throughout Nova Scotia and/or into other jurisdictions. It is also not known if this decision was made at the provincial government level (policy) or if it was made at the hospital level (clinical) level. While Health Canada does not have authority in this space, departmental officials are speaking with stakeholders to learn more about this matter and to ensure that federal regulations are being followed.

Canadian Institute for Health Information. Annual Statistics on Organ Replacement in Canada: Dialysis, Transplantation and Donation, 2010 to 2019. Ottawa, ON: CIHI; 2020.

• Canada is still not meeting current and future patient needs for organ transplantation. As a result, many patients in end-stage organ failure die while waiting for a transplant. As of December 31, 2021, a total of 4,043 Canadians were on wait lists to receive a transplant. A total of 2,782 solid organ transplants – such as kidney, heart, lung, and liver – were performed in Canada in 2021. This is an increase of 6% compared to 2020 and a 23% increase compared to 10 years ago.
• Among organs sought, kidneys are the most requested in the country, an account for 60% of all organs transplanted. In 2020, 41,670 Canadians (excluding Quebec) were living with end-stage renal disease. This represents a 31% increase since 2011.