For a year and a half, event planner Ethan Gill has regularly donated plasma at a commercial donation centre near his home in Whitby, Ont., that was run by an international pharmaceutical company called Grifols.
asserted
that → donate → company
Plasma, a golden-coloured, protein-rich fluid found in blood, is used to produce life-saving medicines for patients with conditions such as a compromised immune system.
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Plasma → find → system
Mr. Gill often went twice a week as one of the ways he gives back to his community, he said – and getting paid up to $70 each time, which he would not be at a Canadian Blood Services centre, was a perk, too.
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he → go → centre
On a recent afternoon in August, he was hooked up to a plasmapheresis machine as normal, and donated nearly a litre of plasma.
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he → hook → plasma
It would be the last donation he would make for the foreseeable future.
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he → make → future
Mr. Gill had no way to know it at the time, but behind the scenes, Grifols’s head office was dealing with an extraordinary situation.
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office → have → situation
For months, Health Canada inspectors had been finding deficiencies at Grifols sites across the country.
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inspectors → find → country
Health Canada’s attempts to get the company to change its practices were repeatedly unsuccessful – but became increasingly urgent after two donors died in Winnipeg and the company began facing intensifying scrutiny in the media and from the public.
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company → get → public
On Wednesday, Aug. 12, Health Canada sent a letter to the company telling it a site in Winnipeg connected to a donor’s death was still not compliant with federal regulations, and with special terms and conditions imposed on the company in March.
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site → send → March
The regulator had already threatened that summer that it could take further compliance actions, even up to suspending Grifols’s licence, if the company did not immediately take action.
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company → threaten → action
That same day Grifols did take action: by telling Health Canada it would stop taking collections in the country indefinitely.
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it → take → country
On Friday, Aug. 14, signs were plastered on the company’s doors across Canada about the indefinite closure.
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signs → plaster → closure
On Sept. 23, Health Canada went through with a suspension of the licence of the Winnipeg site – the first time the regulator had ever suspended a blood establishment licence.
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regulator → go → licence
Grifols gained a major foothold in 2022 as part of a partnership with Canadian Blood Services.
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Grifols → gain → Services
The arrangement was controversial from the start, as Grifols pays donors and CBS does not.
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CBS → pay → donors
While the practice is common in the United States, where most of the global supply of plasma is sourced, it is relatively new to Canada – and unwelcome for those Canadians still haunted by the spectre of the tainted blood scandal of the 1980s.
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it → source → 1980s
But even more deeply, the partnership touched a nerve with some members of the public, advocates and politicians because it essentially gave a commercial entity – a multinational pharmaceutical company headquartered in Spain – responsibility for an important piece of Canada’s health infrastructure.
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it → touch → infrastructure
For some donors, the entrance of commercial plasma collection in Canada has provided a badly needed financial lifeline.
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entrance → provide → lifeline
But it has also exposed questionable practices and urgent questions about the ability of regulators to oversee the kinds of operations that have not existed in Canada until recently.
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that → expose → Canada
The Globe and Mail has spoken to dozens of Canadians – donors, patients, doctors and other health-care professionals involved in blood and plasma collection – and revealed the contents of critical Health Canada inspections in a series of stories published over recent months.
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Globe → speak → months
The saga has raised important questions about how the public and private sectors can work together to provide and protect a scarce – and life-saving – resource.
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sectors → raise → resource
Part 1: A public promise
The roots of Canada’s present blood system reach back to the 1980s.
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roots → reach → 1980s
At that time, the Canadian Red Cross Society collected blood and distributed it to Canadian hospitals – until tens of thousands of patients contracted hepatitis and HIV in a tragedy that came to be known as the tainted blood scandal.
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that → collect → scandal
In the 1990s, Justice Horace Krever led an exhaustive commission that recommended a total overhaul of the blood system.
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that → lead → system
He set out five principles to guide the future: blood is a public resource; donors of blood and plasma should not be paid, except in rare circumstances; Canada should be self-sufficient for blood and blood products; Canadians should have free and universal access to blood and blood products; and the safety of the system is paramount.
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safety → set → system
Federal and provincial governments founded two arm’s-length charities – Canadian Blood Services and Héma-Québec – to run blood and plasma collection outside and inside Quebec, respectively.
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governments → found → Quebec
Both organizations are largely funded by provincial governments.
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organizations → fund → governments
The charities were given responsibility to not only collect and distribute whole blood, which is commonly used for patients in surgery or those injured in emergencies.
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which → give → emergencies
They were also given stewardship of – and the obligation to supply – pharmaceutical products used to treat blood disorders, such as hemophilia, and medicines derived from blood – principally from plasma.
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They → give → plasma
This responsibility has grown substantially over time and buying plasma proteins and related drugs now costs CBS more than $1-billion a year – nearly two-thirds of its annual budget.
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buying → grow → budget
CBS chief executive officer Graham Sher, who has held the role since 2001, says plasma has become the more challenging and expensive part of the organization.
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plasma → hold → organization
“It has added significantly to the size, scale and complexity of our operations,” he said in an interview Monday.
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he → add → interview
CBS set up a network of centres across the country and built the infrastructure necessary to collect and distribute the whole blood Canadians needed.
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Canadians → set → blood
Manufacturing drugs like immunoglobulin, a treatment for patients with immune deficiencies, requires pooling large quantities of plasma and reducing it down to a paste through a process called fractionation.
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Manufacturing → manufacture → process
As CBS collected plasma, it would ship the fluid to manufacturers in the United States or Europe to turn into the pharmaceutical products it would take back.
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it → collect → products
Dr. Sher has long maintained that the organization is not qualified to run such a manufacturing facility.
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organization → maintain → facility
“That is just not something the not-for-profit sector could do,” he said at a 2026 public board meeting.
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he → do → meeting
These manufacturers often collected their own plasma, too.
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manufacturers → collect → plasma
And they used a different business model: unlike non-profit collectors like CBS, who mounted large advertising campaigns that appealed to donor’s altruism, the for-profit plasma collectors paid donors directly.
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collectors → use → donors
That was the easiest and ultimately cheapest way, the companies argued, to create a consistent and recurring supply of plasma to make their drugs.
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companies → argue → drugs
…and 176 more, not listed.
The Aporia
