By STEFANIA SECCIA, Megaphone
Blood: it’s in you to give, unless you’re a sexually active gay man living in Canada. But one local initiative aims to transform that policy at its core.
The Men who have Sex with Men policy (MSM) came to pass in the United States in the early 1980s, before the virus that causes aids was identified. At the time, homosexual men were noted to be a “particularly high-risk group,” according to a Canadian Blood Services backgrounder. The Canadian Red Cross Society, solely responsible for Canada’s blood supply during this period, followed America’s lead. The society introduced donor eligibility criteria that excluded gay men. The policy was included in Health Canada regulations in 1992. When Canadian Blood Services was created in 1988, its number one mission was to restore Canadians’ trust in the system following the tainted blood scandal.
Any man who had sex with another man — even once — since 1977 was deferred from donating blood. But after reviewing the eligibility criteria in 2013, Canadian Blood Services and Hema-Quebec received approval from Health Canada to reduce that deferral period for MSM from an “indefinite period” to five years without having any sexual contact with another man. So if a gay man has not had sex with another man in five years, and meets all other donor eligibility criteria, then he can donate blood.
Turned away at 18
Despite this change in policy, the furor over excluding the gay community has only gotten louder, says Chad Walters, a Vancouver man working with Canadian Blood Services to someday reverse the policy. Walters was 18 years old when he was asked to leave a blood donation clinic because he was a sexually active gay man.
But instead of focusing on the devastation he felt being turned away, he channeled that energy into researching the Health Canada policy stemming back to the tainted blood scandal of HIV and Hepatitis C getting into the national blood supply in the 1980s.
“I think there are two camps involved here,” he says. “There are those people who are angry and upset and encourage boycotts, and they are more angry at Canadian Blood Services and do nothing but sit in that pool of anger, which is detrimental and has an unethical impact. Boycotts are not the answer, in my opinion. The other camp is people who volunteer at the clinic, people who donate to netcad, are engaged on a policy level and are trying to work with and trying to learn more and understand what all of the factors involved are and why we are where we are.”
Walters has been engaged in working with netcad, a Vancouver-based donor clinic, research and development facility that works with Canadian Blood Services. It takes blood donations from donors who would normally be deferred, so instead of going into the national blood supply for transfusions, the blood is instead used for research. In February 2016, he organized a Rainbow Clinic and Open House event at the facility to raise awareness about the work netcad is doing and the opportunity it provides for sexually active gay men to show that they do want to donate blood. It also was meant to stymie the contentious relationship between Canadian Blood Services and the community.
In December, The U.S. Food and Drug Administration (FDA) altered its 30-year ban on blood donations from gay men, allowing ones who have not had sexual contact with another gay man within 12 months to donate. A statement from the FDA says, “Ultimately, the 12-month deferral window is supported by the best available scientific evidence, at this point in time, relevant to the U.S. population.” While an incremental step in the right direction, gay rights advocates said the policy remains discriminatory.
From five to one?
While Canada is keeping a five-year benchmark, Walters says there is a proposal before Health Canada seeking the same one-year timeframe. “In spring 2016 there should be a response,” he says.
The proposal, penned in October and submitted to Health Canada for approval shortly afterward, was the result of 16 stakeholders representing patient groups and the broad LGBTQ community participating in consultation sessions.
Almost all participants “expressed their personal and organizational support for the proposed change from five years to 12 months,” the report states. “[Participants] spoke about the ‘power’ or ‘authority’ that Canadian Blood Services holds in helping reduce stigma around the MSM population (in particular, within rural areas and more isolated communities).”
Walters notes if this change proves successful, it means Health Canada may be open to behavior-based screening next. In the meantime, he’s encouraging gay men to bring allies in to blood clinics to donate on their behalf.
Dr. Dana Devine, chief medical and scientific officer with Canadian Blood Services who helped develop netcad, says the idea to open the facility 10 years ago was to have a blood center that could change things by helping test new devices and collect data on otherwise inaccessible blood.
“We needed a development sandbox,” she says. “netCAD is a great opportunity to stay connected to people who want to be donors [and] participate in the system but who weren’t eligible for one reason or another.”
The change began with the screening process. NetCAD asks people questions related only to their own health.
“We don’t ask men whether they’ve had sex with another man,” she says. “It’s not relevant to what we’ll do with their blood.”
Devine has worked with Walters, including on the Rainbow Clinic, and helped develop the report to Health Canada on reducing the ban from five years to 12 months.
“We know it’ll still exclude a large majority of men, and so we know that what we have to be able to do is be able to safely and consistently identify that population of sexually active gay men who have no more risk than all the other people we allow to donate,” Devine said. “What we have to be able to do is prove to Health Canada we can reliably identify those guys, and say to Health Canada, ‘They’re safe donors, and we’re not introducing a risk.’”
In the next two years, Devine says there will be a better line of sight of what it will take to get Health Canada to a behavior-based system for the community. “Something on a three- to four-year timeline from now,” she says. “We’re committed to do this.”
The need for blood
February tends to be a difficult time for the national blood supply, Devine says, after the hustle and bustle of the holiday season. It serves as a reminder of how much Canadian Blood Services could use having a wider population base to pull from — particularly one that has been denied the right to donate for so long.
“We look for people all year round,” she says. “When we look at overall numbers, we lose about four out of every 10 donors every year because they’ve got something else going on, or travel to a place with Malaria and get deferred for 12 months. The natural turnover of blood donors is about 40 percent of the donor population. We need about 100,000 new blood donors in 2016.”
While the uphill, incremental fight to ultimately reverse the ban on gay men is slowly being backed by science and stakeholder consultations, it’s ultimately up to a reluctant Health Canada, fearful of and careful to not repeat the mistakes of the past.
As Walters says, “Progress is happening. It is slow. Legislation and policy, this stuff moves at a glacial pace — slower than public opinion, social media, and science expects."
Courtesy of INSP.ngo / Megaphone