Health Canada, which describes its relationship with CBS as “arm’s length,” worked closely with the blood authority shaping messaging that paved way for CPR’s arrival.

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The Krever inquiry concluded that blood donation should remain voluntary and unpaid “except in rare circumstances.” Blame for the tragedy lay not only with the Canadian Red Cross reacting too slowly to the AIDS crisis, it concluded; the malfeasance was systemic, driven in part by the profit motive. In addition to collecting blood from volunteers, both agencies work closely with industry, awarding contracts to manufacturers on behalf of provincial and territorial governments. In 2016, CBS spent over $623-million of its $1.1-billion budget on plasma-protein drugs, up from $459-million two years earlier.

Krever also made clear Health Canada must regulate in the interest of the public—not that of companies engaged in commercial activities. Internal government documents suggest neither CBS or Health Canada anticipated the intensity of public protest over CPR. Yet other research indicated paid plasma did affect volunteerism: a 2010 report in the in 2013, CPR representatives met at least twice with Canadian Blood Services between 20, they discussed potential “public-private-sector partnerships,” including CPR testing plasma at CBS labs, using CBS’s storage facility as a backup and referring donors with in-demand blood types to CBS.

Donors are encouraged to give often: “Super Hero Rewards” members qualify for monthly draws; “silver” and “gold” donors are eligible for “prizes valued at over $2,000.” The company promotes plasma donation as an altruistic act (“by becoming a plasma donor, you can help Canada satisfy its own needs for plasma therapies”), even though there are no assurances therapies made by the plasma it collects will end up back in the country.

Eight months later, in October 2016, Canadian Blood Services, the non-profit independent organization entrusted with managing the nation’s blood supply and blood products (Héma-Québec does the same in that province) sounded an alarm about CPR.

was incorporated in July 2009 as the parent of Canadian Plasma Resources, which was registered in November 2010 to operate “plasmapheresis centres.” Plasma collection is high-margin business: extraction that nets the donor $25 can yield therapies worth at least $300, hence the proliferation of paid-plasma centres in the U.

S., Germany, Hungary and the Czech Republic, the four countries where blood brokers are allowed to operate.

Nor had CBS appeared concerned that the for-profit company’s “Give plasma, give life” motto might be confused with CBS’s own “It’s in you to give.” Then in December 2016, CBS announced what those who opposed paid plasma had feared: volunteer blood donation in Saskatoon declined due to CPR’s arrival.

Yet CBS’s concerns didn’t prevent Health Canada from approving CPR’s Moncton collection site in July 2017, effectively setting it up as a competitor with CBS.

In its place: a three-page 2010 document created at a “stakeholder” meeting convened by an industry lobby group.