Canada’s new blood donation policy is a step forward—but there’s still work to be done

Yesterday, Health Canada approved Canadian Blood Services’ proposal to largely lift the deferral period for blood donations by men who have sex with men and some trans people by Sept. 30. The news was met with a mix of praise, relief and disappointment that the policies were still unduly restrictive.

Under the revised policy, a new behaviour-based questionnaire asks whether all potential donors—regardless of their sexuality—have engaged in anal sex with new or multiple sexual partners within the last three months. The reason for the Sept. 30 date, according to Canadian Blood Services CEO, Graham Sher, is that it might take that long to train their 1,600 employees in donor-facing roles.

While every blood donation in Canada is tested for HIV, under current testing capabilities, HIV cannot be detected in a “window period” of approximately nine days after infection—meaning infections in blood from individuals who have very recently been exposed to HIV may not be possible to catch in that window.

Minister for Women and Gender Equality and Youth Marci Ien, who is also responsible for the LGBTQ2 Secretariat, reached out to me when the news came down on Thursday morning. The issue is important to her both as minister, and as the Liberal MP for Toronto’s historic gay village.

“As an ally, I’m absolutely thrilled,” Ien says in a phone interview from isolation after she tested positive for COVID-19 earlier this week. “There wasn’t a door I knocked on during the general election where this wasn’t a huge issue, and it was one thing for me to say, ‘Listen, I absolutely know we have to do more, and I can’t defend that we haven’t done more.’ It’s one thing to say that, but people wanted to see the action, and today we got that action.”

Ien says that this isn’t about the government patting themselves on the back for something that should have been done years ago. She says that, like with conversion therapy, the new guidelines came to pass because activists and regular people said enough was enough.

“They held our feet to the fire, and we’re here,” says Ien.

 Critics have pointed out that today’s decision comes eight years after the Liberals made their initial promise to lift the deferral period. Ien says that the party asked what was needed in order to make the change, and they were told that research would be required.

Because Canadian Blood Services and Héma Québec are arm’s length from the government—which was an important recommendation from the Krever Inquiry in the tainted blood scandal—the federal government could not directly order either agency to make the policy change.

“We came up with the money to make sure that the research was done,” Ien says. “I have to say, we were the first government to do that. While yes, it did take a very long time, that research enabled us to get to where we are today.”

When I asked whether Ien thinks that the party made a promise it couldn’t keep when it comes to lifting this policy or making it happen faster, she pointed out that during a debate in the 2021 election, she agreed with her counterparts that the Liberals did not get it done.

“I’m not going to even try to defend it,” says Ien. “I have been on-side with this since I was voted to serve the people of Toronto Centre.”

One of my frequent criticisms of this government is that they are pathologically incapable of communicating policy challenges effectively, or being frank about what the issues at play are, preferring instead a steady stream of bromides and good-news talking points. The fact that the Liberal Party did not explain the arm’s-length nature of Canadian Blood Services and Héma Québec as the cause of the delays fits into this pattern.

The federal NDP sent out a release that offered measured praise for the decision, but included a particular note of caution.

“We remain concerned about any arbitrary, non-science-based exclusions under the new policy and will join community advocates in working to have those exclusions lifted,” the release stated. 

Advocates have objected, for example, to the three-month window.

NDP MP Blake Desjarlais also raised these continued exclusions in Question Period, and got a vague commitment from Minister of Health Jean-Yves Duclos that the government would keep working toward further changes.

“We’re so grateful to the activists as well as the scientists for having worked over the past few years to get to this outcome, and we look forward to working more together to make sure that Canada is a country in which we can live safely, in dignity, without discrimination,” said Duclos.

During his media availability, Sher noted that the policy changes reflect that their research shows that anal sex is still a significantly higher risk factor for transmission of diseases such as HIV compared to vaginal or oral sex. When it comes to asking donors about condom use, CBS has found that donors “don’t necessarily recall accurately” if they used a condom during every sexual interaction, and there could be slippage or breakage of said condoms. Regarding PrEP use, CBS said that while it can prevent transmission of HIV sexually, there isn’t enough data to show whether or not it can be transmitted through a transfusion, and that research continues.

When I asked Ien if the government plans to continue funding research in order to continue lifting even more of these restrictions, Ien says it’s a good question that she doesn’t have an answer for, but that she will look into it.
While the news was a good step forward, there remains work to be done, and it is incumbent on the government to continue to fund the research—the Liberals should not simply pat themselves on the back for a job well done and consider the matter a fait accompli.