Where is the Announcement?

Health Canada has enacted new rules at the end of 2007 prohibiting organ donation from homosexual males. But the CBC reports that as of this week, those in the organ donation business don’t know about it.

Dr. Gary Levy, of University Health Network in Toronto said,

We have not been informed, first of all, that Health Canada is considering this. Obviously if Health Canada wishes to discuss that, we would hope they would engage all stakeholders.

But according to the CBC report, Health Canada is not considering the changes, they have already made them.

A quick search of media releases and documents for the past month fail to reveal any pertinent information.

Avoiding Controversy?

Perhaps the lack of information stems from a desire to avoid controversy on the issue.

We know that Health Canada consults with experts in blood donation to help develop policy, which indirectly affects organ donation. These parties are also involved in a review with Canada Standards Association for similar purposes.

The Health Canada decision follows a previous one last year by Canadian Blood Services,

Today, Canadian Blood Services announced its decision on the policy of indefinitely deferring any male from donating blood if he has had sex with another male, even once, since 1977 (MSM).

The policy is justified by safety concerns,

Blood operators around the world are faced with the fact that there are pathogens for which there are no tests, or as is the case with the AIDS virus – for which there is a limitation to the available test. Even though our test for HIV is state of the art, there is a short time frame, right after acquisition of the virus, that it is not detectable.

But this policy has come under considerable scrutiny, especially by student groups.

James Pepler, President of the University of Saskatchewan Students’ Union said,

It should be changed. It amounts to discrimination and at a time when they (Canadian Blood Services) need blood, they’re not allowing perfectly healthy people to donate.

A Dire Need Made Worse

Health Canada themselves state,

Canada’s organ and tissue donation rate is one of the lowest among western industrialized countries. Donation rates have levelled off at 14.5 donors per million at a time when the need for transplants has increased by 50 per cent.

Adding additional exclusion factors such as homosexuality would seem to shrink the potential donor pool further, and accentuate existing shortages.

Use of Other Criteria?

To avoid accusations of discrimination, and in the interest of equity, it would appear that blood and organ donation services could potentially focus on specific behaviours and practices to screen donors.

For example, activities with multiple partners or lack of protection would seem more indicative than orientation alone.

However, Canadian Blood Services cite similar practices around the world,

At the present time, United States FDA regulations, as well as Council of Europe Regulations, require the indefinite deferral of men who have sex with men even once since 1977. This includes the U.S., the U.K., France, Germany, Switzerland, Holland, Norway, Denmark, Sweden, Finland, Iceland and Hong Kong. There are a few countries that have shorter deferral periods; 1 year – Argentina, Australia, Japan, Hungary; 5 years – South Africa; 10 years – New Zealand. To our knowledge, Italy is the only country that has moved to a deferral based on specific activities.

Also, some cite recent studies that suggest that behaviour alone is not indicative of HIV rates among homosexual males,

In 2005, over half of new HIV infections diagnosed in the US were among gay men, and up to one in five gay men living in cities is thought to be HIV positive.

Yet two large population surveys showed that most gay men had similar numbers of unprotected sexual partners per year as straight men and women.

Authors explain this discrepancy by higher transmission rates among gay males,

Gay men are therefore far more susceptible to the spread of the virus through the population, even with the same numbers of unprotected sexual partners.

But Health Canada, like Canadian Blood Services, could apparently resolve this issue by screening specific sexual behaviours, timing of incidents, and results of any tests since, rather than rejecting individuals only based on orientation.

The CBC report states,

“I think it’s more of an issue of anal sex, anal intercourse, than it is to do with whether someone is gay or straight,” said Dean Robinson, a gay activist.