In the 1980s, more than 2,000 people in Canada were infected with HIV and over 30,000 with hepatitis C after they had been administered tainted blood products. In the wake of disaster, an inquiry led by Justice Horace Krever exposed years of negligence, bureaucratic inertia and at times corruption at the Canadian Red Cross Society, then in charge of the blood donation system. In consequence of Krever’s recommendations, 1998 saw the foundation of Canadian Blood Services that replaced Canadian Red Cross Society in managing national blood supplies. It took nearly 20 years of Canadian Blood Services’ leadership and dedication to rebuild the Canadian blood system, make it an international success story, and regain the public trust.
We recently caught up with Dr Sher at Research Outreach and talked with him about the organisation’s role, his role as CEO over the last 20 years and the future of blood donation in Canada.
Can you tell us what attracted you to Canadian Blood Services and what your role there involves?
A few years later, in 2001, I became a CEO. Since then, I have been leading the organisation through a multi-year transformation journey aimed at redesigning the entire service delivery model, introducing best business practices, and growing a culture of high performance.
As part of transforming the national blood system, I have also led Canadian Blood Services through a significant expansion in its scope of services, which led to the organisation assuming a national leadership and coordinating role for both organ and tissue donation and transplantation in Canada, and the development of Canada’s national cord blood banking programme. Finally, I co-founded and continue to actively participate in an international alliance of national blood system operators, with the focus of benchmarking, best practice sharing and global policy advancement in our sector.
Can you give us an overview of what Canadian Blood Services does and what its aims are?
Our responsibilities also include: running national patient registries for organ donation and transplantation; operating the OneMatch Stem Cell and Marrow Network, which matches donors to patients that require stem cells transplants; as well as Canadian Blood Services’ Cord Blood Bank.
Moreover, Canadian Blood Services is involved in research and development efforts focused on several areas of transfusion and transplantation science and medicine. We draw in experts from various disciplines who together can bring innovative thinking to bear on real problems.
Patients depend on us to manage a safe, secure and cost-effective blood system
Why was the decision made to centralise Canada’s blood services in 1998? What have been the organisation’s key achievements in that period?
Back in 1998, we inherited a fragmented blood supply system plagued with critical quality failures, badly ageing facilities, and structural complexity. When I became CEO, I recognised that to transform the system in a long-term and sustainable manner we needed to move from crisis management to strategic management. I set about creating a business framework that allowed us to plan for changes over a long horizon and to move the organisation to a much higher level of operational stability and performance success. Since then, the organisation has integrated about a dozen regional, disconnected supply chains into one seamless national system.
Today, whether patients are in Victoria, Iqaluit, St. John’s, or anywhere in between, they can count on the same high-quality product when they need it, without geographical or financial barriers. When new pathogens emerge, like West Nile virus, SARS, H1N1, or Zika, Canadian Blood Services is at the forefront of an international community of scientists working together to protect patients at home and around the globe.
Can you describe Canadian Blood Services’ role in the national formulary of plasma-derived medicine, and synthetic alternatives? What are the benefits and disadvantages of this system?
We manage a pan-Canadian formulary of approximately 45 brands of plasma protein products, which we bulk-purchase on behalf of provincial governments. For the patient’s standpoint, our product selection process supports patients’ and physicians’ involvement in decision-making. It’s also cost-effective. Bulk-buying and price negotiations bring significant savings.
In addition to collecting plasma for transfusion, we collect plasma to be used as a raw material to produce immune globulin (Ig), a critical, lifesaving drug in very high demand. It is our responsibility to ensure enough plasma goes to manufacturing Ig for Canadian patients.
We currently only collect enough plasma to meet about 17% of the demand for Ig. To meet patient needs, we purchase the remainder of the necessary product from the commercial plasma industry. We plan to expand plasma collections in Canada to ensure a secure supply of plasma for Ig for Canadian patients.
Can you tell us more about the OneMatch Stem Cell and Marrow Network?
What role does Canadian Blood Services have in improving the national levels of blood and organ donation?
Our work in organ donation and transplantation may be less well known. Let me name a few of our initiatives aimed at improving matters in this field. Through the Kidney Paired Donation (KPD) programme, we facilitate medically compatible kidney transplants through chains of donor exchanges from medically incompatible pairs. The Highly Sensitized Patient Kidney (HSP) programme improves chances of a kidney transplant for hard-to-match patients. The National Organ Waitlist (NOW) is a real-time data source for non-renal patients throughout Canada.
We work with stakeholders, partners and physician groups to evolve knowledge, policy and technology. This leads to increased donation and transplantation rates, gives patients the best possible chances to receive transplants with optimal outcomes, and gives families the opportunity to honour their loved one’s wishes to become an organ donor.
With more than 800 transplants resulting from the KPD and HSP programmes combined, many Canadians have received transplants that may never have otherwise occurred.
We draw in experts from various disciplines who together can bring innovative thinking to bear on real problems
You are a haematologist by training, and an expert in transfusion medicine. How did you first become interested in this field?
Back then, unrelated bone marrow stem cell transplants had not become standard of care, and so it was a related transplant or nothing. Fortunately, this patient’s brother was a perfect “6 out of 6” match for her, so all was hopeful and positive. Tragically, the day before the planned bone marrow collection, her brother (and donor) was killed in a motor vehicle accident. As such, no transplant option existed for this patient, and she died some months later after relapse of her leukaemia. These two — she 16, he 19 — were the only children of two remarkable parents, who themselves had been children survivors of the Holocaust in Europe. The capacity of these parents to deal with the enormity of the grief and loss they experienced was the most remarkable display of humanity I had ever witnessed. It was profoundly humbling and entirely remarkable, in ways that defy description. Their impact on me personally was so significant, that I switched paths and dedicated my future career areas, and we need to go where the people go to operate as efficiently as possible and make blood donation as convenient as possible for donors.
- For more information on the Canadian Blood Services, their ground-breaking research and blood donation, please visit their website at blood.ca/en.