National blood authority · Federal-provincial-territorial instrument

Canadian Blood Services: the converged supply

Canadian Blood Services (CBS) is the statutory-adjacent national authority that Canada created in 1998 to manage the blood supply after the tainted-blood scandal. Twenty-seven years later CBS's mandate also includes the national organ-transplant waitlist, the national stem-cell registry, and the plasma-fractionation supply chain. This page states the facts of what CBS is, what it runs, and where the ethical pressure points are — drawn from CBS's own publications, CIHI transplant statistics, and the Krever Commission record.

Origin: the Krever Inquiry

Formed 1998. CBS was established as Canada's blood authority in all provinces and territories except Quebec (where Héma-Québec holds the equivalent mandate) on 28 September 1998, replacing the Canadian Red Cross Blood Services. Source: Canadian Blood Services — Wikipedia reference, citing the federal-provincial memorandum of understanding.
Krever Inquiry context. The Commission of Inquiry on the Blood System in Canada — the Krever Inquiry, 1993-1997 — investigated how HIV-contaminated and hepatitis-C-contaminated blood and blood products were distributed to Canadian patients through the 1980s. The Commission's final report in 1997 recommended a new national blood authority structurally separated from the supplier. CBS is the structural response to that recommendation.
Scale of the harm that created CBS. The Krever record established that roughly 2,000 Canadians contracted HIV and approximately 30,000 contracted hepatitis C from the contaminated blood supply. Federal and provincial compensation programmes — the 1986-1990 HIV compensation programme and the Hepatitis C Compensation Agreement (and its later extensions) — account for the fiscal scale of the harm in the billions of dollars of settlements and compensation over three decades.

Governance and money

Not a Crown corporation. CBS is a not-for-profit corporation, independent of the federal government, created by a federal-provincial-territorial memorandum of understanding. Quebec is not a party; Héma-Québec holds the parallel mandate in Quebec.
2023 financials. CBS reported revenue of approximately CAD $1.37 billion and expenses of approximately CAD $1.38 billion for fiscal 2023. Funding comes primarily from provincial and territorial governments. Source: CBS financial statements summarised at en.wikipedia.org/wiki/Canadian_Blood_Services citing CBS Annual Report.
CEO. Dr. Graham D. Sher has served as Chief Executive Officer of Canadian Blood Services. Dr. Sher joined CBS in 2001 and has held the CEO role since. Source: CBS corporate biographical pages at blood.ca/en/about-us/our-leaders.

The plasma problem: 80% is imported from paid US donors

CBS domestic collection policy. CBS collects plasma in Canada from volunteer, unpaid donors. This is CBS's public policy, stated on its donor pages.
Reality of the supply. CBS's unpaid-donor plasma collection meets approximately 13-14% of Canadian demand for immune globulin (IVIG/SCIG), the principal plasma-derived product used for immune deficiencies and a growing list of other indications. Source: CBS public-facing plasma-sufficiency communications.
Gap is filled from the United States. Approximately 80% of Canada's immune globulin supply is imported, primarily from American plasma fractionators whose source material is from compensated plasma donors in the United States. Canadians relying on IVIG/SCIG therapy are therefore dependent on a supply chain that depends on a paid-donor model CBS itself does not use domestically.
Commercial-model criticism. CBS has been publicly criticised for contracting with Canadian Plasma Resources (CPR) and for partnering with Grifols (Spanish/US plasma fractionator) to operate Canadian paid-plasma collection centres, described as "moving away from an unpaid voluntary donor model towards a commercial model based on monetary incentives". Source: public debate documented at Canadian Blood Services — Wikipedia.

The organ-donation mandate — and the MAiD-donor trend

CBS's mandate was expanded from blood and plasma to include national organ-donation coordination. CBS operates the national transplant registry, the national organ waitlist, and the inter-provincial organ-sharing protocol.

Role on the record. CBS "manage[s] a national transplant registry for inter-provincial organ sharing, operate[s] the national organ waitlist, and manage[s] related programs for organ donation". Source: CBS public-facing corporate pages; blood.ca/en/organs-tissues.
2024 national data. Of the 894 deceased organ donors recorded in Canada in 2024:
  • 64% donated following neurological determination of death,
  • 29% donated following death determination by circulatory criteria where death did not follow MAiD, and
  • 7% donated following medical assistance in dying.
A total of 3,212 organ transplants were performed in Canada in 2024. 5% of those transplants used organs from MAiD donors. Source: CBS System Progress Data reporting at professionaleducation.blood.ca/en/organs-and-tissues/reports/system-progress-data-reporting.
Quebec five-year trend. In Quebec (served by Héma-Québec, not CBS, but the national inter-provincial registry aggregates the data), MAiD donors as a fraction of all deceased donors rose from 4.9% (8 of 164 donors) in 2018 to 14.0% (24 of 171 donors) in 2022. Source: Canadian Medical Association Journal descriptive study, CMAJ 196(3):E79.
Policy document on organ donation after MAiD. CBS co-published the 2023 updated "Deceased organ and tissue donation after medical assistance in dying: guidance for policy", available at PMC article PMC10292956. The document sets out the clinical and consent protocols for donation-after-MAiD — how and when organ procurement may follow an administered death.

The accountability question the numbers raise

This page does not allege that any individual MAiD death was motivated by organ demand. It states what the public record shows about the convergence of two federal-provincial systems.

The two systems converge at CBS. The national MAiD regime is a federal-provincial framework under the Criminal Code (s. 241.2) administered clinically under CAMAP-influenced guidance. The national organ-donation and waitlist system is operated by CBS. Both systems rely on the same provincial hospitals and the same clinician cohort.
Track 2 MAiD and organ suitability. Track 2 MAiD patients (death not reasonably foreseeable) are by definition healthier than Track 1 MAiD patients. Track 2 patients who proceed to MAiD are, on average, more likely to have organs suitable for transplant. Canadian Track 2 eligibility began in March 2021 under Bill C-7. CBS transplant numbers from MAiD donors rose from 4% in 2023 to 5% in 2024, with the Quebec earlier-data trend showing roughly a tripling from 4.9% (2018) to 14% (2022).
Consent and sequencing. The organ-donation-after-MAiD policy requires that the MAiD eligibility decision be complete and documented before the organ-donation discussion opens. CBS's published protocol affirms this sequencing. Whether the sequencing is observed in every hospital, and whether the clinician raising MAiD under CAMAP's 2022 guidance is the same clinician who later approaches the patient about donation, are jurisdiction-by-jurisdiction questions that do not yet have a public national audit answer.
What the record does not contain. There is no published national audit of whether MAiD patients' organ status is known, noted, or considered by the assessing clinician prior to the MAiD eligibility decision. There is no published national audit of the interval between MAiD eligibility determination and the organ-donation coordination contact with the patient. Both are auditable questions and both would strengthen public confidence in the sequencing rule.

Donor eligibility policy: the 2022 change

2022 policy change. Effective 11 September 2022, CBS replaced the men-who-have-sex-with-men deferral policy with a sexual-behaviour-based screening policy applied to all donors regardless of gender or sexual orientation. Under the new policy, a donor is deferred for 3 months if they have had anal sex with new or multiple partners in the preceding 3 months. Source: CBS donor-eligibility pages at blood.ca/en/blood/am-i-eligible-donate-blood.
Policy history. The MSM deferral predated CBS — it was inherited from the Red Cross era. Its replacement followed sustained advocacy by public-health ethicists, civil-society groups, and the federal Standing Committee on Health. CBS's move to behaviour-based screening brought Canadian practice into closer alignment with policies in the United Kingdom (which made a similar change in 2021).

Primary sources cited on this page

Correction policy

This page states facts drawn from the public record. It does not accuse Canadian Blood Services of illegality, and it does not accuse any CBS officer or director of wrongdoing. The accountability questions raised in the "convergence" section are genuinely open questions — they are not allegations. If CBS's public reporting already answers them, we will publish the answer alongside the question, sourced to the CBS document that contains it. If you are from CBS and a fact on this page is inaccurate, cite the correct version to the public record and we will publish the correction on the same page, co-located with the original statement.