ARCHIVED - Summative Evaluation of the Blood Safety Contribution Program - Final Report

II. Blood Safety Contribution Program

History of the Blood Safety Contribution Program

Blood safety was recognized as a major issue in Canada following the contamination of the Canadian blood supply with HIV and the Hepatitis C virus in the late 1970’s through the 1980’s. In the Final Report of the Commission of Inquiry on the Blood System in Canada (Krever Report), released in November 1997, Justice Krever emphasized the importance of blood surveillance in the safety of blood. The federal government’s response to the Krever Report included a series of initiatives and provision of additional resources to support and strengthen the safety of Canada's blood system.

In March 1997, Health Canada received approval for activities in support of Blood Safety (Blood ’96). The activities funded were to include regulation of blood, tissues and organs, surveillance and investigation, strategic planning and coordination and litigation. The Centre for Infectious Disease Prevention and Control (CIDPC) [now referred to as Centre for Communicable Diseases and Infection Control (CCDIC)] was allocated additional funding to carry out national blood surveillance activities.

In March 1998, the Surveillance and Epidemiology of Transfusions (SET) working group was created to develop a plan and design a program for a comprehensive blood surveillance system for Canada. Shortly thereafter, in November 1998, Blood Safety Surveillance and Health Care Acquired Infections Division (BSSHCAID) formed to carry out surveillance aspects of blood safety programs.

The Blood Safety Contribution Program (BSCP) formed part of Health Canada’s “Strengthening Health Canada’s Blood Safety Program” (Blood ’98). The program was approved in October 1998, acquiring a funding commitment of $17.5 to $29.6 million annually for the overall effort in the years to follow. Out of this funding, the BSCP was established as a $1.9 million annual contribution program to support surveillance activities related to transfusion/transplantation adverse events across Canada. The BSCP was expanded in 2005 with the approval of “Strengthening the Safety of Drugs, Medical Devices and Other Therapeutic Products” which provided additional contribution funding to the Public Health Agency of Canada for a Cells, Tissues and Organs Surveillance System targeted at the surveillance of transplantation adverse events ($350,000 in 2005-06 and $500,000 in 2006-07 and thereafter).

Funding recipients are both implementation partners as well as beneficiaries. In the short term, recipients benefit as their capacity to conduct surveillance and research is increased. These recipients are not-for-profit organizations, transfusion/transplantation centres and agencies/groups designated by the federal and provincial/territorial authorities of health to conduct surveillance for blood/tissue/organs associate adverse events.

Activities related to blood safety surveillance were originally provided funding under Health Canada and were well under way prior to the emergence of the Public Health Agency of Canada (PHAC). At this point, however, the BSSHCAID, originally formed in November 1998, now falls under PHAC’s IDEP Branch and is currently responsible for establishing the surveillance initiatives associated with the BSCP rough its Transfusion Transmitted Injuries (TTI) Section.  The organizational chart below illustrates TTI Section’s current position within the broader Agency as of October 2008.

Figure 1: Organizational Chart

BSSHCAID’s mission is to prevent, reduce and contain the risk of acquiring health-care associated infections for people who encounter, use or work in the Canadian public health and health care systems. It fosters and engages in partnerships and networks to perform public health activities such as surveillance, risk analysis, policy analysis, and targeted research and dissemination of various communication products. The current priorities are the nosocomial and occupational infections projects and the blood safety surveillance network.

The goals of the TTI Section of the BSSHCAID are: (1) to establish a national surveillance system for Transfusion Transmitted injuries (i.e. infectious diseases and noninfectious adverse events); and, (2) to support targeted research in order to provide information for risk assessment to further reduce the risks associated with blood transfusion in Canada.