An update on our journey to build a more inclusive blood system

*This statement has been updated as of Dec. 15, 2021 at 12:27 ET*

Every day, generous donors across the country make a commitment to help save lives.

Our commitment back to you — our donors, recipients, employees, stakeholders, partners, volunteers and all those who wish to join Canada’s Lifeline — is to build and support a national transfusion and transplantation system that is diverse, equitable and inclusive for all.

At Canadian Blood Services, we are continuing to take necessary steps to further evolve our practices and policies and address systemic discrimination and racism within our organization. We recognize that our future requires a significantly more diverse donor and registrant base in order to meet complex, evolving and underserved patient needs, as well as a workforce that more fully reflects Canada’s population.

“We are committed to diversity, equity and inclusion (DEI) not only because it is the right thing to do, but because as a science- and evidence-based organization, we know that our efforts will help us achieve our vision to help every patient, match every need and serve every person across Canada,” says CEO Dr. Graham Sher.

At our open board meeting on Friday, Dec. 3, 2021, we provided attendees with an update on some of the strategic initiatives we’ve undertaken and implemented since our last public meeting (in June 2021), to advance DEI at Canadian Blood Services:

Moving towards sexual behaviour-based screening for all donors

On Wednesday, Dec. 15, 2021, we made a submission to our regulator, Health Canada, to focus our donor screening criteria on higher-risk sexual behaviour, regardless of gender or sexuality, for all donors and collection types. If approved, this change would allow us to stop asking men if they’ve had sex with another man during our donor screening process.

This is the next step in the process we began nearly a decade ago to make participation in Canada’s Lifeline as inclusive as possible, without compromising the safety of biological products or the adequacy of supply.

Sexual behavior, not sexual orientation, determines risk of sexual transmission of HIV. The change we have proposed would focus on high-risk sexual behaviour among all donors. It would precisely and reliably identify those who may have a transfusion-transmissible infection, regardless of their gender or sexual orientation.

We have more evidence than ever before that this change will not compromise the safety of the blood supply. The evidence we have gathered through the MSM Research Grant Program, international research, epidemiological data and our own extensive risk modelling support the proposed change.

We expect a decision from Health Canada in the first half of 2022. If our submission is approved, implementation would follow several months later, to allow for system updates and staff training.

Expanding eligibility for source plasma donation

In 2019, we started the process of making a change to our source plasma eligibility criteria. In fall 2021, our submission to Health Canada was approved, and since Sept.27, 2021, some gay, bisexual and other men who have sex with men have been eligible to donate plasma at donor centres in Calgary, Alta. and London, Ont.

This is the first time we’ve implemented a screening model that includes sexual behaviour-based questions for men who have sex with men. In these donor centres, gay, bisexual and other men who have sex with men are now eligible to donate source plasma if, in the last three months, they have not had a new sexual partner and if their partner has not had sex with another partner.

While this change marks an important step in our journey toward establishing more equitable blood donation policies and screening processes, our goal remains to focus our screening criteria on higher-risk sexual behaviour among all donors, regardless of gender or sexuality.

Making donor registration more inclusive for trans and non-binary donors

We are currently undertaking work to make donor registration more inclusive for trans and non-binary donors. This includes working with our software system, eProgesa, to incorporate new functionality to support donors’ ability to register their gender in addition to the sex assigned to them at birth.

As part of our Dec. 15 submission to Health Canada for sexual behaviour-based criteria for all donors, regardless of their gender or the sex assigned to them at birth, we also requested to cease asking trans donors about lower genital gender-affirming surgery.

Additionally, to help ensure our donor centres are safe spaces for all donors, our donor centre staff have recently completed mandatory training on trans inclusion. We are committed to working with members of the trans and non-binary community to determine how we can screen donors in a way that is as respectful as possible, without putting recipients at risk.

Developing an Indigenous Reconciliation action plan

Since January 2020, we have been working with Quintessential Research Group Inc., an Indigenous-led consulting firm, on how to respectfully strengthen relationships and partnerships with Indigenous organizations and communities in Canada. To this end, we seek to address existing barriers and improve the representation of Indigenous peoples amongst our donor and registrant base, in order to readily meet rare blood, stem cell and other specific patient needs.

Employees and leaders across the organization have been involved in deepening Indigenous cultural awareness, acquiring knowledge of historical and contemporary issues affecting Indigenous peoples in Canada and developing and enhancing community engagement skills.

To ensure our work with Indigenous communities is meaningful and ongoing, we began taking steps in fall 2021 to create an informed and comprehensive Reconciliation action plan (RAP) to support positive and reciprocal relationships with First Nations, Inuit and Métis peoples.

Creating our RAP is an inclusive process, and once it is ready in March 2022, it will guide our vision for the next several years, focusing on turning our commitments to Reconciliation into actions.

Welcoming our first chief diversity officer

On Dec. 1, 2021, we welcomed Dr. Yasmin Razack as our first chief diversity officer (CDO) and newest member of our executive management team.

In her role as CDO, Dr. Razack will work to advance DEI efforts across our organization, working closely with other senior leaders and all those involved in driving Canadian Blood Services’ DEI strategy to enact meaningful and sustainable change.

Dr. Razack comes to us with nearly two decades of progressive experience in senior leadership roles focused on diversity, equity and community inclusion. For the past seven years, she has served as director of global citizenship, education and inclusion at Centennial College in Toronto. In this capacity, she has actively engaged students, staff and the wider community in transformative learning and the development of collaborative strategic initiatives that address systemic barriers for equity-deserving groups.

Building an inclusive leadership culture

Building an institutional culture of inclusive excellence depends on more than just commitments — it requires leaders who are willing to do the hard work of understanding and addressing systemic inequities and discrimination and acquiring the skills and knowledge to change what they can. As such, leaders at Canadian Blood Services have been involved in mandatory DEI-aligned training to learn how they can more effectively cultivate psychological safety, action change within their roles and further integrate and deepen DEI at all levels of the organization.

Our executive management team has recently undertaken comprehensive training on the impacts of colonization, cultural humility and cultural safety and all people leaders within the organization will be participating in DEI workshops and mental health first aid training in January 2022. Additionally, all leaders and employees have participated in mandatory LGBTQ+ and trans inclusion training; inclusion for employees with disabilities training; and psychological safety training.

“Over the past six months, we’ve marked some important milestones on our journey to build a more inclusive blood system and to foster a culture that is as welcoming as possible. We know, however, that we still have considerable work to do to build trust and repair relationships with historically underrepresented communities and individuals across the country,” says Dr. Sher.

“Though this work, our goal is to ensure that everyone who wishes to join Canada’s Lifeline can do so in the ways that are most meaningful to them, and that every patient has access to the lifesaving products and services they require. We hope that you will continue to hold us accountable for our actions and our commitments to change.”

For more information about our ongoing commitments to diversity, equity and inclusion and to learn more about the progress we’ve made to date, visit blood.ca/DEI.