e-2398 (Health)

The Government of Canada recognizes that too many Canadians are on organ waitlists. Organ donation rates have been improving in Canada but it is clear that there is more work to be done. Every year, hundreds of Canadians die while waiting for an organ transplant. With over 4,300 people in Canada waiting for a transplant and only a fraction of Canadians registered as donors—the need is critical.

Provinces and territories (PTs) are responsible for the management and delivery of health services in their jurisdictions and have the authority to legislate their own policies and programs. As such, the decision to implement an opt-out mechanism for organ and tissue donation falls under their jurisdictions. The decision of the Government of Nova Scotia to implement opt-out legislation for organ and tissue donation makes it the first jurisdiction in North America to do so, with the aim of increasing donations in order to save more lives.

The Government of Canada will continue to work with Canadian Blood Services, the provinces and territories, and other stakeholders to strengthen the donation and transplantation system across Canada.  Recent examples of key federal investments and activities in this area include:

• Health Canada provided an additional $3.1 million over two years to Canadian Blood Services to accelerate work in priority areas to enhance activities such as health professional education, public awareness campaigns, development and implementation of best practices, and system improvements to promote effective and timely access to care.
• Through the Innovative Solutions Canada program, Health Canada invited Canadian small businesses to propose new tools that would use artificial intelligence and deep learning to help specialists quickly and effectively match organ donors and compatible recipients, thus improving the success of organ donations and transplants. Four small businesses received up to $150,000 to refine their research and development and could, if accepted into Phase 2, receive up to $1 million to develop a working prototype.
• On research, the Canadian Institutes of Health Research have invested over $105 million on transplantation over the last 5 years. For example, the Canadian Donation and Transplant Research Program continues advancing research on the many facets of organ and tissue donation and transplantation in Canada. This funding of $3.3 million over three years is a joint investment from the Canadian Institutes of Health Research, Astellas Pharma Canada Inc., the Canadian Liver Foundation, Cystic Fibrosis Canada, the Fonds de recherche du Québec-Santé, and the Kidney Foundation of Canada.
• In 2018, the Government of Canada was pleased to support Motion 189 “Organ and Tissue Donation” which reiterates a commitment to facilitate collaboration on an organ and tissue donation and transplantation system that gives Canadians timely and effective access to care.
• In 2018, the Government supported Bill C-316, which aimed to provide Canadians with another opportunity to learn about how to register for organ donation when filing their income tax returns.
• Budget 2019 proposed $36.5 million over five years and $5 million ongoing to create a pan-Canadian data and performance system for organ donation and transplantation.

The Standing Committee on Health completed a study on Organ Donation in Canada in 2018. As noted in that study, there are many challenges facing the OTDT system in Canada beyond the system of consent.  All levels of government and a wide range of stakeholders must work together on system improvements. The Government Response recognized the need to do more on organ and tissue donation.

To address this challenge, since 2018, Health Canada has been leading an initiative called the Organ Donation and Transplantation Collaborative (the Collaborative) with provinces and territories (except Québec), Canadian Blood Services, patients, families, clinical and administrative stakeholders and researchers. The Collaborative’s goal is to achieve organ donation improvements that result in better patient outcomes and an increase in the number and quality of successful transplantations.

The Collaborative’s priorities are grounded in interviews conducted in 2018 with over 40 experts who provided perspectives on opportunities to improve organ donation rates, patient care and equity of access to donation and transplantation. They also reflect the intent and general direction of the Standing Committee of Health’s 2018 Study on Organ Donation in Canada. Priorities include for example:

• National data to monitor donation and transplantation outcomes and support research and system improvements.
• Improving the efficiency and effectiveness of organ sharing processes across jurisdictions to prevent any missed opportunities for donation.
• Collaboration with and among provinces and territories towards implementation of best or leading practices, for example by maximizing donor identification in hospitals and referrals to transplantation services across Canada and increasing living donation as a preferred treatment option (e.g. kidneys, liver).
• Identifying decision-making and accountability mechanisms to ensure Canadians have access to an organ donation and transplantation system that responds to their needs and those of their families.
• Supporting patient/advocate voices to improve patients’ experiences.

A targeted federal investment of $5 million over 3 years is supporting priorities identified by the Collaborative, including a research initiative evaluating the impact of Nova Scotia’s opt-out legislation, understanding international experiences, and public and health care professional opinions.

Through the Collaborative and other actions, the Government remains firmly committed to improving the organ and tissue donation system in Canada, and most importantly, improving the quality of life of the thousands of Canadians who are currently waiting for a transplant.