Patients with blood cancer face critical shortage as South Africa's stem cell donor regist

Palesa Mokomele has heard the same story too many times. “They are waiting for one person to come forward,” she says, “and too often that person talked themselves out of registering because they were sure someone else already had.” As Head of Community Engagement and Communications at DKMS Africa, Mokomele sees the human cost of that assumption every day, in the faces of patients with blood cancers and serious blood disorders who cannot find a matching stem cell donor.

South Africa’s donor registry holds roughly 200,000 names. In a country of more than 60 million people, that works out to approximately one registered donor for every 300 citizens, a ratio that leaves thousands of patients in a precarious position. Around 70 percent of those who need a stem cell transplant cannot find a compatible match within their own families and must rely on a stranger from the registry. The remaining 30 percent are fortunate enough to locate a relative who matches. For the majority, the search stretches into a waiting game with no guaranteed end.

The shortage does not fall equally across the population. Because donor compatibility depends on inherited tissue characteristics, patients are far more likely to find a match from someone with a similar genetic background. When certain communities are underrepresented on the registry, patients from those groups face dramatically lower odds of finding a life-saving match. Every gap in representation narrows the field for someone already running out of time.

What makes this crisis particularly difficult to solve is that the barrier is largely psychological. DKMS Africa identifies a pattern researchers call the “diffusion of responsibility,” the tendency for individuals to assume that someone else has already stepped up, making their own action feel unnecessary. At the scale of a national registry, that assumption compounds into a critical shortfall.

Misconceptions about the donation process itself add another layer of hesitation. Many people believe donating stem cells requires major surgery. It does not, at least not in most cases. Approximately 80 percent of donations involve collecting stem cells from the bloodstream through an outpatient procedure comparable to donating plasma or platelets, with no surgery and no overnight hospital stay. In the remaining cases, stem cells are collected from the pelvic bone under general anaesthetic. Either way, the donor’s body naturally replaces what was donated within a few weeks.

Meanwhile, the act of registering carries no medical burden at all. Prospective donors receive a swab kit by post, complete it at home and return it by mail. No blood test or clinic visit is required at the initial stage. Those who register are contacted only if they emerge as a potential match for a patient, and they remain entirely free to decide whether to proceed.

August 15 through October 15 marks Bone Marrow Stem Cell Donation and Leukaemia Awareness Month, a period DKMS Africa is using to push for more registrations and to correct the misconceptions that keep willing donors on the sidelines. The campaign’s core message is direct: the registry will only grow to the size its patients need if individuals stop waiting for one another to act.

For patients already in the system, the question is whether enough people will register in time. Those interested in joining can do so through DKMS Africa’s website. Whether the awareness campaign translates into the volume of new registrations that underrepresented communities need remains the harder test.