Everyone has a right to life, but not everyone has equal access

Section 11 of the Constitution is unambiguous: everyone has the right to life. Yet in hospital wards across this country, that right is being quietly forfeited by patients who need a stem cell transplant and cannot find a matching donor because the systems, registries, and resources needed to deliver on that constitutional promise have not kept pace with the need. Closing that distance will require, among other things, reaching one million registered donors by 2030.

The search for a match

Finding a matching stem cell donor is, for many people diagnosed with blood cancer or a serious blood disorder, the difference between surviving and not. That match is determined by inherited genetic markers known as Human Leukocyte Antigens (HLA). A registry needs to be both large enough and diverse enough to give every patient a realistic chance, and in South Africa, both remain a work in progress.

A registry is also only as useful as the donors on it are willing to donate. Registration is the first step, but it is not the same as donation, and the gap between the two has real consequences for someone who has waited months for a match, only to find their identified donor is no longer available or willing to proceed.

In practice, this means that if you or someone you love were diagnosed with blood cancer tomorrow, finding a matching donor could come down to one thing: whether enough people who share your genetic heritage have registered, and are willing to follow through. Ordinary South Africans can change those odds.

A system under strain

The challenges extend beyond the registry. Even for those who find a match, access to transplant is far from guaranteed. South Africa should be performing approximately 600 adult and 250 paediatric stem cell transplants annually based on population size alone. In reality, the system currently manages just 139 adult and 18 paediatric procedures per year. Behind those numbers is a system stretched thin: a handful of transplant centres with limited bed capacity, a public health system serving 84% of the population with constrained funding for unrelated donor transplants, and a shortage of the specialist nurses and physicians that this highly technical field demands.

Five years, and what has changed

To build a registry that truly represents the nation, global stem cell organisation DKMS and South Africa's Sunflower Fund merged in 2021 to create DKMS Africa. The results of this consolidation are now visible in the data. In 2019, White patients in South Africa had a 40% chance of finding a match compared to just 19% for Black patients. By 2025, those figures had shifted to 49% and 47% respectively - a near-closing of the equity gap.

The registry has grown nearly tenfold since the merger, now exceeding 173,000 donors, with more than 56% of new registrations coming from people of colour. Consequently, actual transplant activity is rising. In 2021, 11 stem cell collections were enabled; by 2025, that figure had risen to 42. Furthermore, over 2,900 free HLA typing tests have been provided to state patients, removing the financial barrier that previously prevented many from even beginning the search for a donor.

However, a registry is only effective if the medical system acts as a functional partner. To address structural deficits, the Access to Transplant (ATT) programme was introduced to support the ecosystem beyond the donor search. Through collaboration with the global entity, we have sponsored haematology clinicians’ travel to international registries and conferences. This is a vital exercise in capacity building, allowing local professionals to forge partnerships and transfer global best practices back to South African treatment centres. This exchange of expertise is reinforced locally, where regular participation in medical conferences ensures that the latest insights are shared within the fraternity to drive the best outcomes for patients.

Beyond clinical skills, DKMS Africa has implemented patient support services to handle the "hidden costs" of treatment by assisting with transport, nutrition, and psycho-social support.

Looking forward, the focus is on physical infrastructure, with plans to collaborate with facilities on refurbishments and bed capacity to ensure that improved donor odds translate into improved patient outcomes.

The distance still to travel

Reaching one million registered donors by 2030 would mean, for the first time, a registry large and diverse enough that more South Africans have a fair chance of finding a match. Getting there will require government partnership, sustained public education, and a collective decision that patients’ lives are worth the investment.

Corporate partnerships have transformed workplaces into hubs of access by running donor drives that bring the opportunity to register directly to thousands of South Africans. Equally critical is the role of the education sector. Partnerships with TVET colleges and universities, including the University of KwaZulu-Natal and the University of Cape Town, have helped mobilise a new generation of donors. This is a medical necessity, as younger donors are often clinically preferred for transplantation. This commitment to youth engagement continues to deepen, most recently through a Memorandum of Understanding signed with Rosebank College. The progress of the past five years proves that when South Africans understand what is at stake, they respond.

Human Rights Day is an opportunity to measure the distance between the rights we have written down and the rights we actually deliver. For those with blood cancer and blood disorders, that distance is still very wide. It is measurable in searches that return no match and in the people who did not survive long enough for one to be found. Section 11 says everyone has the right to life. Honouring that promise is a matter of sustained investment, collaboration, and the willingness to show up for people we have never met.

About DKMS

DKMS is an international non-profit organization dedicated to the fight against blood cancer. It was founded in Germany in 1991 by Dr. Peter Harf and DKMS together with the organization’s over 1,200 employees and has since relentlessly pursued the aim of giving as many patients as possible a second chance at life. With over 13 million registered donors, DKMS has succeeded in doing this more than 115,000 times to date by providing blood stem cell donations to those in need. This accomplishment has led to DKMS becoming the global leader in the facilitation of unrelated blood stem cell transplants. The organization has offices in Germany, the US, Poland, the UK, Chile, and South Africa. The organization has offices in Germany, the US, Poland, the UK, Chile, India and South Africa.

DKMS is also heavily involved in the fields of medicine and science, with its own research unit focused on continually improving the survival and recovery rate of patients. In its high-performance laboratory, the DKMS Life Science Lab, the organization sets worldwide standards in the typing of potential blood stem cell donors.

DKMS Africa received its WMDA certification in 2025, cementing its position as South Africa’s biggest and most diverse stem cell donor registry.