Dr. John Aneke, a hematologist completing his specialized training in hemoglobinopathy here in Toronto, presenting on the challenges of providing transfusion support for sickle cell patients in his home country of Nigeria

- great majority of blood donors are "commercial” — selling their blood to whomever needs it
- very high rate of transfusion-transmissible disease (eg HIV)
- most transfusions are unmodified whole blood
- no minor blood group antigen matching

This in a country that
- has the highest prevalence of sickle cell diseases in the world (3% of the 200 million population has HgbSS)
- suffers a high burden of other types of anemia (malaria, G6PD)
- requires majority of population to pay for medical care out of pocket

Still, efforts to build a steady supply of voluntary, non-remunerated blood continue.

Worth remembering that a 1945 survey in Canada also noted heavy reliance on paid/replacement donors, with large areas “completely devoid of blood transfusion facilities.”

By 1960, virtually every Canadian acute care hospital was receiving blood products free of charge. Provincial governments provided buildings to serve as collection facilities, but the cost of the national blood program was otherwise paid for entirely by the Canadian Red Cross

“It is difficult to say what is impossible, for the dream of yesterday is the hope of today and the reality of tomorrow.”

Robert H. Goddard