IN SHORT: South Africans were understandably alarmed by rumours that they would have to pay over R3,000 per pint of blood if they needed a blood transfusion, even if they were blood donors themselves. But that's not true.
A Twitter user caused alarm about South Africa's blood donation service in May 2023, when they claimed that people who donate blood have to pay "over R3,000 a pint" should they ever need it themselves.
"It's a form of vampire business," the user said. The tweet was viewed over 420,000 times in a few days, prompting a segment on a popular local radio station.
Other versions of the claim also circulated, including this tweet with over 70,000 views, as well as here, here, here and here.
But do people in South Africa really pay for blood if they need it, despite having donated it for free? We looked into it.
Blood donation and supply
Blood donation is an essential service that generally involves blood being collected and separated into different parts, such as red blood cells, plasma and platelets.
Donated blood is used in emergency medical situations to give to people who need it, like premature babies, children with anaemia, and people who have been in accidents, have had surgery or who have lost blood as a complication of a pregnancy. This process is called a transfusion.
The South African National Blood Service (SANBS) is a non-profit organisation that coordinates blood donation and supply in the country. In 2015, SANBS reported that a blood transfusion happened in South Africa every 48 seconds, and at least 810,000 units of blood were needed in the country each year to meet demand.
Since blood cannot be made synthetically and has a limited shelf life, regular donations from the public are needed to keep stocks of different blood types at a safe level.
'Generally, patients are not expected to pay for blood from their own pockets' - blood service
People donate blood on a voluntary basis. The process of collecting and eventually getting donated blood to patients who need it is an expensive one, according to SANBS.
Dr Karin van den Berg, medical director of SANBS, spoke about the financial side of blood donation on Radio 702. She said that since blood donation services involved high financial costs, and the SANBS was not directly subsidised by the government, the costs involved in providing the service needed to be recovered.
SANBS published a price list for blood products for 2023, some of which cost as much as R3,000.
However, SANBS said that "generally, patients are not expected to pay for blood from their own pockets". Instead, if someone in a public hospital required a blood product, the costs were covered by the government.
If someone is in a private hospital on medical aid, the medical aid covers these costs, which are a prescribed minimum benefit, or a benefit all medical aid schemes must legally provide in all plans.
The only situation where a patient would need to pay directly for a blood product is if they were admitted to a private facility and were not covered by medical aid.
But, SANBS says, patients in this situation could contact them to discuss any financial difficulty around this.
"We have never not given blood to anybody, whether they're a blood donor or not, just because they couldn't pay," Van den Berg clarified. "We have never taken legal action against anybody because they haven't paid us [for blood products]."
Why doesn't SANBS pay donors?
Donors in South Africa are not paid for giving blood to SANBS. "Under the National Health Act 61 of 2003, it is illegal for blood donors to be given any financial or other rewards," according to SANBS.
This is in line with guidelines from the World Health Organization (WHO) and other major public health bodies.
Paying people to donate blood, or giving people who had previously donated blood a discount on blood products should they need to pay for them, "would fall foul of the law", Van den Berg said.
Paying people for blood brings with it challenges that might compromise the health of both the donors and the patients who receive blood transfusions.
SANBS said payment could provide an incentive for people with financial challenges or who were impoverished to donate blood, despite not being eligible in some way that could harm themselves or the patient receiving the blood product.
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Before blood is collected and tested, donors undergo a screening process to determine if donating blood would harm them, for example, because their body weight, blood pressure or iron levels were too low.
The screening also reduces the likelihood that the blood could harm recipients. According to the WHO, prevalence of bloodborne infections is lowest among "regular, voluntary, unpaid blood donors".
Despite not being paid for the blood product, donors are sometimes provided with compensation for any financial loss they had during the process of donating.
The original tweet included a screenshot of a text message, apparently from SANBS, saying people would be rewarded for donating blood with a limited Spotify or Showmax streaming-service subscription.
But, Van den Berg said, this kind of reward was "a small token of appreciation", in line with WHO guidelines, rather than payment for blood.
People in South Africa do not pay for blood transfusion and are not paid to be blood donors.
