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Pay donors in 3rd world countries with under-represented populations to register and donate

Certain populations are under-represented in existing bone marrow registries. The majority of these populations are in countries with relatively low incomes. Pay donors in these countries a small amount to register and a larger amount to donate.

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Written by DeletedUser

The perception is that bone marrow donors are not paid, and only in special situations are they reimbursed. The perceived risk is also greater compared to donating blood. Paraphrased from, "donors can have headaches, joint or muscle aches, or fatigue for 1-2 days due to a drug called filgrastim, and experience soreness 1-2 weeks after. Most marrow donors are back to their normal activities in two to seven days." Apparently, not enough people would willing do something that may take them out for two to seven days for free. If they were rewarded with $1,000 a greater amount would be willing to donate, and if the reward was $10,000 an even greater amount would be willing to donate. To increase the supply of bone marrow registrants and donors, pay potential donors a small amount to register, cotton swab and etc., and a larger amount to donate. People respond to incentives. Blood donors are paid either in cash or goods such as movie tickets. Why not give bone marrow donors similar incentives? The question then becomes what is the cheapest most efficient way to do so. I believe paying people in 3rd world countries money, food, or goods to register and donate is the most cost effective.

Here are the 2009 per capita GNI (PPP) numbers for the populations/countries mentioned as having under-represented bone marrow registries. Per capita GNI is a measure of how much income each person makes.

Country GNI GNI per day

Bangladesh 1550 4.25

Bhutan 5290 14.49

India 3250 8.90

Maldives 5250 14.38

Nepal 1180 3.23

Pakistan 2680 7.34

Afghanistan* 860 2.36

Sri Lanka 4720 12.93

* - 2008 numbers

So for a mere $3.23, you can pay what the average person in Nepal makes in a day to get him or her to register. That is a strong incentive for 5-10 minutes of their time. To get them to donate, they should at least be paid what ever time they cannot work due to soreness and the side effects of filbastrim which usually is 2-7 days. Insurance in addition to medical care should be made available at no cost. 30 days wages in Nepal would be around $97. A whole month's worth of wages/goods/services is great for 2-7 days of soreness.


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Photo of Adam Rodriguez

I would encourage that you expand this to also include people from the developed world. A small amount of money, or a gift card as a thank you, is not unprecedented. Blood banks give you cookies after you donate might get more interest if that same blood bank handed out the monetary value of those cookies ($2).

Veronica, your point is a good one. My creating the market, you are legitimizing the trade. That said, in some cases, a regulated legitimate market is often better for all involved than an unregulated black market for those same goods.

My concern regarding using 3rd world countries is that their bone marrow will be primarily benefiting the rich urban elite. If I live off the grid in a poor village in SE Asia, and I have cancer, even if my mother donates bone marrow, I will never have the means for a transplant.

That said, based on my experience in rural Cambodia, I believe that the cost to register could be much, much lower. For a simple cheek swab, people would be lining up for the equivalent of 12 cents.

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I love this idea because it 1) could reach the populations whose registration is most needed, and 2) because it connects people internationally for a common cause. However, I can't stop the business half of me from wondering how to pay for it?

Photo of Veronica Bluguermann

@Krassimira, thanks for your observation, it's a difficult topic. Anyways, I think is the same case as people selling their children. Same as in Argentina where I come from. Young women are kidnapped and force to prostitute themselves in order to give money to someone who is in charge.
Theses are examples of unofficial markets. But If you create the market you are allowing this things to happen.
Giving money neither will change people's attitude towards donation, nor will put a population in a better situation.
This is my opinion based on my ideals and values, it doesn't mean that I'm right.
Interesting debate!

Photo of Krassimira Iordanova

Matthew, I believe you're bringing a great point.
@Veronica: In the country where I come from, Bulgaria, and in the neighbouring country, Romania, the folks from the Roma community (a subgroup that populates Central and Eastern Europe) live in extreme poverty and it is not unusal that they sell their children for as low as 50$. If they are offered the possibility to register and donate blood/bone marrow and be given monetary incentives, they will definitley do so compared to other alternatives.

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Matthew, thanks for your post. The question of how we can incentivize people to sign up to donate is a common and very important one. We encourage you to hold on to this for the Concepting phase as it's really a potential solution we should all explore together.

Veronica, your comment raises some good questions too, and clearly there's a need for some more discussion during Concepting. In the meantime, are there examples of existing campaigns or programs that have successfully gotten people from all walks of life to register as donors? The Inspiration phase is a great time for research - and we'll be excited to hear what everyone comes up with.

Photo of Veronica Bluguermann

I’m concern about this inspirational concept. This idea reveals how 3rd world countries had suffered (and suffer) from the abuse of power of 1st world countries by showing a little bit of money or just more intimidatory ways. This countries need a change no your pocket change. Where does their donation go? Is it for them? To help themselves? I’m pretty sure it doesn’t.
Secondly I think this author does not know how people live and work in those places. I think is not correct the assumption that paying people for taking a couple of days off will make them go for it.
Lastly, I think the author should be more informed about behavioral change. Giving a reward doesn’t make a true change.
Sorry if I’m to critical.