In Sancti Spíritus, as in other Cuban provinces, blood transfusions increasingly rely on good fortune or the financial means of family members, as official banks report historically low donation numbers, while social media groups see a surge in offers in exchange for a mobile phone or even up to 100 dollars.
What was once an altruistic act is now - without any pretense - turning into a bargaining chip, acknowledged an extensive report published in the official newspaper Escambray.
The scene is familiar: someone posts a desperate plea for a donor for urgent surgery. The responses come quickly: some offer altruistic help; others, a price. Some users are asking for between 3,000 to 12,000 pesos for a donation. Others try to negotiate with food or a high-end mobile phone, as confirmed by several of the testimonials shared by the outlet.
The situation is not new, but it has reached a breaking point. According to the National Office of Statistics and Information (ONEI), Cuba recorded 357,665 blood donations in 2020. In 2023, that number dropped to 254,845, a decrease of nearly 29%.
In Sancti Spíritus, the decline was from 13,634 in 2021 to 7,252 in 2024, representing a drop of 46.8%. This setback cannot be solely attributed to the country's economic exhaustion, but also to the total collapse of the system for attracting and encouraging donors.
The causes: more than scarcity, it is disarticulation
Behind the figures lies a chain of causes, many of which are avoidable. Doctor Mirta Santos León, director of Medical Assistance at the General Health Directorate in the territory, acknowledged that the planning and organization of the program have been inadequate.
"The transportation situation for the operation of mobile blood banks has been inconsistent, as has the provision of snacks for the donors. In 2024, there was a period when we lacked collection bags; this year we haven't had that issue; however, the problem lies in the willingness to donate," he explained.
The covid-19 pandemic also left an open wound: it interrupted the routine of regular donors, many of whom emigrated or reached the age of 65. “The clinics have health monitoring for healthy patients, and before, they had their donors identified and would call them every three months,” something that has been lost, added Raumara Ramos, acting director of the Provincial Blood Bank.
Logistical issues are only the tip of the iceberg. The disinterest from mass organizations like the Committees for the Defense of the Revolution (CDR) has been significant. Jorge Luis Nápoles, the provincial coordinator until recently, admits it openly: “it’s not functioning like it used to; this is a reality that neither the blockade nor the economic situation can justify. The monthly plan for the area is 1,000 donations; today we are falling short.”
He added that, unlike decades ago, doors are no longer knocked on, nor are health hearings or neighborhood debates held on the subject, as this is a province that "has 308,000 members of the cederista movement and a plan for 12,000 donations a year. We have plenty of willing hands to donate."
In Topes de Collantes, for example, donors have been called up to eight times and cannot be attended to because the mobile blood bank does not show up. The blood extraction center in Trinidad, "today with the worst results in the area" and in poor condition, relies on some organization to "provide a vehicle." And in areas like Tunas de Zaza, mobile blood banks haven't arrived in over two years.
When donating doesn't pay off: the lost incentive
Another key factor is the loss of incentives. Donors were previously recognized with diplomas, food packages, or community activities. "It's a shambles that in a bank the snack consists of a poorly made bite and a soda, or not having a sip of coffee to offer" the donor, according to the words of the former coordinator of the CDR.
The donors themselves say: “I don’t do it out of volition, but to help a neighbor”; “I have 50 donations, but they don’t even call me anymore,” “I’ve never donated for personal gain; although they don’t even give diplomas anymore”; “the snacks aren’t the same,” they comment in surveys conducted by the local press.
Some local initiatives, such as those in Taguasco or La Sierpe, have managed to sustain more commendable results thanks to the active management of the authorities. In provinces like Cienfuegos, the government collaborates with small and medium-sized enterprises to ensure at least a basic module for those who donate. However, these are exceptions. In most municipalities, voluntary donations are a relic of the past, the report analyzed
Closed doors, open market
While institutions fail to reactivate the system, the informal market is strengthening. At the entrance of the Provincial Blood Bank in Sancti Spíritus, workers have detected "suspicious movements" of individuals coordinating paid donations. Although it has not been formally proven, everyone in the sector knows: the buying and selling of blood takes place "out the door," the media reported.
Social media groups are another visible scenario. Although the administrators claim they block those who try to sell blood, they acknowledge that such cases are frequent.
“The blood is not for sale. If we detect this detestable act, we will remove the person from the support group,” clarified the Facebook group Blood Donations in Cuba, the administrators Zoila Mora and Alier Proenza, who agreed that there are always opportunists who have interacted with them to sell the donation.
The phenomenon is not only illegal - it can be classified as an illicit economic activity - but it is also ethically unacceptable. “By paying a commercial price for blood, we are no longer talking about a donation; instead, it becomes a transaction; the body is being commodified, and consequently, so is the way humans should relate to one another,” argued sociologist José Neira Milián from the University of Sancti Spíritus.
Neira went further: what is at stake is the moral erosion of a part of society that no longer feels summoned or represented by the values that once mobilized them. And in the face of permissiveness, the phenomenon becomes normalized. “It is no longer a signal, it is a fact and must be addressed as such,” he emphasized.
An urgency that is addressed with temporary fixes
In hospitals, the reality is becoming increasingly harsh. At the Camilo Cienfuegos Provincial General Hospital, the 20 to 30 transfusions conducted daily rely solely on the blood brought in by family members. On April 25, for instance, the provincial blood bank had zero voluntary donations available.
Despite this, emergencies are being addressed, assures the head of the Transfusion Service, Sonia Sánchez. However, everything else—elective surgeries, scheduled treatments—is contingent upon the patient "resolving" it on their own.
Some refuse to donate. They say, “No, I don’t have to donate, mine has to be here when I get sick.” It is unfortunate that this way of thinking still exists, and that people do not understand that blood flows through the veins and is not manufactured by any scientist in a lab; there is no other way but to donate it to save lives,” lamented Aliosky Polo, director of the Camilo Cienfuegos provincial general hospital in Sancti Spíritus.
Can a broken system be rebuilt?
The decline of the National Blood Program is not only a consequence of the multisystemic economic crisis affecting Cuba. It reflects a demobilized structure, lacking true leadership, incentives, and proper conditions. The capacity for mobilization has been lost, bartering and cynicism have become normalized, and the problem continues to grow in the shadow of inaction.
Over a year ago, the Provincial Party Bureau requested to reactivate the program. By 2025, Sancti Spíritus plans to achieve 12,000 donations, according to official plans.
The current situation raises doubts about whether such a goal can be achieved. Mobile banks continue to lack transportation. Donors are not returning. Mass organizations are not coordinating. And while all this happens, blood is still being sold on Facebook as if it were an appliance.
But in the midst of marketing, there are still exceptions. Escambray mentioned the case of the young man Raikol, who, despite needing multiple transfusions due to leukemia, received blood from dozens of people across the country without anyone charging a penny, demonstrating that solidarity is not dead. It just needs to be recognized, encouraged... and protected.
The shortage of donors, the decline in recruitment campaigns, and the precariousness of the healthcare infrastructure are factors that authorities cite as justification for the shortage of blood derivatives in the public health system.
However, at the end of April, the business group BioCubaFarma publicly acknowledged the intention to commercialize the blood plasma from donors as part of a new foreign investment project.
With this initiative, the government not only formalizes the commercialization of its citizens' blood, but also opens a new avenue to finance its pharmaceutical sector amidst the deep economic crisis the island is experiencing.
In 2017, the NGO Archivo Cuba reported that the Cuban government had obtained 34.5 million dollars in a single year from the sale of blood plasma abroad.
Archivo Cuba strengthened these claims in 2021 by announcing that it would publish new studies on the trade in blood and human organs by the Cuban regime.
He also pointed out that official blood donation campaigns, promoted by the government as acts of altruism, concealed the true commercial purpose of many of those extractions.
The research by Archivo Cuba progressed even further in 2022 when it revealed that between 1995 and 2019, the Cuban regime had earned more than 1.323 billion dollars through the sale of blood and its derivatives, tissues, glands, and human organs.
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