1. Li Ke saw a toilet filled with blood while caring for her father with lymphoma during his hospital treatment. He needed transfusions two to three times a week; when blood was unavailable, he ached and felt dizzy and weak. Doctors couldn’t say when the next transfusion would arrive. A blood drive organized by her friend’s husband’s soccer team kept him alive for another two weeks. Li, who later joined the mutual-aid platform Nuanbai Xiaowu, says this is not an isolated case, as many blood-disease patients end up this way. [para. 1][para. 2][para. 3][para. 4]
2. China’s blood supply faces a severe test. A National Health Commission bulletin released Aug. 28 showed that 2025 recorded 15.1 million voluntary blood donations, collecting 25.5 million units, with a donation rate of 10.9 per 1,000 people — roughly 11% below 2023 levels. While collection has declined, demand has continued to rise as medical care improves and the population ages. The China Blood Transfusion Industry Development Report 2025 showed that 2024 donations reached 26.9 million units, while clinical demand was about 33 million units, shrinking the buffer between supply and demand. [para. 5][para. 6][para. 7][para. 8]
3. This mounting pressure is forcing reform. The State Council’s 15th Five-Year Plan for National Health aims to strengthen supply and raise the donation rate to 13 per 1,000 people by 2030. China is also preparing its first systematic revision of the Blood Donation Law in nearly 30 years; a draft revision is expected to be submitted to the NPC Standing Committee this year. Proposed changes include raising the maximum donor age to 65 from 55 and reducing the minimum interval between whole-blood donations to three months from six months. [para. 9][para. 10][para. 11]
4. For patients with serious blood disorders, waiting is unavoidable. Lin Xue’s father, diagnosed with acute myeloid leukemia, had hemoglobin falling to 40 grams per liter and platelets to single digits, yet he still couldn’t get a transfusion promptly. Supplies tightened during summer and winter holidays, and he once waited more than 10 days. Chemotherapy destroys the body’s blood-forming capacity, so transfusions are needed for nearly every treatment cycle and for marrow-clearing before transplants. Hospitals typically prioritize emergency and critical-care patients, pregnant women, and new mothers, leaving blood-disorder patients to wait. [para. 14][para. 16][para. 17][para. 19][para. 20][para. 21][para. 22][para. 23]
5. When formal supplies fail, mutual donations from relatives and friends often become the only route. Chen Yun’s brother received more than 10 packed red blood cell transfusions; when his hemoglobin fell to just over 4 grams per liter, doctors told the family they first had to arrange mutual donations. At many hospitals, a “one-for-one exchange” is an open secret: families must “deposit” blood for other patients before blood is released to them, and even then they wait in line, with lower-hemoglobin patients receiving blood first. Chen and her sister donated several times, but mandatory intervals between donations prevented them from sustaining her brother’s needs. [para. 24][para. 25][para. 27][para. 28][para. 29][para. 30][para. 31][para. 32][para. 33]
6. With few alternatives, Chen turned to referred donors and paid them a “nutritional allowance” for directed donations. Patient advocate Jiujiu notes that after six months or a year, families exhaust relatives and friends, then seek “blood scalpers” near blood centers, where two units (each 200 ml) can cost around 5,000 yuan ($744). The gray market grew from the mutual-donation mechanism encouraged by Article 15 of the 1998 Blood Donation Law. Scalpers exploited it, so in September 2017 authorities ordered most localities to gradually scale back and end mutual donations by March 2018; cities like Beijing and Shanghai scrapped their policies. A December 2025 draft of the revised law removed Article 15, yet mutual donations haven’t truly gone away. An emergency-department doctor calls it a “last resort,” and some medical workers tolerate unofficial directed donations due to the conflict between need and compliance requirements. [para. 34][para. 35][para. 36][para. 37][para. 38][para. 39][para. 40][para. 41][para. 42][para. 43][para. 44][para. 45][para. 46]
7. China’s precarious blood balance is squeezed from both sides. Improving medical services and an aging population push demand higher, while the donor pool shrinks. A hematology nurse said hospitals are expanding departments, with one hematology ward becoming two to admit everyone. Geng Hongwu of Tsinghua University said the increase in hospitals, beds, and surgeries places enormous pressure on collection institutions. Official statistics show voluntary donors, collection volume, and donations per 1,000 people all declined 7% in 2024, then another 4.57%, 5.36%, and 4.39% respectively in 2025. Beijing and Guangdong saw rates exceeding 20 per 1,000, but several regions like Shanghai, Hunan, and Shaanxi saw rapid falls in all three measures. [para. 47][para. 48][para. 49][para. 50][para. 51][para. 52][para. 53][para. 54][para. 55]
8. A key factor is fewer births. Young people are the main force in blood donation, but their share of the overall population is declining. Zhou Weihua of Zhejiang University said demographic shifts are already affecting blood collection. The 2024 industry report showed a notable contraction in the 18-25 age group; in Tianjin, donations from that group were 21% lower than in 2021. Zhou warned that as the low-birthrate trend intensifies, the base of eligible blood donors will shrink significantly over the next decade. [para. 56][para. 57][para. 58][para. 59]
AI generated, for reference only
Sign in with Google
Sign in with Facebook
Sign in with 财新