Principal Director and Head, Pediatric Hematology Oncology and Bone Marrow Transplant, Fortis Memorial Research Institute, Gurgaon, India
Part 2 of 14 in BMT in Sickle Cell Anaemia and Other Haematological Disorders
Why Africa Has No Bone Marrow Donor Registry, and How Haploidentical Transplant Solves It
August 6, 2026
Not even one unrelated bone marrow donor registry exists anywhere in Africa, a gap that Dr. Vikas Dua identifies as one of the biggest obstacles facing African sickle cell patients who need a transplant but do not have a matched sibling. This absence of a registry is a central reason haploidentical, or half-match, transplant has become so important for this patient population.
The Scale of the Registry Gap
Germany holds the largest unrelated donor registry in the world, with the United States holding the second largest. Dr. Vikas Dua contrasts this with the situation across the African continent, where, despite sickle cell disease affecting a huge population, sub-Saharan Africa alone accounting for around 75% of the world's cases, no country has built a comparable registry. Some transplant activity does take place within Africa, notably in South Africa and in Benin City, Nigeria, but patients without a matched sibling and without access to these limited local options have historically had very few paths to a cure.
How Haploidentical Transplant Closes the Gap
Haploidentical transplant uses a half-matched donor, typically a parent, since a mother or father is always a 50% genetic match to their child. This means that unlike a matched sibling transplant, which depends on a 25 to 30% chance of a sibling being a full match, a haploidentical transplant is available to nearly every patient, because nearly every patient has a parent willing and able to donate. Dr. Vikas Dua reports that haploidentical transplant achieves an 85 to 90% cure rate for sickle cell disease, making it a realistic and effective option even where no donor registry exists.
What This Means for Sickle Cell Patients in Africa
For African families exploring sickle cell treatment, the lack of a local donor registry no longer has to be the barrier it once was. By travelling for bone marrow transplant in India and using a parent as a haploidentical donor, patients can access a curative transplant without waiting on a registry that does not exist in their home country. Fortis Memorial Research Institute, Gurgaon has built specific experience in haploidentical transplant for exactly this reason.
← HLA Typing and Donor Matching for Bone Marrow Transplant in India | Series index | Cure Rates for Sickle Cell Bone Marrow Transplant: What the Data Shows →
This article is based on a Jivo Masterclass session conducted by Dr. Vikas Dua, Principal Director and Head, Pediatric Hematology Oncology and Bone Marrow Transplant, Fortis Memorial Research Institute, Gurgaon, India. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass — Dr. Vikas Dua taught doctors across Africa on July 28, 2024.
FROM THE LIVE Q&A
Dr. Paul
Is there a possibility for transplant in prostate cancer, and are there only two donor registry banks in the world?
Dr. Vikas Dua
There is no role of bone marrow transplant in prostate cancer — none, and no research on it either. On registries: the biggest bank is in Germany, the second biggest in the US, but there are many other banks in other parts of the world — there isn't even a single bank in Africa. That's one of the reasons transplants aren't happening in Africa, other than South Africa and some in Benin City, Nigeria. All of you need to come together and have your own registry, so that if somebody requires stem cells, you have your own bank — you people have to come out with the solution.
Frequently Asked Questions
Can the same principles apply in children with cerebral palsy?▼
That's a very good question, but there is no role of bone marrow transplant in cerebral palsy. There are researches going on about whether transplant helps for cerebral palsy, but we don't have an answer in black and white — at the present moment there is no indication for doing a transplant for cerebral palsy.
Is there any age limit for successful bone marrow transplant in sickle cell disease?▼
Sooner is better — it is better to do a transplant early — but we have done transplants even for adults. I showed a picture of a Nigerian person, Mr. Buhari, whose transplant was done at the age of 34, and he's doing well.
How much does the treatment cost, including accommodation, if the patient travels to India, and how long would they stay?▼
For a matched sibling donor transplant, roughly it is around $25,000 for the transplant; for a half-match transplant it is around $35,000. For accommodation and other logistics you need $10,000 more — so roughly $35,000 for a full match and $45,000 for a half match. The stay is around three months.
How do you find HLA compatible donors, and if they have to be found in the family, what criteria are used?▼
We do HLA typing of the patient and siblings — there's a 25 to 30% chance the siblings are a complete match to the patient on HLA. So you need to do HLA typing and you will come to know whether you have a full match in the family or not.
How long exactly are transplant children kept immunosuppressed?▼
Usually after one year we stop all the immunosuppression — only 10 to 15% of patients need it for a longer duration, but in the majority of patients we stop immunosuppression after one year of transplant.
Which countries have the largest bone marrow donor registries?▼
Germany holds the largest unrelated donor registry in the world, with the United States holding the second largest.
Does any African country have an unrelated bone marrow donor registry?▼
No African country currently has an unrelated donor registry, though some transplant activity takes place in South Africa and in Benin City, Nigeria.
How does haploidentical transplant work when no donor registry is available?▼
Haploidentical transplant uses a half matched donor, typically a parent, since a mother or father is always a 50% genetic match to their child. This makes it available to nearly every patient regardless of registry access.
What cure rate does haploidentical transplant achieve for sickle cell disease?▼
Haploidentical transplant achieves an 85 to 90% cure rate for sickle cell disease.
In This Series: BMT in Sickle Cell Anaemia and Other Haematological Disorders
- 1.Bone Marrow Transplant for Sickle Cell Anaemia
- 2.Why Africa Has No Bone Marrow Donor Registry, and How Haploidentical Transplant Solves It
- 3.What Is the Best Age for Bone Marrow Transplant in Sickle Cell Disease?
- 4.Bone Marrow Transplant for Thalassemia in India
- 5.Cord Blood Transplant for Sickle Cell Disease: Is It Used in India?
- 6.Cost of Bone Marrow Transplant for Sickle Cell Anaemia in India
- 7.HLA Typing and Donor Matching for Bone Marrow Transplant in India
- 8.Matched Sibling vs Haploidentical Transplant for Sickle Cell Disease
- 9.Non-Myeloablative Conditioning: Reducing Infertility Risk in Sickle Cell BMT
- 10.Life After Bone Marrow Transplant: Recovery and Immunosuppression
- 11.Who Needs a Bone Marrow Transplant for Sickle Cell Disease?
- 12.Cure Rates for Sickle Cell Bone Marrow Transplant: What the Data Shows
- 13.Sickle Cell Disease Burden in Africa: Why Bone Marrow Transplant Matters
- 14.What Is Bone Marrow Transplant and How Does It Cure Sickle Cell Anaemia?