Although South African laws governing stem cells and regenerative medicine are still very stringent, there are signs of movement, according to Dr Reza Mia, the nation’s first physician to be certified by the American Board of Regenerative Medicine (ABRM).
He told The Star that while cell therapy and research are still effectively banned in this country, what has changed is that there are now very narrow, clearly defined pathways that allow research and treatment without breaking the law.
The original ban stemmed from ethical concerns around foetal stem cells harvested from fertilised embryos, he said. “At the time, stem cells could only be obtained by destroying a developing baby. That was the core ethical issue, and rightly so.”
But government attitudes are evolving, he added.
Mia is not just an aesthetic doctor: he also leads an aerospace company, and noted that the Department of Science & Technology’s recent decision to award Pegasus Universal Aerospace a second tax incentive – a 150% tax rebate on stem cell research and development – was an encouraging sign.
“That’s a significant step in the right direction,” he said. “It shows the government is willing to support ethical, legally compliant research in a field with enormous potential.”
One of the biggest challenges in regenerative medicine is sourcing safe and effective stem cells. “Autologous stem cells taken from a person’s own fat are legal,” he said, “but those cells are always as old as the patient. They don’t have the same regenerative power we see in younger cell sources.”
Umbilical cord stem cells offer a more potent alternative. “These are young, powerful stem cells that are often simply thrown away after birth,” he said. “In South Africa, they must be obtained from a registered stem cell bank, which dramatically reduces risk.”
Registered banks, he added, subject donors and cells to extensive screening. “The testing is rigorous. It’s designed to ensure no infectious diseases are transmitted to recipients.”
Stem cells are largely immune-agnostic. “Unlike blood transfusions, cross-matching is usually not required.”
The law also strictly regulates who is authorised to perform stem cell procedures. “No doctor can legally do this work without specialised training recognised by the HPCSA,” said Mia.
Global research advances are making regenerative medicine increasingly difficult to ignore, he added. “We’re seeing real remission in Type 1 diabetes, promising results in Parkinson’s disease, heart tissue repair after heart attacks, and cartilage regeneration that could change orthopaedic care.”
Neurological research is also advancing rapidly. “Stem-cell-derived brain organoids are allowing us to model Alzheimer’s disease in ways we never could before,” he said. “That speeds up drug development dramatically.”
“Stem cell medicine isn’t a miracle,” he said. “But the science is advancing fast, and with proper regulation and training, South Africa can participate responsibly.”
Decline in donors on global database
Meanwhile, although there are more than 43m registered stem cell donors worldwide, half of them were recently removed from the registry because their contact details were outdated or for other reasons.
Stem cells are the building blocks of life. Found in bone marrow, they are unique in their ability to regenerate and produce new blood cells.
For patients with life-threatening blood disorders like leukaemia, lymphoma or severe aplastic anaemia, a stem cell transplant is often the last hope, a second chance at life when all else has failed.
The procedure has been a game-changer since 1968, saving lives and transforming families. But matching a donor to a patient is no easy feat. Tissue typing, or Human Leukocyte Antigen (HLA) matching, is incredibly complex.
Why are donors disappearing?
The World Marrow Donor Association (WMDA) reports that nearly 50% of registered donors were removed from the global database in 2023.
The reasons donors are removed vary. Medical conditions, immigration, age limits (donors are retired at 61), or personal withdrawal all play a role. But a significant factor is simply a lack of awareness.
Many donors don’t realise how vital it is to keep their information current or how their decision to donate could save a life.
In South Africa, the South African Bone Marrow Registry (SABMR) says this global decline has already hit home.
“The odds of finding a suitably matched donor are about 1 in 100 000, and for patients from ethnically diverse or mixed heritage backgrounds, those odds are even slimmer,” said Jane Ward, deputy director of the SABMR, adding that 11% of donors had vanished from their system.
“We understand that life gets busy, people move, change phone numbers, or simply forget to update their details. But when someone signs up as a donor, a degree of commitment is required. Lives literally hang in the balance,” Ward said.
Most donors are eager to help, but Ward notes a troubling trend: some people withdraw due to fear or discouragement from family who don’t fully understand the process.
The reality is far less daunting, she added. “Stem cell donation is typically non-invasive, often involving a process similar to donating blood.”
She said patients are only taken to the transplant stage “if we find and contact their match”.
“And if that donor isn’t reachable, there’s often no second option.”
In response to the growing crisis, the SABMR has launched a campaign to strengthen donor retention and engagement, including educational outreach; annual check-ins surveys to confirm donors’ commitment and update their details), and recommitment drives, to ensure recruits understand the lifelong impact of their choice.
Ward emphasised the urgency for younger donors: “Our database is more than 30 years old, and we urgently need new, youthful donors to step up.”
See more from MedicalBrief archives:
SA man donates stem cells to patient in South America
UK launches global-first study to ID stem cell super donors
Lack of ethnic diversity among donors a problem for SA Bone Marrow Registry