Professor Szer said the ensuing risk of delayed or damaged goods meant the registry could no longer confidently meet patient needs.

“A bone marrow transplant is one of the few elective emergencies that exists,” Professor Szer said. “When we know it needs to happen, we need to plan the treatment precisely around the transplant time.”

Registry chief executive Lisa Smith said the pandemic had highlighted the risks of Australia’s “actively shrinking” donor pool and resulting “policy of dependence on overseas donors”.

“We need significantly increased levels of donor recruitment and to do that we need urgent policy direction from government to support that position,” Ms Smith said.

In the past five years the federal government has commissioned two independent reviews into the bone marrow transplant sector without publishing the findings.

Ms Smith said that government inaction had prompted the registry in 2019 to take the unusual step of spending $600,000 from its emergency contingency reserves to recruit 6000 new donors.

The recruitment project, Strength to Give, drew on international standard practice to pilot online, cheek-swab registration.

Under this recruitment model, people sign up online and have a swab-kit posted to them which they then return by post. The swab sample is sent to a laboratory for tissue testing to allow donors to be matched with patients.

Last year, the federal government contracted the registry to recruit a further 6000 new donors using Strength to Give. But the program ground to a halt four months ago when the additional funds dried up.

Ms Smith said additional investment was required to sustain and build the donor pool to reduce the risk of avoidable patient deaths.

She said the registry needed 100,000 new donors in the next five years and could recruit that number at a cost of only $13 million using Strength to Give.

The registry already holds that amount on trust in unused revenue from the export of cord blood but needs federal government permission to use it to fund donor recruitment. The federal government released $4 million from the cord blood fund in the 2019 financial year for another purpose.

“Sitting on significant sums of money on behalf of [the federal] government while we have this urgent and pressing need for investment into donor recruitment is something we’d like to see resolved,” Ms Smith said.

Thirty-one-year-old Sophie Patnicroft-Gray, who had a bone marrow transplant two years ago after being diagnosed with acute myeloid leukaemia, said, “people will die needlessly” if Strength to Give is not scaled-up and properly funded.

“It’s really heart-breaking that there will be deaths that could have been prevented had the government taken action on this,” Ms Patnicroft-Gray said.

“Knowing the money is there, it doesn’t seem like an outrageous thing to ask the government to fund and prioritise Strength to Give, but it does seem outrageous that the funds are available and are not being used for any purpose.”

The Red Cross model delivers around 5000 new donors to the registry every year from within its blood donor pool.

Cancer charity UR the Cure founder Pamela Bousejean said despite the considerable funding the Red Cross received to recruit new donors, it was “entirely secondary” to its key priority of blood donations.

“It’s sickening to think people will die even though the money is already there to fund Strength to Give and [the federal government] is just ignoring the problem,” she said.

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Ms Bousejean said the Red Cross screening model also had the effect of excluding anyone who could not give blood from joining the registry.

“The [Red Cross] recruitment clearly hasn’t worked,” she said. “We need to build a younger, more ethnically diverse donor pool and Strength to Give is best suited to deliver that.”

The Red Cross declined to say how much funding it received for donor recruitment, the number of people it was contracted to recruit and the cost per person recruited.

“We’re always working to improve outcomes for donors and patients and we’re working closely with the ABMDR to grow the bone marrow [donor pool],” a Red Cross spokesperson said.

The federal department of health said a decision on bone marrow donor reform would be made in the near future.

September marks Blood Cancer Awareness Month. On the Leukaemia Foundation’s latest figures, over 50 Australians are diagnosed with blood cancer every day and it remains the second deadliest cancer in the country.

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