Texas has become a crucial link in a global supply chain that keeps millions of patients alive but is dependent on low-income people who need cash.
Blood plasma, the straw-colored liquid in our veins that carries blood cells, is used in trauma care and surgery, but its biggest role is as the raw material for “plasma-derived therapies.” Those therapies include immunoglobulins for people with primary immune deficiencies, clotting-factor products for bleeding disorders, and other neurological conditions. Because these medicines rely on proteins found only in human plasma, manufacturers cannot simply replace donors with a synthetic substitute.
That dependency has helped fuel a rapidly expanding international market. Cornell’s SC Johnson College of Business estimates the global plasma economy to be at about $35.8 billion in 2024, with projections nearing $80 billion by 2034.
The market’s growth also reflects an unusual imbalance: the United States supplies roughly 70% of the plasma used worldwide for medicines, in large part because it allows cash compensation for frequent donations. In 2023, U.S. blood-product exports were valued at about $37 billion — making blood products one of America’s largest goods exports, ahead of coal and gold.
Texas is the beating heart of the global plasma system as a critical supply source. Texas has roughly 178 plasma collection centers — more than any other state.
Along the Texas-Mexico border, some centers cluster near international crossings, drawing Mexican nationals who legally enter the U.S. to donate for pay — a practice that raises additional questions about cross-border economic pressure and regulation.
Supporters of paid plasma donations argue compensation keeps supply stable and can provide a financial bridge for donors facing tight budgets. Academic work highlighted by the University of Colorado Boulder finds donors skew younger and lower-income, and it links new plasma centers to reduced reliance on high-cost borrowing such as payday loans.
Critics counter that the same facts underscore ethical risk. The World Health Organization advises against compensated systems for human materials, citing exploitation concerns and uncertainty about the long-term health effects of frequent donation.
It is undeniable that plasma is necessary to treat millions of people who otherwise would die or be disabled. But similarly, it’s undeniable that the global system of collecting blood plasma is dependent on people motivated by economic desperation.
It is true that the U.S. donors are willing participants in a market exchange for their plasma and being able to earn additional income is a benefit.
However, casting this exchange as an improvement over the alternative of taking out predatory payday loans is a limited view and avoids the larger question of why so many people are put into a position where they are so impoverished they must go through the discomfort and physical risk of selling their plasma for the profit of a multibillion-dollar global business.
