As a result of the contamination of blood supplies, Mexican government prohibited the paid donation (1987) and the country formally joined the framework promoted by WHO and PAHO focused on the enhancement of repetitive altruistic donation. Nevertheless, this kind of donation is still minoritarian in the Mexican Republic and it is largely majoritarian a blood management system that has not received particular attention from the social sciences: the replacement donation. In the article, I describe and analyze the dynamics of replacement donation, following the results of a fieldwork that I have conducted in the city of Oaxaca since 2013. In particular I highlight the specificity of this form of blood collection and distribution, based on the empowerment of the families in their search for donors. I pay particular attention to the issues of health inequalities and the difficulties in the access to blood as a therapeutic resource. In conclusion, I discuss the ambiguous position that in the blood-system have the private blood banks and I analyze the tools that they use to act as private companies in a context in which the sale of blood and blood products is formally prohibited.
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