Although African countries have made progress by establishing nationally coordinated blood transfusion services, policy frameworks and national standards for collecting, testing, processing, storing and distributing blood and blood products, the 2022 World Health Organization (WHO) African Region Status Report on Blood Availability, Safety and Quality also shows a low number of blood donors in Africa.
The number of facilities accredited by the Africa Society for Blood Transfusion Step-Wise Accreditation Programme doubled between 2013 and 2020. Additionally, the number of countries with policies, legislation, national standards and guidelines for the clinical use of blood increased from 19 in 2013, to 23 in 2020.
“This confirms progressive implementation of the WHO regional strategy on regulating blood and blood products,” the report says, adding that appropriate regulatory systems are key to optimal blood quality, safety and availability.
But according to WHO, blood donation rates remain too low to meet the demand, with 38 African countries recording a combined shortfall of more than 3 million units of blood in 2020.
In Ghana, for example, around 180 000 blood donations were collected in 2022 – far short of the year’s target of 308 000 donations. The COVID-19 pandemic also drove down the number of voluntary blood donors in Kenya, Lesotho, Malawi and Mauritius, from more than 80% to less than 50%.
Significant challenges remain, cautions Dr Mohamed Ismail, team lead for Medicines Supply Health Infrastructure at the WHO Regional Office for Africa:
“With blood collection rates still more than five times lower than high-income countries, accessibility to all who need it remains compromised.”
Weak donor recruitment programmes, cultural resistance and lack of community education are some of the barriers to sufficient availability of blood and blood products needed to save lives, the report says. These factors are compounded by financial constraints, inappropriate clinical use of blood leading to overconsumption, and loss of blood products through a high proportion of discarded blood units, among other things.
Dr Shirley Owusu-Ofori, chief executive officer of the Ghana National Blood Service, says they are intensifying efforts to encourage daily voluntary donations, working with WHO to strengthen capacity and advocacy.
“Emergencies requiring blood cannot wait; we need blood ready all the time,” she points out.
Two-thirds of the donor blood used on the African continent is for internal medicine, gynaecology and paediatric patients, with severe anaemia in women following post-partum haemorrhage accounting for 70% of total blood transfusions in several African countries.
