The World Health Organization (WHO) Regional Committee for Africa is set to examine and adopt a crucial “Framework to advance universal access to safe, effective and quality-assured blood products in the WHO African Region: 2026–2030”.
This framework addresses persistent challenges in ensuring adequate and equitable access to life-saving blood and blood products across the region, where more than 50% of blood needs remain unmet, leading to severe health consequences.
Blood transfusion is a critical component of healthcare, especially for vulnerable populations such as women with postpartum haemorrhage, children affected by malaria, trauma victims, and patients with chronic conditions like sickle-cell disease. Despite its vital role, Africa remains the WHO region with the most severe blood shortages.
Current Situation and Key Challenges:
In 2022, the WHO African Region, comprising 13.8% of the global population, collected only 5.2 units of blood per 1000 population, well below the WHO-recommended minimum of 10 donations per 1000.
The proportion of voluntary non-remunerated blood donations (VNRBDs) stood at 68.4%, falling short of the 80% recommendation. While 98.5% of donations were screened for the four mandatory transfusion-transmitted infections (TTIs) in 2022, this still falls short of the 100% target, with specific gaps in screening for hepatitis C (97.3%) and syphilis (97.1%).
Major challenges include:
• Limited policies, leadership, and governance: Many countries lack strong legal and regulatory frameworks, political commitment, and awareness regarding the essential role of national blood transfusion services (NBTS). Only 31% of countries have a national haemovigilance system.
• Insufficient skilled workforce and funding: There is a lack of qualified personnel and adequate financial resources.
• Inadequate blood regulatory oversight: Most regulatory authorities prioritize medicines, leaving blood safety oversight weak.
• Limited availability of blood and blood products: Blood shortages are common due to insufficient national donor programmes, cultural resistance, and limited public education.
• Deficiencies in safety and quality assurance: Weak quality management systems, unreliable supply of test kits, and limited participation in external quality assessment schemes compromise blood safety.
• Inappropriate clinical transfusion practices: Gaps in training for medical staff, poor storage practices, and absence of effective hospital transfusion committees contribute to suboptimal use of blood.
• Inefficient data collection and information management: Blood is often not integrated into national health information systems, hindering evidence-based decision-making.
The COVID-19 pandemic further exacerbated these issues, with blood donation rates dropping by 17% in 2020.
Vision, Goal, and Objectives: The framework’s vision is to achieve universal access to safe, effective, and quality-assured blood and blood products, contributing to Universal Health Coverage (UHC) in the WHO African Region.
The goal is to ensure that all people requiring blood transfusion in the Region have access to these essential products.
To achieve this, the framework outlines seven strategic objectives, including:
• Strengthening governance and stewardship.
• Ensuring sustainable financing and increased investments.
• Upgrading infrastructure and equipment.
• Developing human resources for both blood service personnel and clinicians.
• Improving data collection and monitoring.
• Promoting blood donation awareness and education.
• Enhancing surveillance, haemovigilance, and pharmacovigilance systems.
• Optimizing clinical transfusion practices through patient blood management.
• Fostering partnerships and collaboration.
Targets by 2030 include:
• Reaching seven donations per 1000 population.
• Achieving an 80% rate of blood donations from VNRBD.
• Achieving a 100% rate of screening for the four mandatory TTIs.
• 100% of countries (47/47) implementing national guidelines on the clinical use of blood.
• 50% of countries (24/47) establishing national haemovigilance and pharmacovigilance systems.
• 20% of countries (10/47) establishing a national blood regulatory system.
Priority Interventions: Member States are urged to adopt and implement priority interventions tailored to their national contexts. Key actions include:
• Developing and implementing evidence-based policies, plans, and regulatory frameworks.
• Improving management of blood services through well-structured NBTS and enhanced capacity for managers.
• Building human resource capacity through training and integrating blood safety into health curricula.
• Ensuring adequate and sustainable funding by allocating specific government budgets and developing cost-recovery strategies.
• Developing strategies for blood donor education, recruitment, and motivation, emphasizing culturally tailored public education and youth programmes.
• Testing all donated blood in a quality-assured manner and increasing the availability of quality-assured blood components.
• Promoting appropriate clinical use of blood through national guidelines and establishing hospital transfusion committees.
• Strengthening monitoring and evaluation systems to track availability, safety, and quality of blood services.
The WHO will support Member States by providing policy guidance, technical support, capacity-building, and advocacy, while partners are encouraged to provide funding and technical assistance.
The framework underscores that strengthening governance, securing funding, enhancing infrastructure, and promoting voluntary blood donation are key actions required to improve access to safe and effective blood transfusion services.
https://www.afro.who.int/sites/default/files/2025-08/AFR-RC757%20Framework%20to%20advance%20universal%20access%20to%20blood%20products.pdf
