Blood Transfusion in Economically Restricted and Developing Countries

Over the past 10–20 years there have been major improvements in blood safety in low and lower middle-income countries (LIC, LMIC), largely driven by the human immunodeficiency virus (HIV) epidemic. Unfortunately, improvements in blood supply adequacy have not been as marked, and many challenges to the provision of an adequate supply of safe blood in these countries remain, particularly in countries that have relied or still rely heavily on external funding. Indeed, these challenges could increase if external funding decreases without concomitant increase in country-based funding. This chapter reviews some of these challenges with particular reference to sub-Saharan Africa (SSA) outside of southern Africa, where most countries are LIC or LMIC.

Income groups referred to are those defined by the World Bank (LIC, LMIC, and high-income country [HIC] being countries with gross national income per capita in 2017–18 of ≤US$1005, US$1006–3995 and ≥US$12,236, respectively) and, unless stated otherwise, data concerning transfusion activities are taken from the World Health Organization (WHO) 2016 Global Status on Blood Safety and Availability (GDBS), which is based on data reported from 180 countries, primarily data collected in 2013.