Just half of the blood needed for transfusion each year in the African region is collected, leaving many facing life-threatening shortages. The COVID-19 pandemic has further worsened the shortfall, with donations dropping by 17% over the past year.

One of the critical requirements for blood transfusion is in saving the lives of women who suffer severe bleeding during pregnancy, delivery or after childbirth. Such haemorrhage can be fatal within two hours if untreated. “Without this transfusion, I could have died,” says Guemaime*, who suffered haemorrhage while giving birth recently at Blanche Gomez Mother and Child Hospital in Brazzaville, the capital of the Republic of Congo.

Of the 196 000 women who die each year in sub-Saharan Africa from pregnancy-related complications, a third die from bleeding. Pregnant women need blood transfusion to treat anaemia or bleeding due to pathologies in some pregnancies, says Dr Guy Armand Yoka, gynaecologist and head of the obstetrics department at Blanche Gomez Mother and Child Hospital.

Half of the maternal deaths from severe bleeding in the world occur in sub-Saharan Africa and about 65% of these deaths occur after birth. Mortality ratio per 100 000 live births in the region stands at 542 compared with 10 per 100 000 live births in Europe. Up to 75% of these maternal deaths are directly due to five complications: haemorrhage, sepsis, eclampsia, obstructed labour and abortion complications. Most of these complications require timely availability of blood to save the life of the mother and the child.

While the need for blood is universal, access for all those who need it is not. Blood shortages are particularly acute in developing countries. The severe disruptions to key health services due to the pandemic as well as movement restrictions and other measures to curb the spread of the virus in many African countries have not only reduced blood donations, but also demand, which dropped by 13% owing to the suspension of routine surgeries in some countries and fewer people seeking care in health facilities.

At Congo’s National Blood Transfusion Centre, for instance, donations fell by 10% in 2020 compared with the year before when 85 000 pouches of blood were collected, says Dr Oscar Mokono, the centre’s director, attributing the fall to the pandemic. “Blood concerns us all. We cannot overcome the shortages without donations.”

In 2021, the World Blood Donor Day—marked every year on 14 June—is being celebrated under the theme “Give blood and keep the world beating” to highlight the essential contribution blood donors make to keep saving lives and improving the health of others.

To improve the supply of safe blood in Africa, World Health Organization (WHO) is collaborating with organizations such as the Coalition of Blood for Africa, the Organization of African First Ladies for Development and the private sector to improve access to quality blood supplies. In partnership with Facebook, WHO has also set up a Regional Blood Donations feature, which connects people with nearby blood banks. The tool is now live in 12 countries and over 3.8 million Facebook users have signed up to be notified of blood donation opportunities.

Inadequate financing and lack of effective systems to collect, analyse and ensure safe and steady supply of blood undermine the availability and provision of this critical life-saving product in many countries in Africa, where around 5 million pouches of blood—half of the required quantity—are collected every year.

WHO is also supporting countries through guidelines and policy development, notably national blood transfusion policies, screening and analysis strategies as well as preparation and quality control of blood products.

*Full name withheld to protect identity