The population of Sub-Saharan Africa has an average annual income of $400–1000 and cannot afford blood produced according to the standards established by affluent countries. To prepare enough safe blood in a sustainable fashion, African countries need to optimize use of their own resources and develop ways to produce affordable safe blood appropriate to their own situations. Uncritical adoption of external advice and models, particularly those from more wealthy countries, may lead to problems of sustainability unless they are adapted for use in resource-poor environments. Sub-Saharan African countries have developed a variety of systems to achieve the objective of producing safe blood. These vary from centralized, high volume, modern blood centers to locally organized donor programs for isolated district health care facilities. The wide range of systems to recruit, select and retain blood donors and of availability of choice of reagents and equipment to screen blood allows flexibility so that the transfusion process can be adapted to local circumstances and resources. With variations in the prevalence rate of HIV, HBV and HCV, the cumulative prevalence is invariably high in Africa and therefore, test sensitivity is critical. Nucleic acid testing is highly sensitive but is not affordable. New inexpensive and effective testing technology as well as pathogen inactivation techniques directed towards the needs of developing countries should become a major target of external support.
Allain, J.P.; Owusu-Ofori, S.; Bates, I. Blood Transfusion in Sub-Saharan Africa. Transfusion Alternatives in Transfusion Medicine (2004) 6 (1) 16-23. [DOI: 10.1111/j.1778-428X.2004.tb00108.x]