The World Health Organization (WHO) has updated its fact sheet on blood safety and availability.
The fact sheet is based on data from several sources and covering several years 2011 through 2013).
Blood transfusion saves lives and improves health, but many patients requiring transfusion do not have timely access to safe blood.
Providing safe and adequate blood should be an integral part of every country’s national health care policy and infrastructure.
In 2013, 73%, or 122 out of 167 countries, had a national blood policy. Overall, 65%, or 108 out of 167 countries, have specific legislation covering the safety and quality of blood transfusion, including:
- 79% of high-income countries;
- 64% of middle-income countries; and
- 41 % of low-income countries.
There are 3 types of blood donors:
- voluntary unpaid
An adequate and reliable supply of safe blood can be assured by a stable base of regular, voluntary, unpaid blood donors.
Of the 112.5 million blood donations collected globally, approximately half of these are collected in the high-income countries, home to 19% of the world’s population.
In low-income countries, up to 65% of blood transfusions are given to children under 5 years of age; whereas in high-income countries, the most frequently transfused patient group is over 65 years of age, accounting for up to 76% of all transfusions.
In high-income countries, transfusion is most commonly used for supportive care in cardiovascular surgery, transplant surgery, massive trauma, and therapy for solid and haematological malignancies.
In low- and middle-income countries it is used more often to manage pregnancy-related complications and severe childhood anaemia.
The blood donation rate in high-income countries is 33.1 donations per 1000 people; 11.7 donations in middle-income countries and 4.6 donations in low-income countries.
Data about the gender profile of blood donors show that globally 28% of blood donations are given by women, although this ranges widely. In 16 of the 119 reporting countries, less than 10% of donations are given by female donors.
An increase of 10.7 million blood donations from voluntary unpaid donors has been reported from 2008 to 2013.
The highest increase of voluntary unpaid blood donations is in the African (85%) and South-East Asian (74%) Regions. The maximum increase in absolute numbers was reported the South-East Asia region (5.3 million donations), followed by the Western Pacific Region (2.8 million donations).
In total, 74 countries collect over 90% of their blood supply from voluntary unpaid blood donors; however, 72 countries collect more than 50% of their blood supply from family/replacement or paid donors.
Only 43 of 175 reporting countries produce plasma-derived medicinal products (PDMP) through the fractionation of plasma collected in the country, whereas the majority of the other 132 countries import PDMP from abroad.
WHO recommends that all blood donations should be screened for infections prior to use. Screening should be mandatory for HIV, hepatitis B, hepatitis C and syphilis.
- 16 countries are not able to screen all donated blood for 1 or more of the above infections.
- Irregular supply of test kits is one of the most commonly reported barriers to screening.
- 81% blood screening laboratories in high-income countries are monitored through external quality assessment schemes, as compared to 55% in middle-income countries and 34 % in low-income countries.
- The prevalence of transfusion-transmissible infections (TTI) in blood donations in high-income countries is considerably lower than in low- and middle-income countries
The capacity to provide patients with the different blood components they require is still limited in low-income countries:
- 43% of the blood collected in low-income countries is separated into components,
- 78% in middle-income countries and
- 96% in high-income countries.
Clinical use of blood:
Unnecessary transfusions and unsafe transfusion practices expose patients to the risk of serious adverse transfusion reactions and transfusion-transmissible infections.
WHO recommends the development of systems, such as hospitals transfusion committees and haemovigilance, to monitor and improve the safety of transfusion processes. In this regard:
- 125 countries have national guidelines on the appropriate clinical use of blood.
- Transfusion committees are present in 67% of the hospitals performing transfusions in high-income countries and in 34% of the hospitals in middle- and low- income countries.
- Clinical audits are conducted in 54% of hospitals performing transfusion in high-income countries and in 42% of hospitals in the middle- and low- income countries.
- Systems for reporting adverse transfusion events are present in 92% of hospitals performing transfusion in high-income countries and 40% in middle- and low- income countries.
- 72% of high-income countries have a national haemovigilance system, compared to only 28% of middle- and low-income countries.
Link to the updated fact sheet:
Link to WHO Guideline document on Blood Donor Selection (English)[PDF] (128 pages):
Link to WHO’s Global database for blood safety:
Link to WHO’s page on Blood Safety: