The world is running low on blood, first global analysis reveals

The world is in the midst of a critical shortage of blood essential for life-saving transfusions, researchers have warned.

A global report showed 119 out of 196 countries – mainly in Africa, Oceania and south Asia – do not have enough supply to meet hospital demands.

Those nations combined are more than 100million units of blood short of World Health Organisation (WHO) targets. They are all middle-to-low-income.

The WHO recommends countries have at least 10 donations per 1,000 people. But in Africa, 38 countries collect fewer than that target, researchers estimate.

South Sudan was found to have the lowest supply of blood at just 46 units per 100,000 people. 

The world is in the midst of a critical shortage of blood essential for life-saving transfusions. Researchers estimate 119 countries do not have enough supply to meet hospital demands. They include nations in Africa, Oceania and south Asia (shown in red, yellow and orange)

Researchers said the African nation’s need for blood was 75 times greater than its supply. 

The scientists found India had the largest absolute shortage, with the country experiencing a shortfall of nearly 41million units. 

They say more investment needs to be made in low and middle-income countries to expand national transfusion services. 

Transfusions save millions of lives each year and replace blood that is lost through surgery or injury or provide it if your body is not making blood properly.

Patients may need a blood transfusion if they have anaemia, sickle cell disease, a bleeding disorder such as hemophilia, or cancer.

Developing countries rely on these transfusions due to a higher prevalence of blood-borne diseases and complications during pregnancy.


Most people can give blood.

Donors have to be:

  • Fit and healthy
  • Weigh between 50kg (7st 12lbs) and 160kg (25st)
  • Aged 17-to-66 

Donors can be 70 if they have given blood before, or older if they have donated in the past two years. 

Men can donate every 12 weeks and women every 16 weeks.

Males can give more frequently due to them generally weighing more, which correlates to them having more iron. 

Giving blood removes iron from the body. 

This is an essential mineral that helps to give a person strength and energy.

A person may be unable to give blood if they:

  • Are undergoing medical or hospital treatment
  • Take certain medication
  • Have traveled to ‘restricted areas’ recently
  • Have a tattoo or piercing
  • Are pregnant or recently gave birth
  • Feel ill
  • Have cancer
  • Are receiving blood or an organ transplant

Source: NHS Blood and Transplant 

More than 100million units of blood are donated each year to these nations, which make up 80 per cent of the entire world’s population.  

High-income countries, home to just 16 per cent of the global population, bear the burden of this, providing 42 per cent of the blood in developing nation’s banks.   

For their study, researchers from the University of Washington looked at the WHO Global Status Report on Blood Safety and Availability for every country in the world.

To estimate the total blood needs of any one country, the researchers calculated how many units of blood would be needed for 20 different medical conditions.

Taking into account their prevalence by region, the team then estimated the gap between supply and demand in each one of these nations. 

They then cross referenced this with data from the WHO Global Status Report on Blood Safety and a 2017 Global Burden of Disease study.

The team based blood usage rates using US inpatient practices.

They note this may underestimate the true blood needs in developing countries where tropical diseases, STIs and malaria are far more common than they are in America.

But they say these initial findings give health bosses a rough estimate which can help them prepare for the future. 

Their findings, published in the journal The Lancet, revealed every single country needed more blood than the WHO goal. 

The team of academics calculated total blood supply around the world was around 272million units. 

But with demand being 303m units, the world was 30m units of blood short. In the 119 countries with insufficient supply, that shortfall reached 100million units.

And, with exponentially increasing populations and greater access to hospital care, demand is only going to increase, the researchers say.  

Lead author Meghan Delaney, from the Children’s National Hospital in Washington, said: ‘As more people are able to access care in low and middle income countries, the demand for blood transfusions will increase further.

‘And – without financial, structural and regulatory support – will widen the gap we’ve uncovered between global supply and demand of blood.’

Co-author Christina Fitzmaurice, a professor in haematology at the University of Washington, added: ‘Other studies have focused on blood safety, such as the risk of transmitting infections such as HIV.

‘But ours is the first to identify where the most critical shortages lie, and therefore where the most work needs to be done by governments to increase donation, scale-up transfusion services, and develop alternatives.’ 

Writing in the study, the authors conclude: ‘Strategic investments are needed in many low-income and middle-income countries to expand national transfusion services, blood management systems, and alternatives to blood transfusions.

‘There is a large unmet need for more government support, financially, structurally, and through establishment of a regulatory oversight to ensure supply, quality, and safety.’ 


Blood transfusion

A blood transfusion is when you’re given blood from someone else (a donor). It’s a very safe procedure that can be lifesaving.

Why it’s done

A blood transfusion may be needed if you have a shortage of red blood cells.

This may be because your body’s not making enough red blood cells or because you have lost blood.

For example, you may need a blood transfusion if you have:

  • a condition that affects the way your red blood cells work – such as sickle cell disease or thalassaemia
  • a type of cancer or cancer treatment that can affect blood cells – including leukaemia, chemotherapy or stem cell transplants
  • severe bleeding – usually from surgery, childbirth or a serious accident

A blood transfusion can replace blood you have lost, or just replace the liquid or cells found in blood (such as red blood cells, plasma or cells called platelets).

Ask your doctor or nurse why they think you might need a transfusion if you’re not sure.

What happens

Before having a blood transfusion, the procedure will be explained to you and you’ll be asked to sign a consent form.

A sample of your blood will also be taken to check your blood group.

You’ll only be given blood that’s safe for someone with your blood group.

During a blood transfusion:

  • You sit or lie down in a chair or bed.
  • A needle is inserted into a vein in your arm or hand.
  • The needle is connected to a tube and a bag of blood.
  • The blood runs through the tube into your vein.

It can take up to 4 hours to receive 1 bag of blood, but it’s usually faster than this.

You can normally go home soon after, unless you’re seriously unwell or needed a lot of blood.

How you might feel during and after

You might feel a sharp prick when the needle is first inserted into your vein, but you should not feel anything during the transfusion.

You’ll be checked regularly while receiving the blood. Tell a member of staff if you feel unwell or uncomfortable.

Some people develop a temperature, chills or a rash. This is usually treated with paracetamol or by slowing down the transfusion.

Your arm or hand may ache and have a bruise for a few days after.

Contact a GP if you feel unwell within 24 hours of having a blood transfusion, especially if you have difficulty breathing or pain in your chest or back.


Blood transfusions are common and very safe procedures.

All donor blood is checked before it’s used to make sure it does not contain serious infections such as hepatitis or HIV.

There’s a very small risk of complications, such as:

  • an allergic reaction to the donor blood
  • a problem with your heart, lungs or immune system (the body’s defence against illness and infection)

The risks will be explained before having a transfusion, unless this is not possible – for example, if you need an emergency transfusion.

Speak to your doctor or nurse if you have any concerns.


A blood transfusion will only be recommended if it’s needed and other treatments will not help.

If it’s possible that you’ll need a transfusion (for example, if you’re due to have surgery or you have anaemia), you may sometimes be given medicine to:

  • lower your risk of bleeding, such as tranexamic acid
  • boost your number of red blood cells, such as iron tablets or injections

These can reduce your chances of needing a blood transfusion.

Giving blood afterwards

Currently, you cannot give blood if you have had a blood transfusion.

This is a precautionary measure to reduce the risk of a serious condition called variant CJD (vCJD) being passed on by donors.

Find out more about who can give blood on the NHS Blood and Transplant website.

Source: NHS