Consequences of centralised blood bank policies in sub-Saharan Africa

Safe and reliable transfusion services remain largely unavailable to the world's poorest populations, particularly in sub-Saharan Africa.1 WHO responded to this crisis with a strategy focused on centralising blood transfusion services, the exclusive use of volunteer donors, donor blood testing, and transfusion stewardship.2 On the basis of our experience in Malawi, we think that this policy has unintentionally decreased the availability of blood products for patients with acute haemorrhage.