Global Progress on Blood Supplies Highlights Persistent Inequalities and Weaknesses in Governance, Financing and Regulation

The World Health Organization (WHO) reported sustained global progress in improving blood supply safety, with a 19% increase in blood collections between 2013 and 2023, according to data from 132 countries. However, disparities in access to safe blood persist, particularly in lower-income regions, where governance, financing, and regulatory challenges hinder equitable distribution, the organization said.

Voluntary, unpaid donors accounted for 85% of the 120 million blood donations recorded globally in 2023, underscoring their critical role in maintaining safe and sustainable blood systems. Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, emphasized that “no one should die because safe blood is unavailable when it is needed,” while highlighting the “cornerstone of safe and sustainable blood supplies” provided by unpaid donors.

Persistent inequalities in blood availability

High-income countries, which represent 15% of the global population, collected 36% of all blood donations in 2023, according to WHO analysis. In contrast, 24 countries reported fewer than five donations per 1,000 people, reflecting severe constraints in meeting patient needs. Blood donation rates varied widely, from 0.4 to 53 donations per 1,000 population, with low-income nations struggling to maintain reliable supplies due to limited financing, weak infrastructure, and insufficient donor recruitment.

The proportion of blood from voluntary unpaid donors also differed significantly by income level. While 98.4% of donations in high-income countries came from unpaid donors, the figure dropped to 63.4% in low-income countries, where health systems often face challenges in sustaining adequate blood supplies. This gap exacerbates disparities in access to life-saving transfusions for patients with conditions such as sickle-cell disease, haemophilia, and severe anaemia, as well as those requiring emergency care during childbirth or trauma.

Stronger governance and financing needed

WHO’s analysis revealed gaps in regulatory frameworks, with nearly one-third of countries lacking specific legislation to ensure blood safety. Only 64% of nations reported systems for inspecting blood services, 62% had licensing mechanisms, and 40% indicated some blood transfusion services were accredited. These deficiencies highlight vulnerabilities in quality assurance across the blood supply chain.

Sustainable financing remains a critical challenge, as 14% of countries reported no dedicated government funding or cost-recovery mechanisms for blood services. WHO called on governments to strengthen governance, ensure long-term financing, and expand quality assurance programs to address these gaps. The organization also urged improvements in clinical transfusion practices and data systems to support evidence-based decision-making.

“These measures are essential to ensuring universal access to safe, effective, and quality-assured blood and blood products, regardless of where people live,” the report stated. The findings align with WHO’s World Blood Donor Day campaign, which emphasizes the role of unpaid donors in saving lives and building resilient health systems.

Global status report highlights systemic challenges

The Global status report on blood safety and availability 2025, based on data from 168 countries, underscores the need for targeted investments. The report notes that while voluntary donations have driven progress, systemic barriers—including inadequate governance, financing, and infrastructure—continue to limit access in lower-income regions. It also highlights the importance of expanding access to plasma-derived medicinal products and improving clinical use of blood.

WHO recommended that countries prioritize strengthening national blood systems, supported by international partnerships. The organization’s 2026 World Health Day campaign, themed “Together for health. Stand with science,” aims to reinforce the role of scientific evidence in addressing global health inequities, including those related to blood availability.