South Africa spending billions on blood

South Africa’s Provincial Departments of Health have collectively spent over R11.7 billion on blood and plasma products from non-profit organisations over the past five years.

This is according to a response from Health Minister Aaron Motsoaledi to a Parliamentary question from Economic Freedom Fighters Member of Parliament (MP) Omphile Maotwe.

Motsoaledi revealed that provincial health departments had paid the South African National Blood Service (SANBS) and the Western Cape Blood Service (WCBS) a total of R11,730,136,212 over the past five financial years.

The Minister explained that the activities of the SANBS and WCBS are not limited to the collection and storage of blood.

“The transfusion services produce various red cell, platelet and plasma products from donor blood. The SANBS and WCBS also test donor blood for HIV, Hepatitis B and C, Syphilis, and the blood group.

Gauteng was the most significant contributor to the total sum, paying R4.7 billion throughout the period, followed by KwaZulu-Natal at R2.3 billion.

Limpopo and the Western Cape were the only other provinces to spend more than R1 billion on blood products over the five years, at R1.2 billion and R1.1 billion, respectively.

The province with the lowest expenditure was the Northern Cape at R123.6 million, followed by the Free State at R414.2 million.

Why non-profits?

When asked why South Africa has not yet developed its own capacity to collect and store blood samples in public health institutions, the Minister explained that legislation mandates that a non-profit organisation undertake this task.

He pointed to the National Health Act, which states that “the Minister must establish a blood transfusion service for the Republic by granting a licence to a non-profit organisation.”

Motsoaledi says that it would not be cost-effective or practical for Provincial Health Departments to develop their own blood banking service.

“A safe blood service requires not only the collection and storage of blood, but also donor recruitment, mobile and fixed donation clinics, accredited laboratories, specialised staff, transport logistics, and continuous quality assurance.”

Therefore, he says several countries opt to use non-profit blood services as they provide specialised expertise, are efficient and cost-effective, and build a strong sense of trust among the public and donors.

Building strong relationships with donors is critical to ensure that it can meet the needs of South African patients, who currently require 3,500 units per day.

The SANBS recently highlighted that less than 1% of the South African population are active blood donors, and to further exacerbate the short supply, each unit of blood only lasts for 42 days after collection.

There is also the added challenge of incentives, as it is illegal for blood donors to receive any financial or other rewards.

More than 493,646 people made over 1 million blood donations to the SANBS and WCBS in 2021, at a rate of 21,278 per week.

This enabled the two organisations to collect over 1 million units of blood, 40,436 plasma units, and 33,021 platelet units. A total of 365,000 patients received blood products that year.

Some donors have shown significant commitment to the cause, such as Dirk van der Westhuizen and Frederik Oosthuizen, who have saved approximately 1,824 lives through blood donations, according to SANBS.

“For most people, donating blood is motivated by pure altruism – the knowledge that their unit of blood can save up to three lives as blood is separated into red blood cells, plasma and platelets,” the SANBS says.