• Voluntary donors wane, slump to 10% of all contributions
• Lagos meets 65% of demand but 70,000 units shortfall in 2024
• Experts blame cultural myths, religious misconceptions
Massive shortage of blood supply vis-à-vis national demand has put accident and emergency services in dire straits, with several blood banks nearly empty nationwide.
The concerns, as relived by care professionals on the eve of the International Blood Donor Day 2025, border on waning voluntary donations, lack of awareness and unfounded cultural beliefs – that have combined to deprive care facilities of 80 per cent of blood demand by sick Nigerians.
At the National Hospital visited by The Guardian, the blood bank is almost empty. Findings showed that most givers are family replacement donors who visit only when a family member needs blood.
The consequences of this gap are particularly glaring in Lagos State. With a population of about 22 million, the state requires at least 220,000 units of blood yearly. Yet in 2024, the Lagos State Blood Transfusion Committee (LSBTC) reported collecting only around 150,000 units, leaving a shortfall of nearly 70,000 units.
Health officials in the state have warned that this gap, representing a 35 to 40 per cent deficit, poses significant risks to emergency and routine care.
The crisis is evident at the Lagos University Teaching Hospital (LUTH), one of the country’s largest tertiary healthcare centres. According to internal records, the hospital collects between 10,000 and 12,000 units of blood annually, despite needing up to 15,000 units.
Although these numbers appear relatively close to the hospital’s target, a large portion of this supply still comes from family replacement donors and paid commercial donors, which experts argue are neither sustainable nor safe.
The World Health Organisation (WHO) recommends a minimum blood availability threshold of 10 units per 1,000 population yearly. Nigeria, with a population exceeding 220 million, requires about 2 to 2.2 million units yearly. However, available data indicate that less than 500,000 units are collected, representing just 20 to 25 per cent of the national demand.
The Guardian checks revealed that only about 10 to 15 per cent of blood donated yearly in Nigeria comes from voluntary, non-remunerated donors. The remaining 85 to 90 per cent is sourced from family replacement donors, often recruited in emergencies, or from commercial donors, whose motivations may not always align with safety standards.
This heavy reliance on non-voluntary donors raises ethical and medical concerns, as studies show that voluntary donors generally carry a lower risk of transfusion-transmissible infections.
Despite being the globally recommended source of safe blood, voluntary donors constitute only a small fraction of Nigeria’s donor base. Cultural myths, religious misconceptions, and fears of adverse health effects deter many Nigerians from donating blood freely and regularly.
Director-General of the National Blood Service Commission (NBSC), Prof. Saleh Yuguda, explained that blood donation programmes in Nigeria face numerous challenges rooted in societal attitudes, infrastructural limitations, and systemic weaknesses.
He noted that one of the most pressing issues is the low rate of voluntary, non-remunerated blood donations. He attributed this to limited awareness, inadequate donor mobilisation strategies, and misconceptions about blood donation, adding that infrastructural inadequacies and funding constraints also hinder efficient blood collection, testing, and distribution.
Yuguda lamented that many lives are lost not because of a lack of medical expertise but because safe blood is unavailable when needed.
He said: “To adequately service Nigeria’s vast population, a minimum of 2 million to 2.2 million units of safe blood is required annually, based on WHO’s benchmark of 10 units per 1,000 people. Unfortunately, the country currently falls far short of this mark, collecting only about 450,000 to 500,000 units per year.
“This glaring deficit significantly affects health outcomes, particularly in areas of maternal health, emergency medicine, and chronic disease management. The situation underscores the urgency of transforming the nation’s blood donation culture and investing in sustainable systems for voluntary blood collection.”
Yuguda noted that the health system suffers from infrastructural gaps, with many healthcare facilities in rural and semi-urban areas lacking adequately equipped blood banks or safe cold chain systems.
He added that logistical bottlenecks, inadequate funding, and the absence of consistent public education campaigns further hamper effective blood collection and distribution.
“Awareness remains low, and often blood is only sought in moments of crisis rather than through regular voluntary contributions, making emergency response extremely challenging,” he said.
Yuguda emphasised that transitioning to a system based predominantly on voluntary donations is a priority goal for the NBSC, and intensifying efforts to build trust and educate the public.
Yuguda added that allegations of blood racketeering in some health facilities are deeply concerning and represent a breach of both medical ethics and national policy.
“Such illegal practices often thrive in environments where oversight is weak, blood is in high demand, and transparency is lacking. In some cases, the scarcity of blood leads facilities to commercialise the service, charging exorbitant fees, especially in emergencies, despite the legal and moral obligation to make blood accessible and safe.
“The National Blood Service Act (2021) unequivocally prohibits the sale of blood and mandates that all donations should be voluntary and non-remunerated. The law empowers the NBSC to regulate, license, and monitor blood service providers nationwide, and any facility found engaging in racketeering risks sanctions, including fines, licence revocation, and potential prosecution. We are working closely with relevant regulatory and security agencies to identify and address these infractions and to ensure that blood services remain ethical, safe, and accessible to all Nigerians,” he said.
SPEAKING with The Guardian, a consultant haematologist and Head of the Department of Haematology at the National Hospital, Dr Ekaete Iniabasi David, lamented that the hospital’s blood bank is almost empty.
David blamed the country’s blood crisis on scepticism and a poor attitude towards blood donation. She said: “You know, some people are sceptical for reasons best known to them, and then I think our people generally are not very generous when it comes to donating blood. We just don’t have that culture of going to donate blood.”
Meanwhile, there are health benefits of donating blood, which include regeneration. “So, you’re kind of helping your body to replenish itself when you donate blood.”
She appealed to Nigerians who are fit to donate blood. “Every time you donate blood, it is recorded. So, if that individual, for some strange reason, at a later date, needs blood, we are obliged to get blood for that person because, in the past, he has helped other people.”
She explained that, contrary to public perception, the money being charged to patients who need blood is actually for blood screening and not for blood procurement.
A consultant haematologist at LUTH, Prof. Titi Adeyemo, said that most of the blood used in Nigerian hospitals comes from family replacement donors, who require relatives to donate before their loved ones receive transfusions.
She described this system as not only unsustainable but also potentially dangerous, especially for patients with chronic conditions like cancer and sickle cell disease that require frequent transfusions.
According to Adeyemo, when families run out of willing donors, they often turn to commercial blood donors, referring to people who sell their blood for money. These donors, she warned, often hide health conditions and high-risk behaviours to qualify for payment, thus putting patients at risk of infections and other complications.
She emphasised that voluntary, unpaid donors are the safest source of blood. Such individuals, she explained, are more likely to be honest about their health and can be deferred if unwell. However, less than 10 per cent of blood donors in Nigeria currently fall into this category.
The professor pointed out that delays in securing blood have become a major contributor to Nigeria’s high maternal mortality rate, particularly during childbirth complications. Accident victims, gunshot patients, and individuals experiencing sickle cell crises are also at risk when blood is not readily available.
She also addressed deep-rooted myths that prevent people from donating, such as fears of becoming weak, falling ill, or not having enough blood due to poor nutrition. She clarified that all donors undergo medical screening and are deferred if unfit, with advice for improving their health for future donations.
Adeyemo said blood donation benefits the donor as well. It helps the body regenerate new blood and often reveals underlying health conditions during routine pre-donation screenings. She noted that each unit of donated blood can be separated into red cells, plasma, and platelets, potentially saving up to three lives.
Echoing similar concerns, the Executive Secretary of the LSBTC, Dr Bodunrin Osikomaiya, confirmed that Lagos only meets about 60–65 per cent of its yearly blood requirement.
She attributed the shortfall to persistently low voluntary donation rates and the absence of a real-time electronic database, which complicates accurate blood demand assessment.
Osikomaiya noted that this uncertainty often leads physicians to over-request blood as a precaution, further distorting demand forecasts. She revealed that as of December 2024, only 13.1 per cent of blood collected in Lagos came from voluntary donors, with the majority sourced from family replacements and paid donors.
For long-term change, Osikomaiya advocated integrating blood and organ donation education into school curricula to instil a culture of civic responsibility from an early age. She also called for intensified public awareness campaigns throughout the year on the need for Nigerians to donate blood voluntarily.
