A woman gives birth in a small hospital somewhere in sub-Saharan Africa, and everything goes well until it doesn’t, because she starts to bleed and the bleeding won’t stop, and every doctor in that room knows exactly what she needs, since the answer hasn’t changed in decades: blood which is needed quickly, but there at the one moment it matters most, it becomes unavailable. 

That scene happens thousands of times a year across the continent, which is the reason Africa Health Business has spent years running the secretariat of the Coalition of Blood for Africa (CoBA), which is the first private sector–led platform dedicated to advancing safe and sustainable blood systems across Africa. It brings together multi stakeholders to drive policy change, raise awareness, and strengthen advocacy efforts working towards a future where no life is lost due to lack of access to blood.  

Heavy bleeding after childbirth is one of the leading causes of death for new mothers in Africa, causing somewhere between a quarter and a third of all maternal deaths in the region, and more than 80% of the world’s deaths from this cause happen in sub-Saharan Africa and South Asia combined, while severe anemia in children with malaria and injuries from road accidents make up most of the rest of the need for blood. The fix for all these is simply blood, something we have known how to collect and use safely for hundreds of years, yet Africa just doesn’t have enough of it, which is the gap CoBA exists to bridge. 

The Arithmetic of an Empty Blood Bank 

The shortage is easy to see once you look at the numbers: African countries collect around 5.2 units of blood for every 1,000 people, well below the World Health Organization’s target of 10. Blood donations across the region only cover an estimated 20 to 50% of what hospitals actually need with 18 of 47 countries in the WHO African Region get at least 80% of their blood from unpaid, voluntary donors, which is the safest and most reliable source, and everywhere else leans more on family members giving blood or paid donors, both of which are harder to keep up over time and carry more risk. 

This is a humanitarian crisis in the most immediate sense, and it is also, just as much, a money problem, and looking at it that way opens up a very different set of fixes, along with a very different set of people who need to help fix it. 

A Financing Failure Dressed as a Medical One 

Africa’s health systems are stretched thin, with average health spending across the continent sitting around 5% of GDP even though the region carries roughly a quarter of the world’s disease burden while getting only a small share of global health spending, and things have gotten harder recently, since aid to Africa has dropped by an estimated 70% since 2021 and the continent’s health funding gap now runs into the tens of billions of dollars every year. Against that backdrop, blood has to compete with vaccines, medicines, and buildings for funding, and it usually loses, mainly because a blood supply chain rarely shows up as one clear cost the way a batch of vaccines or a new hospital wing does, leaving nothing simple for a minister or investor to point to and pay for. 

That is the gap CoBA was built to close, because blood is essential infrastructure that almost nobody plans for as infrastructure, even though it needs the same kind of investment health systems already give happily to oxygen supply, medical tests, or medicines, including cold storage and transport, trained staff to collect blood safely, labs that test it, ways to find and keep donors, and delivery routes that actually reach small rural clinics. Looked at this way, blood security is a genuinely good investment, since the need is steady, the results are easy to measure, and the payoff shows up directly in fewer mothers and children dying, numbers that donors, governments, and investors already watch closely. 

What the Secretariat Sees 

As CoBA’s secretariat, Africa Health Business works directly with the coalition’s growing list of partners, including health ministries, blood banks, blood product makers like Terumo Blood and Cell Technologies, and groups such as the Africa Society for Blood Transfusion and the Global Blood Fund, and that work, along with our wider advisory work in healthcare deals and health financing, keeps showing us the same thing, which is that health systems that treat blood supply as core infrastructure, backed by real money and real partnership with the private sector, get better results than systems that treat it as an afterthought buried inside the general health budget. It has also shown us that no single organization, government, or donor can fix this alone, which is exactly why CoBA was set up as a coalition rather than a single project, and why it needs more members, not fewer, to match the size of the problem. 

Three Fixes, No New Science Required 

Turning blood security from an afterthought into something that gets funded doesn’t take new ideas, just a few clear changes and a few more organizations willing to help make them happen, starting with health and finance ministries setting a clear, separate budget line for blood supply chains instead of burying the cost inside general hospital spending, where it is usually the first thing cut when money is tight. Health investors and development banks should look at blood infrastructure, including cold storage, lab capacity, and donor systems, with the same care they already give to diagnostics or drug manufacturing, areas that draw far more money for a similar or even smaller impact, and the private sector needs more room to play a bigger part, not as a favor or a donation but as a real business partner building better ways to find donors, move blood around, and test it for safety. This is exactly the kind of teamwork CoBA was built to make happen, matching organizations that have money, technology, or reach with the health systems that need them most. 

None of this calls for new science, since the medical fix for blood shortages has existed for decades, and what has been missing all along is the will to treat blood like every other essential health item, which means planning for it, budgeting for it, and investing in it, instead of simply hoping it shows up, alongside a group of partners big enough to see that plan through. 

The woman in that small hospital did not need a miracle, she needed a system that had already decided, long before she walked through the door, that blood was worth paying for, and building that system is a money and business problem as much as a medical one, one that Africa’s health sector is well placed to solve once it stops treating blood as an emergency and starts treating it as something to plan for, a problem that gets easier to solve with every new partner who joins in, which is really an open invitation to any organization, public or private, that wants to be part of the solution.