On Nakasero Hill, overlooking the bustle of Kampala, sits an institution that is as critical to Uganda’s survival as any major hospital or ministry building. The Uganda Blood Transfusion Services (UBTS) is not a place of sirens and stretchers; instead, it is a place of quiet diligence, where technicians test, store, and distribute the most essential resource in medicine: safe blood. Every pint that leaves its cold rooms carries the possibility of life restored, a mother saved from postpartum haemorrhage, a child rescued from malaria-induced anaemia, or a road accident victim given a second chance.
Yet for decades, Uganda’s blood supply has been chronically short. The country has grown to a population of 46 million people, which, according to World Health Organisation standards, translates to a need for at least 460,000 units of blood annually. Until recently, UBTS managed to collect between 360,000 and 400,000 units a year, covering only about 90 percent of the demand. The missing 10 percent, though modest in numbers, often meant empty shelves at hospitals and desperate moments when patients could not receive transfusions in time.
It was this gap that the Uganda Intergovernmental Fiscal Transfers (UgIFT) Program, supported by the World Bank and implemented by the Government of Uganda, sought to address. With targeted investments in blood safety infrastructure, UgIFT has enabled UBTS to expand its reach, improve its capacity, and bring services closer to communities that had long been underserved.
From Humble Beginnings to a National Service
The Uganda Blood Transfusion Services began in 1989 with support from the European Union. In those early days, the country’s only functional blood bank was in Kampala, and it collected barely 100 pints of blood each month, serving a small radius of about 100 kilometres. Hospitals depended on “replacement” donations, where relatives of patients were required to donate blood before surgeries or treatments could proceed.
Over the years, the service grew. With support from various partners, UBTS eventually established ten regional blood banks and nine smaller collection centres. By 2016, when international donor support wound down, the Government of Uganda assumed full responsibility for financing UBTS through the Ministry of Health and the Ministry of Finance. Despite these expansions, the gap between national need and actual supply persisted.
“Blood is the lifeblood of a nation,” reflects Dr Dorothy Kyeyune Byabazaire, the Executive Director of UBTS. “Without it, healthcare simply cannot function. For years, we were only just managing. But with the UgIFT investment, we are now seeing real transformation.”
UgIFT’s Strategic Interventions
The turning point came when the UgIFT Program directed resources to strengthen blood transfusion services. Three new regional blood banks were constructed and fully equipped in Hoima, Arua, and Soroti. These facilities are not merely buildings; they are state-of-the-art centres with laboratories, cold storage, testing equipment, and housing for staff to ensure round-the-clock service. Vehicles were also provided to enable daily community-based blood collection drives, a vital step since most donations must be collected in the field from schools, workplaces, and civic groups.
The choice of Hoima and Arua was deliberate. Both regions host large refugee populations, where the demand for healthcare is intense and unpredictable. Until recently, hospitals in these districts relied on blood transported all the way from Kampala, a logistical burden that often delayed emergency response. Now, with their own modern facilities, these regions not only meet their own needs but also supply blood to other parts of the country. Soroti, which had initially received partial funding through the COVID-19 response, was completed and fully equipped under UgIFT, providing Eastern Uganda with a vital lifeline.
Each of the three facilities is capable of processing up to 50,000 units of blood annually. Combined, this additional capacity has already begun to close the supply gap, pushing Uganda closer to the WHO benchmark.
Lives Saved, Confidence Restored
The results have been significant. In 2023, UBTS collected roughly 400,000 units of blood, an increase of almost 40,000 units from the previous year. Hospitals that once struggled to secure supplies now report fewer stock-outs. Communities in refugee-hosting districts are seeing lives saved that would once have been lost.
One story comes from Hoima, where a young mother suffered heavy bleeding after childbirth. In the past, doctors might have waited for hours, even days, for blood to arrive from Kampala. Today, with a new blood bank just kilometres away, blood was available within minutes, and the mother lived to care for her newborn. In Arua, a boy admitted with severe malaria anaemia received an immediate transfusion, something that previously might not have been possible in time.
These are not isolated cases. Across Uganda, the availability of safe blood is becoming less of a question mark and more of a certainty. As Dr Kyeyune puts it, “People who walk into hospitals today are more likely to find blood available than in the past. That availability is saving lives every single day.”
Challenges That Remain
Despite the progress, the road ahead remains challenging. The blood donor base in Uganda is heavily reliant on secondary schools, which contribute nearly 70 percent of the blood collected. During school holidays, shortages are inevitable, leaving hospitals vulnerable. UBTS has begun to diversify its outreach by partnering with churches, rotary clubs, the police, the army, and corporate organisations. These partnerships are beginning to yield results, but the culture of regular voluntary donation is still in its infancy in Uganda.
Another strain comes from preventable conditions. Children suffering from malaria-induced anaemia account for over 60 percent of blood transfusions nationwide. Mothers with complications in pregnancy and childbirth account for another large share. Dr Kyeyune notes that strengthening primary healthcare, ensuring access to mosquito nets, antenatal care, and safe delivery practices, would reduce demand for blood and allow supplies to serve cases that are truly unavoidable, such as accidents, cancer, or complex surgeries.
Cost is another persistent obstacle. Processing a single unit of blood costs around USD 100, an expensive undertaking in a health system already under financial pressure. UBTS is exploring research and innovation to ease this burden, including pathogen reduction technologies that could cut testing costs and plasma fractionation that could generate income from surplus plasma by producing medicinal products.
Looking Ahead: Sustainability and Expansion
UgIFT has demonstrated the power of targeted investment, but sustaining this progress will require continued commitment. Several older facilities, such as those in Mbarara, Mubende, Kabale, and Moroto, are in urgent need of reconstruction. Without further investment, they risk becoming bottlenecks in the system. As Uganda continues to upgrade health centres across the country, demand for blood will only rise, making expansion not just desirable but necessary.
For UBTS, the vision is clear: every regional referral hospital should have a modern, fully equipped blood bank. Only then can the country guarantee equitable access to safe blood in emergencies.
Dr Kyeyune’s message is both a note of gratitude and a call for continued support. “We are deeply grateful to the World Bank, to the Ministry of Finance, and to the Ministry of Health for prioritising blood safety. Without these investments, we would not be where we are today. But we must go further, because every additional blood bank is not just a building, it is lives saved, communities reassured, and a nation strengthened.”
Blood as Development Infrastructure
Uganda’s story of blood transfusion is about more than health. It is about national development. Just as roads open markets and electricity powers industry, safe blood makes healthcare possible. It underpins maternal health, malaria control, surgical capacity, and emergency readiness. Without it, the most ambitious health reforms collapse. With it, systems thrive and lives are extended.
By supporting the construction of blood banks in Hoima, Arua, and Soroti, the UgIFT Program has done more than close a medical gap. It has laid a foundation for resilience. In the process, it has restored confidence to communities, strengthened the health system, and demonstrated that even the most invisible infrastructure, like blood services, can produce the most visible results.
As Uganda pursues Vision 2040 and the Sustainable Development Goals, the lesson is clear: investments in blood transfusion are investments in national survival.
“There is no factory for blood. It must come from people. That is why this work is so important.”
