Islamabad: Nearly five percent of blood donations screened in Pakistan during 2023 tested positive for hepatitis B, hepatitis C, HIV, syphilis or malaria, World Health Organization’s latest Global Status Report on Blood Safety and Availability 2025 said on Friday, as fewer than eight percent of blood donations in the country came from voluntary unpaid donors.
The report shows that Pakistan screened 1,555,462 blood donations in 2023 and detected 31,325 donations positive for hepatitis C, 20,668 for hepatitis B, 2,423 for HIV, 18,514 for syphilis and 1,781 for malaria.
Combined, blood screening detected more than 74,700 reactive donations for these infections, representing nearly five percent of all donations screened, although some donations may have been reactive for more than one infection.
Hepatitis C was the most frequently detected infection, found in 31,325 donations or 2.01 percent of all units screened. Hepatitis B was detected in 20,668 donations, accounting for 1.33 percent of screened units, while 2,423 donations, or 0.16 percent, tested positive for HIV.
The report also recorded 18,514 blood donations positive for syphilis, representing 1.19 percent of screened donations, while 1,781 donations, or 0.11 percent, tested positive for malaria.
Although all infected blood units are discarded and never transfused to patients, health experts say the findings provide important insight into the burden of blood-borne infections among people presenting to donate blood and underscore the importance of rigorous screening of every donation.
According to WHO data, Pakistan collected 1,595,248 blood donations in 2023 through 272 blood establishments that together covered around 84 percent of the country’s blood collection system.
Of these donations, only 126,172 were made by voluntary non-remunerated donors, accounting for just 7.9 percent of all blood donations collected during the year.
In contrast, 878,189 donations, or 55 percent of the total, came from family or replacement donors, while another 590,887 donations were reported under other donor categories.
The figures indicate that Pakistan continues to rely heavily on replacement donors, where relatives and friends are often required to donate blood when a patient needs surgery, cancer treatment, thalassaemia care, emergency trauma treatment or management of severe bleeding during childbirth.
The low level of voluntary donation contrasts sharply with the global picture outlined by WHO. Worldwide, more than 85 percent of blood donations now come from voluntary unpaid donors, regarded as the safest and most reliable source of blood.
Health experts maintain that regular voluntary donors generally have lower rates of transfusion-transmissible infections because they donate repeatedly, undergo regular health assessments and are less likely to conceal risk factors associated with infection.
The WHO report suggests that despite years of awareness campaigns and blood donation drives, Pakistan has yet to establish a strong culture of regular voluntary blood donation capable of meeting the country’s growing demand for blood and blood products.
The findings are particularly significant because Pakistan remains among the countries carrying a heavy burden of viral hepatitis. The detection of more than 31,000 hepatitis C-positive donations and over 20,000 hepatitis B-positive donations reflects the continuing circulation of these infections in the wider population.
The detection of more than 2,400 HIV-reactive donations comes as Pakistan continues to report rising numbers of HIV infections across several provinces, with health authorities warning of a growing epidemic in key populations as well as increasing transmission among children and the general population.
The WHO report notes that Pakistan screens all donated blood for HIV, hepatitis B, hepatitis C and syphilis before being released for transfusion in accordance with international recommendations. Blood donations are also screened for malaria under national protocols.
The report also highlights the growing use of blood component therapy in the country. During 2023, blood centres prepared 839,354 units of red blood cells, 388,864 units of fresh frozen plasma, 237,500 platelet units and 92,122 units of cryoprecipitate from donated blood.
These components allow physicians to provide targeted treatment to patients suffering from trauma, blood disorders, cancers, liver disease and surgical complications without transfusing whole blood unnecessarily.
Pakistan also reported collecting blood products through apheresis procedures, including 7,670 platelet units, 1,000 plasma units and 500 red blood cell units.
On governance and regulation, Pakistan reported having a national blood policy, a strategic plan for blood safety, legislation governing blood services, and systems for inspection and licensing of blood establishments.
Globally, WHO estimated that more than 120.4 million blood donations were collected in 2023, including 111 million whole-blood donations and 9.4 million donations collected through apheresis procedures.
However, access to blood remains highly unequal. High-income countries, home to only 15 percent of the world’s population, accounted for 36 percent of global blood donations, while low-income countries, where around eight percent of the world’s population lives, collected only two percent of all donations.
The report warns that many low- and middle-income countries continue to face shortages of safe blood because of inadequate financing, weak regulatory systems and insufficient voluntary donor recruitment programmes.
WHO said strengthening voluntary blood donation programmes remains one of the most effective ways to improve both the safety and availability of blood supplies and reduce dependence on replacement donors.
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