By Desire Tshuma
Harare – At churches on Sundays, at university campuses midweek, and at company premises across Zimbabwe, the appeal is familiar. Donate blood, save a life, it costs nothing. Thousands of Zimbabweans respond each month. No donor receives payment. The bags are donated. Fuel and logistics are often covered by sponsors.
But for patients who need that blood in hospital, the cost is anything but nothing.
In private health facilities, a single unit is reportedly being charged at around US$500. In public hospitals, families speak of steep “processing fees” they are expected to pay before blood is released. For a woman hemorrhaging after childbirth, a child with severe anemia, or a victim of a traffic accident, the directive from health workers is blunt: pay first, then we transfuse.
The National Blood Service Zimbabwe maintains that it collects blood on a voluntary, unpaid basis in line with national and global policy. Processing, laboratory testing, cold-chain storage and distribution all come at a cost, the service argues, and those expenses have to be recovered. Government also provides NBSZ with an annual grant from the fiscus.
What is missing, critics say, is clarity. There has been no public breakdown of how a $500 charge is arrived at. No detailed accounting of how much is spent on test kits, staff, storage, transport and wastage. And no transparent report showing how grant funding is applied against revenue from blood issuance.
That vacuum has bred suspicion. In hospital corridors and on WhatsApp groups, people are asking whether a public good donated freely is being turned into a source of profit. NBSZ is a parastatal under the Ministry of Health and, by law, any surplus is supposed to be reinvested in its operations. There is currently no public evidence of funds being diverted for private or political use. But in the absence of published financials, perception hardens into belief.
Health advocates argue the situation is untenable. They are calling on NBSZ and the Ministry of Health to publish monthly data on units collected, units issued to hospitals, and the actual cost per unit. They want a regulated ceiling on what public hospitals can charge patients, so that no one dies waiting to raise hundreds of dollars in an emergency.
They are also pushing for a functional exemption mechanism for pensioners, children and the unemployed, one that does not require weeks of paperwork while a patient deteriorates. Some also propose that donors be notified when their donation is used, through a simple SMS alerting them to the hospital and date. The aim, they say, is to restore the human link between donor and patient that has been lost in the current system.
NBSZ plays a critical role in the health system. Screening blood prevents the transmission of HIV, hepatitis and other infections. Proper storage saves lives. But when the product of a free donation becomes unaffordable to the very communities that gave it, the social contract frays.
Until the books are opened and the price is brought within reach, the question being asked in wards across the country will not go away. Zimbabweans donate blood to save lives. They should not be priced out of receiving them.