Despite the current early stage of development of health systems in most African countries, the journey leading to a proper kidney donation and transplantation service should be initiated. It should start with a legal framework for cell, tissue and organ donation and transplantation on the basis of the WHO Guiding Principles. The objective of meeting patients’ needs with self-sufficiency requires to plan and start from the beginning of a stepwise journey:
Centralized coordination and oversight,
Integrated management of kidney diseases from the epidemiology of chronic kidney disease and prevention to renal replacement therapies,
Management of kidney disease as part of the health system’s progress towards universal health coverage to strive towards equity,
Early initiation of donation after death of corneas and kidneys,
Inevitable in several countries, carefully monitored public-private partnership and,
Often lacking but a sign of quality, transparency of organization, activities and outcomes for patients and donors.
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