Developing nations face many challenges in health care, including having a safe and available blood supply. The goals of developing nations are similar to the rest of the world; to have a sustainable, volunteer-based blood supply that is safe from transfusion transmitted disease. In 2004, the US President's Emergency Plan for AIDS Relief (PEPFAR) was appropriated to fund AIDS education, treatment and research. AABB, working with the Center for Disease Control (CDC), was tasked with improvement (or creation) of five countries blood services — Kenya, Mozambique, Rwanda, Tanzania and South Africa. AABB's work in Africa will be discussed as well as country specific stories of creating sustainable blood services.