MBABANE – For decades, Jehovah’s Witnesses have refused blood transfusions, but thousands of members in Eswatini now face a significant change.
The church has given individual members the choice to accept or donate four main blood components, while maintaining its prohibition on whole-blood transfusions.
The development follows a decision by the Governing Body of Jehovah’s Witnesses announced on September 18, 2026. Under the new position, individual Jehovah’s Witnesses can decide whether to accept or donate red blood cells, white blood cells, plasma and platelets.
The decision applies globally, meaning it also affects Jehovah’s Witnesses in Eswatini. The organisation’s longstanding position against whole-blood transfusions, however, remains unchanged.
For years, Jehovah’s Witnesses have been known for refusing blood transfusions on religious grounds, based on their interpretation of the Biblical command to abstain from blood. The latest decision does not completely remove that position. Instead, the organisation has made decisions concerning the four main blood components a matter of individual conscience.
This means a Witness who requires medical treatment involving any of the four components can personally decide whether to accept them. A member can also decide whether to donate blood where the stated purpose is for it to be separated into components or fractions for use by another person.
The organisation said the decision does not mean that Jehovah’s Witnesses are being instructed to accept blood components. Rather, each individual is responsible for making a personal decision based on conscience. The change will affect thousands of Jehovah’s Witnesses in Eswatini, where the organisation has a significant presence.
According to the latest figures published by Jehovah’s Witnesses, the country recorded a peak of 3 519 publishers during the 2025 service year. The organisation reported an average of 3 431 publishers, with 74 congregations operating across the country.
A total of 8 902 people attended the organisation’s annual Memorial during the year. The figure of 3 519 refers to publishers who are active members involved in preaching and should not be interpreted as the total membership of Jehovah’s Witnesses in Eswatini. The development could have implications for healthcare workers treating Jehovah’s Witnesses patients, particularly where treatment requires blood components.
Previously, healthcare workers dealing with Witness patients who declined blood transfusions had to consider the patient’s religious position when determining treatment options. The new position gives individual members greater discretion concerning the use of the four main blood components. However, healthcare workers will still need to establish each patient’s individual wishes because the decision is based on personal conscience.
The development was welcomed by South Africa’s Minister of Health, Dr Aaron Motsoaledi. The South African Department of Health said the decision could ease some of the challenges previously faced by healthcare workers treating Jehovah’s Witnesses.
Motsoaledi described the development as a ‘giant leap’. He said Jehovah’s Witnesses’ previous position had sometimes created difficulties for healthcare workers, particularly when blood transfusions were considered necessary in emergency or critical-care situations.
The minister said doctors had, in some cases, been required to approach the courts when children needed blood transfusions but their parents objected on religious grounds. He welcomed the change, saying it would reduce the burden on healthcare workers.
The South African Department of Health also noted that whole blood is rarely used for ordinary transfusions, as modern medical practice generally involves the use of specific blood components. Jehovah’s Witnesses can now personally decide whether to accept these components from another person.
They can also personally decide whether to donate blood for the purpose of providing these components or fractions to another person. The organisation has stressed that these are matters of individual conscience. The position on whole blood has not changed.
Jehovah’s Witnesses can now personally decide whether to donate blood where the purpose is to provide blood components or fractions for another person. This could potentially expand the pool of people who are willing to donate blood components, including in countries such as Eswatini.
However, the organisation has not instructed its members to become blood donors. The decision is instead left to individual conscience. For Eswatini, the development comes at a time when blood availability remains an important issue for the healthcare system, particularly for patients requiring blood and blood components during emergencies, surgery and treatment of serious medical conditions. The new position could therefore have implications beyond Jehovah’s Witness patients themselves if some members choose to donate blood for the production of components used to treat other patients. The decision was made by the Governing Body of Jehovah’s Witnesses and applies to members around the world. This means that Jehovah’s Witnesses in Eswatini do not need a separate local decision for the new position to apply to them. The organisation’s latest figures show that the country had 74 congregations during the 2025 service year, with an average of 3 431 publishers.
The annual Memorial attracted 8 902 people. The figures indicate that the change could have a significant local reach, although the organisation does not publish a conventional total membership figure for Eswatini. The change therefore marks a significant development in the way Jehovah’s Witnesses approach blood-related medical decisions. While the church has retained its prohibition on whole-blood transfusions, individual members can now decide whether to accept or donate red blood cells, white blood cells, plasma and platelets. The decision effectively shifts responsibility for these choices from a uniform religious position to the conscience of each individual member.
