The establishment of systems to ensure that all donated blood is screened for transfusion-transmissible infections is a core component of every national blood program. Globally, however, there are significant variations in the extent to which donated blood is screened, the screening strategies adopted and the overall quality and effectiveness of the blood screening process. As a result, in many countries the recipients of blood and blood products remain at unacceptable risk of acquiring life-threatening infections that could easily be prevented.These recommendations are designed to support countries in establishing effective national programs to ensure 100% quality-assured screening of donated blood for transfusion-transmissible infections. In countries where systems are not yet fully in place, the recommendations will be helpful in instituting a step-wise process to implement them.