**4.5 Transplant programmes**

Despite the burden of ESKD in SSA, only few countries have sustained transplant programmes [20]. There are only 62 centres across 7 countries in SSA [3]. Nigeria with a population of 206 million has 15 renal transplant centres (RTCs) with majority recording low activities ranging 1–5 transplants per year (Personal Communication). South Africa with a population of 59.37 million (2020) has 14 RTCs and did 250 to 450 kidney transplants annually between 1991 and 2015 [35].
