Based on this extensive review that describes the magnitude of the end stage renal disease problem in Africa and the progress in its treatment, the answer to the question posed in the title is, “We’ve come far, but we need help as we strive to become countries with higher Health Care Indices” [1].

The needs are well-described: Education of the public and future medical professionals, stable and adequate health care funding, transplant center and national transplant outcome registries, central facilities for histocompatibility testing, immunosuppression protocols based on immunologic risk factors, and, perhaps, consideration of pre-calcineurin inhibitor immunosuppression protocols such as donor-specific transfusions when calcineurin inhibitors are unavailable because of cost or import restrictions [2, 3].

We salute the dedicated professionals who’ve brought renal transplantation in Africa this far [4]. They’ve done the best they can with what they have; they and their patients deserve the resources to do more.