Transplanting problems

Saturday, 26 April 2014 00:00 -     - {{hitsCtrl.values.hits}}

The Health Ministry has appointed a one-woman committee to investigate the recent trade of live kidney transplants in the country. But it could well be the tip of the iceberg. Certain organisations have estimated one organ is sold every hour somewhere in the world. This follows a Chinese media exposé of young men selling kidneys for about $ 5,500 in Hangzhou. Organ trafficking is no longer the stuff of urban legend, it’s a grim reality. According to the World Health Organization’s (WHO) global organ transplant report, 106,879 organ transplants were performed worldwide in 2010. But this data doesn’t identify whether the organs were bought and sold. WHO conservatively estimates the proportion of traded or trafficked organs is up to 10%, or roughly 11,000 in 2010. But the true figure could be much higher. Kidneys are the most common organ transplanted, and much of the illegal organ market is likely to consist of kidneys from living “donors”. These people are motivated to sell by extreme poverty, yet they rarely see any long-term financial gains. Often, they receive less than they are promised by brokers; one Indian study showed the average payments is just $1,070, rather than the promised average of $1,410. Vendors are often the breadwinner of their family, but the impact of selling a kidney on their physical and mental health frequently disables them from future work. They suffer social stigma and tend to regret their decision to sell. Payment for organs not only increases supply, it also enables customers to avoid organ allocation systems in their own country and jump straight to the head of the queue. Wealth, rather than medical criteria, strongly determines how long you wait for an organ on the black market. The Declaration of Istanbul on Organ Trafficking and Transplant Tourism was developed in 2008 in an attempt to curb international trade in organs and travel for commercial organ transplantation, known as “transplant tourism”. It provides ethical guidance for policy makers and doctors working in transplantation medicine. WHO estimates only 10% of global needs for organ transplantation is currently met. Some commentators suggest that the only way to meet needs and to eliminate the black market is to establish legal markets, at least for kidneys. Others argue that legalisation will simply relocate the problems of existing markets and expand the trade. WHO and supporters of the Declaration of Istanbul believe the best solution involves developing better systems of deceased organ donation, encouraging altruistic living kidney donation, preventing needs for transplantation by treating diseases that lead to organ failure such as diabetes and hepatitis as well as implementing laws that prohibit organ trading and trafficking. To achieve these goals, countries must take responsibility for meeting their own transplant needs by pursuing self-sufficiency and putting in place stronger measures to prevent people from other countries conducting transplants in their country. Clearly Sri Lanka’s legal and policing frameworks need to be strengthened in this area. Australia has made valuable progress in recent years with the creation of the Organ and Tissue Authority and the work of the Donate Life Network, and the introduction of legislation criminalising organ trafficking. This is one example Sri Lanka can learn from in protecting itself from global organ trafficking.