Monday, April 02, 2007

Organ transplant tourism

I had missed this, but via Slate, I became aware that the WHO proposes global agenda on transplantation

This week, at the second Global Consultation on Transplantation the World Health Organization (WHO) presented countries and other stakeholders with a blueprint for updated global guiding principles on cell, tissue and organ donation and transplantation.

Those principles aim to address a number of problems: the global shortage of human materials - particularly organs - for transplantation; the growing phenomenon of 'transplant tourism' partly caused by that shortage; quality, safety and efficacy issues related to transplantation procedures; traceability and accountability of human materials crossing borders.

There is a worldwide shortage of organ donors, which leads to a shortage of organs. And as the WHO make clear, it's a serious problem.

Recent estimates communicated to WHO by 98 countries show that the most sought after organ is the kidney. Sixty-six thousand kidneys were transplanted in 2005 representing a mere 10% of the estimated need. In the same year, 21 000 livers and 6 000 hearts were transplanted. Both kidney and liver transplants are on the rise but demand is also increasing and remains unmatched.

Of course, such shortages have some pretty obvious consequences.

Reports on 'transplant tourism' show that it makes up an estimated 10% of global transplantation practices. The phenomenon has been increasing since the mid-1990's, coinciding with greater acceptance of the therapeutic benefits of transplantation and with progress in the efficacy of the medicines - immuno-suppressants - used to prevent the body's rejection of a transplanted organ.

The organs are not harvested from tourists and other unwilling victims, as the urban legends often claims, instead they are bought from poor people. In Pakistan the practice is widespread, as this Reuters' article makes clear.

"There are villages that are in the poorer parts of Pakistan where as many as 40 to 50 percent of the population of the village we know only has one kidney," Moazam told the briefing.

She said donors are often promised as much as 150,000 rupees ($2,500) for an organ but may only get a fraction of that after brokers' fees and associated medical costs are paid.

And of course, the donators don't get proper medical care afterwards, thus risking their lives.

China is also an option used by some, and here there is some evidence that many of the organs are from some of the thousands of people executed each year. Something which China's Deputy Health Minister Huang Jiefu admitted last november.

As the article in the last link makes clear, the 'transplant tourism' in China has direct negative consequences for the average Chinese in need of an rogan transplant.

Many transplant recipients are foreigners who pay large sums of money to avoid long waiting lists in their own countries. Currently, more than 1 million Chinese people are waiting for transplants.

Foreigners, however, are taking priority because they can pay more for organs, with kidneys reaching around NZ$90,000 and livers $193,000.

Unsurprising, I am in full agreement with Dr Howard Zucker, who stated

"Human organs are not spare parts," said Dr Howard Zucker, WHO Assistant Director-General of Health Technology and Pharmaceuticals. "No one can put a price on an organ which is going to save someone's life."

However, as long as people in some parts of the world have a hard time getting their basic needs covered, there is an organ shortage, and there are people willing to buy organs from others, this problem will continue to exist.
I think the WHO is on the right track in making it harder to deal in organs, but the basic problem of an organ shortage also needs to be addressed. One way we all can help addressing that problem, is to register as an organ donor if possible.

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Blogger Kaethe said...

I'd like to see an opt-out policy for organ donation, rather than an opt-in. But prisoners have to be banned, I think, as a safeguard of their rights.

April 02, 2007 9:33 PM  
Blogger Kristjan Wager said...

I'm quite in agreement with an opt-out policy being better, and it is looking like one such might be implemented in Denmark. Not for a couple of years though.

I hadn't considered prisoners' rights an issue in this case, but you are quite right - it should be in the US, and probably also elsewhere. Of course, the countries were such a safeguard are most necessary, are probably the least likely to make one.

April 02, 2007 10:29 PM  
Blogger Kaethe said...

I agree about safeguards and who needs them. I just think it helps everyone to be reminded of human rights whenever possible, especially during a time when the US population is happily throwing them away with both hands.

April 05, 2007 5:47 PM  
Blogger ThePoliticalCat said...

As I blogged recently, there is a scheme afoot in the U.S. to give prisoners time off for organ donation. Disgusting! Are the powerless to be used as organ farms for the wealthy?

April 10, 2007 4:49 AM  
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