• What are red marketsInternational Business Times | 09 December 2017
    [read the article]


    By Lara Rebello

    ‘What are red markets? World's major organ trafficking countries bank on poverty and desperation

    A recent investigative piece into the conditions of African migrants stuck in Libya raised the curtain on the underground slave trade rings in the country and triggered international calls for investigations into the matter. It also shed light on the organ market that has been burgeoning alongside — banking on the bodies of financially desperate migrants. The migrant crisis in Africa as well as other parts of the world has offered organ traffickers a steady flow of donors — willing or unwilling — to sever ties with their kidneys, livers and other body parts....

  • DICG Statement on GKEP

    Statement of the Declaration of Istanbul Custodian Group concerning ethical objections to the proposed Global Kidney Exchange Program


    To download a copy of the statement, please click here.

     


    In accordance with the principles of the Declaration of Istanbul and the Guiding Principles of the World Health Organization (WHO), the Declaration of Istanbul Custodian Group (DICG) is committed not only to discouraging practices and policies that directly or indirectly contribute to organ trafficking and transplant tourism but also to supporting the development and strengthening of equitable programs of donation and transplantation around the world....

  • How Indians were trafficked for organs in EgyptThe Indian Times | 23 November 2017
    [read the article]


    By Sumitra Debroy

    ‘Donate your kidney or face jail in Cairo’

    Yaseer Ahmed Basha (29) father to a six-year-old son and a three-year-old daughter, is unaware that he too is now an accused in the international kidney racket for selling his left kidney to Malad resident Pankaj Rao. He maintained that he was threatened and tricked into giving his kidney after he went to Cairo in July with the promise of driving an Uber cab. "It was 99% deception, but 1% my greed for money." He now makes a living driving an autorickshaw to support his parents there and his family in Taloja...

  • Some U.S. Hospitals Dont Put Americans First for Liver TransplantsProPublica and Fox 8 WVUE New Orleans| 20 November 2017
    [read the article]


    By Charles Ornstein and Lee Zurik

    Some U.S. Hospitals Don’t Put Americans First for Liver Transplants

    At a time when there aren’t enough livers for ailing Americans, wealthy foreigners fly here for transplants.

    Dr. Gabriel M. Danovitch, Honoury member of the Declaration of Istanbul Custodian Group, talks about national self sufficiency in organ donation.

    Also see Fox 8 News video on this co-published story...

  • Delhi govt suspends Apollo Hospitals kidney transplantation licenceHindustan Times | 17 November 2017
    [read the article]


    By HT Correspondent

    Delhi govt suspends Apollo Hospital’s kidney transplantation licence

    The Delhi government has ordered the suspension of Indraprastha Apollo Hospitals’ licence for kidney transplants till January 5 after police busted a kidney racket involving secretarial staff of doctors working at the hospital last year.

    During the suspension period, the hospital cannot register new kidney transplant patients, but close to 40 patients who have been cleared by the committee for transplantation will continue with their treatment...

  • Bonds of lifeThe Japan News | 27 October 2017
    [read the article]


    By The Yomiuri Shimbun

    Bonds of life — the Organ Transplant Law 20 years on

    The Yomiuri Shimbun writes in a five part installment on the Organ Transplant Law in Japan and the 20 years after it came in practice.

    The article link focus on desperate recipients who has traveled to other countries for transplantation, but for a fuller understanding of the situation in Japan, read all five.

  • Should you be allowed to sell your kidneyGizmodo Media Group | 09 October 2017
    [read the article]


    By Whitney Kimball

    Should You Be Allowed to Sell Your Kidney?

    Giz Asks, talked to bioethicists, disagreeing doctors and the World Health Organization about their opinions...

  • What are red marketsInternational Business Times | 09 December 2017
    [read the article]


    By Lara Rebello

    ‘What are red markets? World's major organ trafficking countries bank on poverty and desperation

    A recent investigative piece into the conditions of African migrants stuck in Libya raised the curtain on the underground slave trade rings in the country and triggered international calls for investigations into the matter. It also shed light on the organ market that has been burgeoning alongside — banking on the bodies of financially desperate migrants. The migrant crisis in Africa as well as other parts of the world has offered organ traffickers a steady flow of donors — willing or unwilling — to sever ties with their kidneys, livers and other body parts....

  • DICG Statement on GKEP

    Statement of the Declaration of Istanbul Custodian Group concerning ethical objections to the proposed Global Kidney Exchange Program


    To download a copy of the statement, please click here.

     


    In accordance with the principles of the Declaration of Istanbul and the Guiding Principles of the World Health Organization (WHO), the Declaration of Istanbul Custodian Group (DICG) is committed not only to discouraging practices and policies that directly or indirectly contribute to organ trafficking and transplant tourism but also to supporting the development and strengthening of equitable programs of donation and transplantation around the world....

  • How Indians were trafficked for organs in EgyptThe Indian Times | 23 November 2017
    [read the article]


    By Sumitra Debroy

    ‘Donate your kidney or face jail in Cairo’

    Yaseer Ahmed Basha (29) father to a six-year-old son and a three-year-old daughter, is unaware that he too is now an accused in the international kidney racket for selling his left kidney to Malad resident Pankaj Rao. He maintained that he was threatened and tricked into giving his kidney after he went to Cairo in July with the promise of driving an Uber cab. "It was 99% deception, but 1% my greed for money." He now makes a living driving an autorickshaw to support his parents there and his family in Taloja...

  • Some U.S. Hospitals Dont Put Americans First for Liver TransplantsProPublica and Fox 8 WVUE New Orleans| 20 November 2017
    [read the article]


    By Charles Ornstein and Lee Zurik

    Some U.S. Hospitals Don’t Put Americans First for Liver Transplants

    At a time when there aren’t enough livers for ailing Americans, wealthy foreigners fly here for transplants.

    Dr. Gabriel M. Danovitch, Honoury member of the Declaration of Istanbul Custodian Group, talks about national self sufficiency in organ donation.

    Also see Fox 8 News video on this co-published story...

  • Delhi govt suspends Apollo Hospitals kidney transplantation licenceHindustan Times | 17 November 2017
    [read the article]


    By HT Correspondent

    Delhi govt suspends Apollo Hospital’s kidney transplantation licence

    The Delhi government has ordered the suspension of Indraprastha Apollo Hospitals’ licence for kidney transplants till January 5 after police busted a kidney racket involving secretarial staff of doctors working at the hospital last year.

    During the suspension period, the hospital cannot register new kidney transplant patients, but close to 40 patients who have been cleared by the committee for transplantation will continue with their treatment...

  • Bonds of lifeThe Japan News | 27 October 2017
    [read the article]


    By The Yomiuri Shimbun

    Bonds of life — the Organ Transplant Law 20 years on

    The Yomiuri Shimbun writes in a five part installment on the Organ Transplant Law in Japan and the 20 years after it came in practice.

    The article link focus on desperate recipients who has traveled to other countries for transplantation, but for a fuller understanding of the situation in Japan, read all five.

  • Should you be allowed to sell your kidneyGizmodo Media Group | 09 October 2017
    [read the article]


    By Whitney Kimball

    Should You Be Allowed to Sell Your Kidney?

    Giz Asks, talked to bioethicists, disagreeing doctors and the World Health Organization about their opinions...

  • Kidney trafficking broker faces courtKhmer Times | 20 October 2017
    [read the article]


    By Buth Reaksmey Kongkea

    Kidney trafficking broker faces court

    An alleged member of an organ trafficking ring was charged yesterday over a year-long kidney sale operation involving at least 10 victims.

    Construction worker Cheoun Thi, 38, of Phnom Penh was accused of unlawful removal of organs with purpose and “the act of selling, buying or exchanging a person”, which includes selling, buying or exchanging organs.

    The charges, laid in Phnom Penh Municipal Court, fall under the Law on Suppression of Human Trafficking and Sexual Exploitation. They carry a jail term of up to 15 years...

  • Nigerians warnedBuzzNigeria | 18 October 2017
    [read the article]


    By Iheoma Hendy

    Kidney Trafficking: Federal Goverment Alarmed Over High Rate Of Practice, Expose Hospitals

    The health ministry has written to the Nigerian Medical Association to warn all doctors in relevant specialties to create awareness for Nigerians intending to travel to Egypt for medical attention.

    The memo by the Director for Hospital services, Dr Wapada I. Balami for the Minister of Health entitled, "41 suspected illegal human kidney traffickers on the trail in Egypt" raises concern about patients possibly seeking treatment abroad and their doctors referring them to any complicit hospital...

  • Kidney for sale - Iran has a legal market for the organsLos Angeles Times | 15 October 2017
    [read the article]


    By Shashank Bengali and Ramin Mostaghim

    'Kidney for sale': Iran has a legal market for the organs, but the system doesn't always work

    The advertisements are scrawled in marker on brick walls and tree trunks, and affixed to telephone utility boxes, sidewalks and a road sign pointing the way to one of Iran’s leading hospitals.

    “Kidney for sale,” read the dozens of messages, accompanied by phone numbers and blood types, splashed along a tree-lined street opposite the Hasheminejad Kidney Center in Tehran.

    New ads appear almost daily. Behind each is a tale of individual woe — joblessness, debt, a family emergency — in a country beset by economic despair.

Incentives, kidney donation, and the myth of the Iranian waiting list

In a recent New York Times article, Tina Rosenberg argues that the United States should introduce financial incentives for living kidney donors. She writes, “In 2014, there were 17,106 kidney transplants in the United States, but more than twice that many people went on the waiting list.”

She believes that use of incentives could resolve this problem because the legal Iranian market for organs has “essentially eliminated” the waiting list for a kidney.

Such claims about the Iranian waiting list, which are commonly invoked in support of kidney markets in the United States and elsewhere, are simply false. People with end stage kidney failure living in the United States are more likely to receive a transplant than those living in Iran. Commentators debating the issue of incentives for donation have a responsibility to draw on the best available evidence in their arguments, and should not simply recycle and perpetuate myths about the success of the Iranian market.

What counts as proof that a waiting list has been eliminated?

The alleged success of the Iranian kidney market is regularly cited in public commentary and academic debate by advocates of financial incentives. References in scholarly publications can usually be traced back to a 2002 publication by Iranian nephrologist Ghods in which he declared that, “the renal transplant waiting list [in Iran] was eliminated by the end of 1999.”

What does it mean to “eliminate” a waiting list for transplantation? In many countries people in need of a kidney transplant may be unable to join a national waiting list for transplantation because

  • They cannot access healthcare services necessary for diagnosis of kidney failure, or required to prepare them for transplantation such as dialysis;
  • They cannot afford transplantation services or immunosuppression;
  • They do not meet eligibility criteria for the waiting list, where criteria such as age or comorbidities are designed to keep the list sufficiently short to match the supply of organs available for transplant;
  • There is no national waiting list for transplantation.

In a 2006 publication by Ghods and Savaj which is also cited as evidence that incentives have solved the problem of organ shortages in Iran, the authors again claim that “by 1999, the renal transplant waiting lists in the country was eliminated successfully”. In this paper, they offer an explanation which shows that the size of the waiting list in Iran is influenced by lower rates of diagnosis of end stage kidney disease:

In Iran, as in other developing countries, the prevalence of patients with ESRD is markedly lower compared with the prevalence of patients who are on renal replacement therapy in developed countries. A major cause of this is the many patients who are from villages and small towns and do not receive a diagnosis and are not referred for dialysis therapy. There also is no adopted restricting policy for accepting patients with ESRD for renal transplantation; however, the low prevalence of patients with ESRD results in fewer numbers of transplant candidates. This is the main reason that the renal transplant waiting list was eliminated quickly and successfully in Iran….”

Ghods, A. J., & Savaj, S. (2006). Iranian model of paid and regulated living-unrelated kidney donation. Clinical journal of the American Society of Nephrology, 1(6), 1136-1145. (p.1139)

The truth about the Iranian waiting list

Claims about the successful elimination of the Iranian waiting list in the early 2000s were questioned by commentators such as Griffin. However, incentive advocates have preferred to express ethical concerns about some elements of the Iranian model, arguing that better regulated incentive systems will address these, rather than to question the success of the model.

Commentators writing today ought to draw on more recent analysis of the Iranian market. A recent report by Iranian experts clearly shows that there is indeed a waiting list for kidney transplantation in Iran:

Rouchi, A. H., Ghaemi, F., & Aghighi, M. (2014). Outlook of Organ Transplantation in Iran. Iranian journal of kidney diseases, 8(3).

In this paper, the authors provide the following table summarising the disparity between the number of transplants and the number of patients waitlisted for transplantation in 2011:

Iran Waiting list

The authors note that, “the never-disappearing waiting list for kidney transplantation will be growing steadily”.

UNODC publishes toolkit for assessment of trafficking in persons for organ removal

Screen Shot 2015-06-28 at 5.11.07 pmThe United Nations Office on Drugs and Crime has published a toolkit for use in the assessment of trafficking in persons for organ removal.

"The toolkit aims to provide both a general overview of trafficking in persons for the purpose of organ removal and specific tools to assist concerned actors with assessing the phenomenon. The structure of the toolkit reflects this two-pronged approach in that its first part seeks to inform about the context in which trafficking in persons for organ removal can take place, the relevant legislative framework and international guidance, actors and modi operandi as well as good practice responses. The second part has very specific questionnaires that aim to allow for a better understanding of and a more systematic collection of data on the crime."

You can download the Assessment Toolkit here courtesy of UNODC.

Financial Incentives for Living Kidney Donors: Are They Necessary?

AJKD

 2015; Published online June 6


Dominique E. Martin and Sarah L. White

In the face of the perceived failure of altruistic organ donation programs to generate sufficient kidneys to meet demand, introducing financial incentives for living donors is sometimes argued as the only effective strategy by which lives currently lost while awaiting kidney transplantation might be saved. This argument from life-saving necessity is implicit in many incentive proposals, but rarely challenged by opponents. The core empirical claims on which it rests are thus rarely interrogated: that the gap between supply of and demand for donor kidneys is large and growing, the current system cannot meet demand, and financial incentives would increase the overall supply of kidneys and thus save lives. We consider these claims in the context of the United States. While we acknowledge the plausibility of claims that incentives, if sufficiently large, may successfully recruit greater numbers of living donors, we argue that strategies compatible with the existing altruistic system may also increase the supply of kidneys and save lives otherwise lost to kidney failure. We conclude that current appeals to the life-saving necessity argument have yet to establish sufficient grounds to justify trials of incentives.

To read the complete article, click here. (Subscription required.)

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