SWCHSMUN 2014
WHO Background Guide
Sir Winston Churchill HSMUN Conference
SWCHSMUN 2014
Table of Contents
History of the Committee…………………………………………………Pages 2-3
Current Membership in WHO…………………………………………..Page 3
Topic 1: Genetically Modified Foods…………………………………Pages 4-9
Topic 2: Infectious Diseases in a Globalized World……………Pages 10-12
WHO Background Guide | SWCHSMUN 2014
Topic 3: Illegal Organ Trafficking……………………………………….Pages 13-20
1
History of the Committee:
The first primary objective of WHO at the time when it was founded was to
eradicate malaria, tuberculosis, and sexually transmitted infections, as well as to
improve maternal and child health in compromised and vulnerable areas. The
agency’s initial efforts included a mass tuberculosis vaccination drive in 1950 and
a malaria eradication drive in 1955. Later, WHO began to coordinate its efforts
with other international organizations, including the United Nations Development
Program (UNDP), the World Bank, and the Food and Agriculture Organization
(FAO). The agency also began to broaden its perspective when it enacted a
resolution on Disability Prevention and Rehabilitation in 1976. One of WHO’s
earliest and most prominent victories was the eradication of the only known
human disease to be completely eliminated –smallpox. In 1967, some 15 million
cases of smallpox (an incurable and often deadly disease) were occurring in more
than 30 endemic countries. This prompted the launching of the Intensified
Smallpox Eradication Programme, which initially aimed to curb the spread of the
disease through mass vaccination.
Though the agency’s theoretical goal was to vaccinate 100% of the population, a
regional outbreak in Nigeria provided insight into a novel and more feasible
strategy.
Using a new technique of surveillance and containment, vaccinating vulnerable
populations and isolating infected individuals, the transmission chain of smallpox
could be broken even if less than half the population received the vaccination. In
this way, WHO-led efforts managed to halt the spread of smallpox and officially
released a statement in 1979 announcing global eradication of the disease.
Thereby the process of institutional memory and local adaptation became
WHO Background Guide | SWCHSMUN 2014
The World Health Organization is a specialized United Nations agency, created in
1946 to discuss and combat issues concerning international public health. It is a
global body of leadership that directs and aids in research, provides policy
recommendations based on empirical data, and sets global health standards. Its
constitution states that its objective is “the attainment by all people of the
highest possible level of health.” WHO was the first specialized agency in the
United Nations to which every member nation subscribed. Its constitution was
ratified in 1948, and its first leaders were Andrija Stampar, a Croatian medical
scholar, and G. Brock Chisholm, a Canadian First World War veteran. WHO was
preceded by the Health Organization, an agency of the short-lived League of
Nations.
2
essential to WHO’s progress and development, setting the stage for many other
global health-related achievements. Other historical operations of WHO included
a list of “essential medicines” compiled in 1977, which forms the basis of national
drug policy in both developed and developing countries. This also means that
governments of sovereign states refer to WHO for guidelines regarding national
health expenditures. In 1989, the agency began a global program to combat
HIV/AIDS, followed up by UNAIDS in 1996 to coordinate comprehensive global
action regarding the AIDS epidemic. In 1988, the Global Polio Eradication Initiative
was established.
Though international progress in medical technology and health policy has led to
shifts in WHO’s focus, its general objectives remain the same, as outlined in its
Constitution: to act as a directing and coordinating global authority on health
matters; to assist governments in strengthening health services; to promote the
improvement of nutrition, sanitation, and hygiene; to collaborate with scientific
and professional groups that contribute to the advancement of health; and to
make recommendations regarding health policy.
Current Membership in WHO:
Angola
Burkina Faso
Cameroon
Djibouti
Gabon
Ghana
Mauritania
Mauritius
Nigeria
Senegal
Uganda
Zambia
South Sudan
Bahrain
Bangladesh
China
Japan
Jordan
Kyrgyzstan
Malaysia
Maldives
Pakistan
Qatar
South Korea
Saudi Arabia
Thailand
Hungary
Poland
Moldova
Russia
Slovakia
Ukraine
Belgium
France
Norway
Spain
Switzerland
United Kingdom
United States
Argentina
Brazil
Chile
Cuba
Ecuador
Guatemala
Mexico
Uruguay
WHO Background Guide | SWCHSMUN 2014
There are 193 member states in WHO, but due to space restrictions at the
Churchill campus, membership in this committee will be restricted to the
following countries.
3
The problem of genetically modified (GM) foods stems from the controversy of
distributing foods that have been tampered with. Many fear the unknown effects
that may hide within the chemical structure of GM foods and hence there is
worldwide hesitance for allowing its availability. In 2006, GM crops grew by 97%
in countries including China (3%), Paraguay, (2%), Canada (6%), Argentina (17%),
South Africa (1%), India (4%), and the United States (53%).1 As of 2007, 282.4
million acres (114.3 million hectares) were planted, showing a 12% increase
compared to the statistics of 2006. 2 Even with all the controversy, the world
cannot deny the opportunities that GM foods present: new ways of creating food
to help fight against pesticide toxicity, poverty, food-borne diseases, and more. It
is no wonder that there is an overall movement towards using GM foods. Utilizing
GM foods has provided amazing contributions towards the Millennium
Development Goals of halving poverty by 2015.3 Globalization seems to bring a
portion of the GM food’s controversy. Many believe that it is unnatural to be
eating foods that have been manipulated; it is the going against the flows of
nature.4 Others view this as the start of a possible endangerment of farmers and
the farming economy because of fear that farmers will not be able to compete
with the technology.5 We see this as a commencement of the fusion of both
agriculture and industry as the urge for mass production and standardization
becomes stronger.6 Additionally, globalization obviously introduces the reduction
of differences in culture and therefore in foods as well.
In the mid-1990s, the Calgene Company was the first to create the first GM
tomatoes.7 As new competitors emerged, the GM food production moved to
Europe where the controversies began to take flight. Protests about the use of
GM foods, public mistrust, and backlash from scientists brought suspicion toward
GM foods. Some countries, such as India, embraced the production of GM foods.8
The WHO is hard at work in order to assess many public concerns about GM
foods. In 2003, the Codex Alimentarius Commission instituted the Codex
Principles for the Risk Analysis of Foods Derived from modern Biotechnology in
order to provide a framework for risk analysis of GM foods.9 Also, the Cartagena
Protocol of Biosafety was created in order to regulate trans-boundary movement
of living modified organisms (LMOs) in order to protect the environment.10 In
addition, the International Food Safety Authorities Network (INFOSAN) was an
initiative created between the Food and Agriculture Organization (FAO) of the
United Nations and the WHO in order to foster better communication regarding
GM food safety.11 As of today, the WHO is hard at work on improving four main
WHO Background Guide | SWCHSMUN 2014
Topic 1: Genetically Modified Foods
4
Allergenicity
Allergies are produced as a result of the body’s immune system antigens and
antibodies reacting towards unknown substances such as bacteria, parasites, and,
in this case, proteins that are unable to be killed through heat, stomach acid, or
intestinal enzymes. Immunoglobulin E (IgE), and a mast cell are the culprits for
allergic reactions. The allergen that enters the body usually causes lymphocytes to
react against it by producing IgE antibodies. The antibodies attach to mast cells
and prepare themselves for the next time the individual eats the select food. If
the food is eaten again, various chemicals are produced to create an allergic
reaction. The symptoms produced include nausea, diarrhoea, abdominal pain,
hives (eczema), asthma, light-headedness, anaphylaxis, weakness, itching, etc.15
One of the major reasons for why GM foods might induce allergies is due to the
new types of proteins introduced to the foods by the genes implanted. These may
unfortunately act with the aforementioned IgE, which plays a major role in
allergic reactions. Another reason for the creation of new allergens may be due to
DNA damage of native cells of the foods through genetic engineering.16 Massive
changes to the natural functioning of DNA may occur; such changes may include
deletions, mutations, and the on/off switching of genes. Allergenicity is a major
concern revolving around the use of genetically modified foods. Many patterns of
WHO Background Guide | SWCHSMUN 2014
areas dealing with GM foods: establishing safety assessment frameworks,
creating risk assessments in order to improve risk communication and
management efforts, standardizing safety assessments, and utilizing GM foods to
address developing countries’ needs.12 The Codex Alimentarius Commission is
working on adopting premarket risk assessments, a major source of debate today;
provisions of the Cartegena Protocol on Biosafety have also been at work to help
the situation.13 In addition, the Committee on Food labeling is developing
guidelines since the 1990s in order to help with the labeling issues.14 Another
important implementation was in 2000, when the United Nations Environmental
Programme (UNEP) and the Global Environment Fund (GEF) established the
protocol for countries to create their own national bio-safety frameworks
systems. The frameworks implemented usually consist of monitoring
mechanisms, ways to improve awareness and participation, regulations, and
improving administrative and decision mechanisms. There are a few of the issues
revolving around GM foods. It is suggested that delegates research the rest of the
issues (most notably, labeling and safety assessments of GM products) because
they will also be very important during the conference.
5
Labeling and Detection of GM Foods
Labeling is an ongoing issue for GM food distribution. Various countries, including
members of the EU, Japan, and New Zealand have instituted mandatory labeling
of GM goods. To date, there is a lack of consensus among UN Member States over
the labeling issue. This issue with labeling stems from the fact that some scientists
believe that GM foods do not harm people; they are nutritionally equivalent to
the real thing.20 Yet, there is a big trust issue about risk assessments made among
the public in European countries. Many politicians express that it is the choice and
right of consumers if they want labeling on the product.21 The issue of detecting
GM foods is entangled with the labeling problem. It is difficult to identify if foods
are genetically created. For example, polymerase chain reaction (PCR) is a
common way of identifying GM foods. The problem is that it is very difficult to
detect any of the DNA, especially in processed foods. Not only that, but detection
brings tests and further problems commence such as lack of standards, false
results, costs, etc. PCRs exemplify the predicament, as it is very expensive and it is
very limited in availability, plus it produces mean false positives.22 Foods like
meats and soybean oil usually do not show any evidence of GM proteins.23 Many
people supporting labeling state that consumers have the right to know whether
they are eating a GM food, while those against labeling believe the labeling
implies a non-existent safety risk.24 They would also produce unneeded marketing
costs and impair the development of GM technology.25 Moreover, labeling has
proved to inhibit the delivery of GM goods to poor countries that are in need of
supplies. One example of GM crops that fail to be delivered are rice crops that are
vitamin A enriched.26
WHO Background Guide | SWCHSMUN 2014
allergen exposure are found around the world. For example, buckwheat allergies
in the Far East found are to be more common than in Europe.17 There is much
public contention in the European Union about the distribution of GM foods. It
has resulted in a so called “moratorium on approval of GM products.”18 There are
various safeguard clauses made by member states to ban the use of oilseed rape
products and maize (both genetically modified), yet most of them were denied by
the Scientific Committee on Plants because the reasons did not justify the bans.19
There is much debate over this issue in other parts of the world as well. Recently,
southern Africa has begun to view the use of GM foods as a source of food aid for
the various emergency situations that it may encounter. Yet, the national
governments within the region have shown signs of reluctance because of fears
for allergenicity and other reasons.
6
United Kingdom
The United Kingdom believes in the expansion of GM crops. It has pushed for the
12 year moratorium to become obsolete in order to proceed with further
commercialization of the products. It was one of the first countries in Europe and
the European Union to accept the use of GM crops due to its cheapness when it
was first traded in by the United States in 1996.30
Hundreds of millions of pounds are invested in agricultural research all over the
world to improve and expand GM research and production.31 Foods accepted for
GM production in the UK include: wheat, potatoes, tomatoes, soya, and maize.32
In order to protect the population against any hazards that GM products may
contain, the Advisory Committee on Novel Foods and Processes (ACNFP) provides
safety assessments on the foods.33
WHO Background Guide | SWCHSMUN 2014
Antibiotic-Resistance Gene Transfer
Antibiotic resistance genes are commonly implanted in plant cells to create GM
plants that will produce GM products. Unfortunately, fear of the maladaptive
effects of this implantation has spurred further contention against the GM
controversy. Antibiotic resistance genes are implemented within the plant cells in
order to protect them from the antibiotic, thus allowing them to survive by
breaking down the poisonous antibiotic chemical.27 In order to identify plant cells
that received the gene, they are given antibiotic resistance marker genes. The
rare yet unfortunate problem is that some antibiotic resistance marker genes may
be taken up by bacteria within the area of digestion or even around the crops.
This may create antibiotic resistance against various treatments that would have
originally killed the bacteria, causing harm to the population, medically and
economically. Although the issue has not happened, it is still a possibility as a
result of bacteria’s astounding reproductive rate. One way to reduce the chances
of this happening is to take out the antibiotic resistance marker genes to reduce
any gene uptake.28 Yet many have found the extraction of marker genes to be
very difficult. Other systems are at work to improve the current marker genes.
Such systems include herbicide resistance genes, visible markers, etc. One major
impact of this is to further add fuel towards banning GM foods in European
countries. The commercialization of GM foods with the antibiotic resistance
makers sparked uneasiness and outcry in European countries and as such the EU
recommended the phasing out of GM foods containing these markers. 29
7
Questions to Consider
1. How have GM foods affected your country?
2. What is the public opinion about GM foods?
3. What is your government’s position on GM food regulation?
4. What NGO’s or WHO regulations have helped your country’s overall situation
with GM
products?
5. How has the GM food issue affected your country?
Suggested Websites
Endnotes
1 http://www.ornl.gov/sci/techresources/Human_Genome/elsi/gmfood.shtml
2 http://www.monsanto.com/biotech-gmo/asp/topic.asp?id=200 7GlobalReport
3 http://www.monsanto.com/biotech-gmo/asp/topic.asp?id=2007GlobalReport
4 http://www.eubios.info/EJ123/ej123g.htm
5 Ibid.
6 Ibid.
7 http://www.geneticallymodifiedfoods.co.uk/development-history-gmfoods.html)
8 Ibid.
WHO Background Guide | SWCHSMUN 2014
WHO
http://www.who.int/foodsafety/biotech/en/
SciDev
http://www.scidev.net/en/
FAO
http://www.fao.org/
AllAfrica
http://allafrica.com/
GMO-Compass
http://www.gmo-compass.org/eng/home/
IFPR
http://www.ifpr-icpr.net/
New Agriculturist
http://www.new-ag.info/index.php
8
WHO Background Guide | SWCHSMUN 2014
9 http://www.who.int/foodsafety/biotech/meetings/en/gma
nimal_reportnov03_e n.pdf
10 Ibid.
11 http://www.who.int/foodsafety/fs_management/infosan/en/index.html
12 http://www.who.int/foodsafety/biotech/general/en/index.html
13 http://www.who.int/foodsafety/publications/biotech/20questions/en/
14 http://www.agmrc.org/media/cms/cartergruere_929BEB69BA4EE.pdf
15 http://www.medicinene t.com/food_allergy/page2.htm
16 http://www.organicconsumers.o rg/articles/article_5296.cfm
17http://www.scidev.net/en/policy-briefs/could-genetically-modified-foods-be-anewsourceo.html
18 http://www.who.int/food safety/publication s/biotech/20questions/en/
19 Ibid.
20 http://www.agmrc.org/media/cms/cartergruere_929BEB69BA4EE.pdf)
21 Ibid.
22http://www.afic.org/Detecting%20Genetically%20Modified%20Foods%20%20Easier%20said%20than%20done.htm)
23 http://www.agmrc.org/media/cms/cartergruere_929BEB69BA4EE.pdf
24 Ibid.
25 Ibid.
26 Ibid.
27 http://www.gmocompass.org/eng/safety/human_health/45.antibiotic_resistance_genes_transgenic_plants.html
28 Ibid.
29 Ibid.
30 http://www.agmrc.org/media/cms/cartergruere_929BEB69BA4EE.pdf
31 http://www.guardian.co.uk/environment/cif-green/2010/jul/12/britishpressure-gmcropsunwelcome-europe
32 http://bmb.oxfordjournals.org/ cgi/reprint/56/1/62.pdf
33 http://www.acnfp.gov.uk/
9
Topic 2: Infectious Diseases in a Globalized World
However, what makes SARS notable from a biosecurity standpoint is not its death
toll, but rather its implications for future, deadlier epidemics. For one,
international air travel has created a so-called “global village” wherein a virus can
leap from even the remotest of areas and become a global crisis within weeks or
even days. In light of this development, many epidemiologists consider SARS an
unequivocal call for “better global citizenship” on matters of transnational
importance, stressing the need for full disclosure on time-sensitive issues with
global consequences (the Chinese government, for example, had initially been
reluctant to report SARS cases to the WHO).
Another important development in biosecurity measures came with the case of
Andrew Speaker in 2007. Speaker, an Atlanta native, was diagnosed with a rare
form of multi-drug-resistant tuberculosis (MDR-TB) in May 2007. After his
diagnosis, Speaker flew commercial to several different nations, including France,
Greece, Italy, and Canada, before returning to the United States. During Speaker’s
travels, however, confusion arose as to the severity and contagiousness of his
tuberculosis, and European health officials speculated that he might have been
suffering from extensively drug-resistant tuberculosis (XDR-TB), a much rarer
form of the disease. Both European and American CDC officials attempted
WHO Background Guide | SWCHSMUN 2014
Two salient examples reflect the growing global threat posed by infectious
diseases in the 21st century, the first being the pandemic of severe acute
respiratory syndrome (SARS) that seized the attention of global media in 2002 and
2003. On November 16, 2002, a businessman living in Foshan, a small town in the
Guangdong province of China, fell ill with what was then diagnosed as a case of
atypical pneumonia. Several weeks later, a chef specializing in exotic wildlife
presented similar symptoms and was transferred to a hospital in Guangzhou, the
capital of Guangdong. By the end of the year, dozens of cases of the same disease
had been reported throughout the province. Despite initial confusion and
difficulty in isolating the pathogen behind these cases, the mysterious ailment
was identified as an entirely new disease: severe acute respiratory syndrome
(SARS). In a matter of months, SARS had spread to nearly 30 nations, likely by way
of exposure through air travel, infecting thousands of otherwise healthy civilians.
By the time the epidemic subsided at the end of 2003, the disease had infected
8,098 people and killed 774.
10
to apprehend Speaker and force him into isolation, and US border security came
under scrutiny for allowing Speaker to cross the US-Canada border without issue.
While Speaker, as it turned out, suffered from a much more treatable form of
tuberculosis, the entire case nonetheless raised grave concerns over the protocols
surrounding international travel barriers in the context of diseased passengers. As
far as this body is concerned, when considering these recent disease outbreaks, it
is crucial to consider the sociopolitical and environmental factors that have the
potential to exacerbate future epidemics. Laurie Garrett, a leading infectious
disease epidemiologist and bestselling author, argues in her book The Coming
Plague: Newly Emerging Diseases in a World Out of Balance that certain
‘destabilizing’ factors not only facilitate the spread of diseases, but also increase
the severity of outbreaks worldwide:
Garrett and other leading global public health experts argue that this
destabilization has come as a result of the breakneck speed globalization and
industrialization the world has seen in the past century: human activity, including
warfare, has increasingly impinged upon the natural world, collapsing and
simplifying ecologies and leaving certain ‘gaps’ for infectious diseases to exploit.
What is more, it has been argued that the same reckless human behavior has led
to the advent of entirely new strains of disease—strains that are often resistant to
common methods of treatment. Such strains come about as a result of frequent
abuse and misuse of antibiotics as well as reckless application of disinfectants, to
which certain bacteria and viruses can develop immunity. The aforementioned
case of Speaker’s XDR-TB is a prime example, as are recent outbreaks of
Methicillin-resistant Staphylococcus aureus (MRSA) and several new influenza
strains in the United States. Similar links have been established in the
aforementioned case of SARS, with China’s rapid urbanization and accompanying
“Era of Wild Flavor” contributing to the genesis of the disease, and an increase in
international travel responsible for the disease’s quite literal overnight spread
around the world.
WHO Background Guide | SWCHSMUN 2014
“While the human race battles itself… the advantage moves to the
microbes’ court. They are our predators and they will be victorious if we,
Homo sapiens, do not learn how to live in a rational global village that
affords the microbes few opportunities.”
11
Delegates must decide how to effectively implement policy that can work towards
effective transnational cooperation towards the management of infectious
diseases while simultaneously respecting the political considerations that will
undoubtedly come into play when dealing on a nation-to-nation basis.
Questions to Consider
1. What biological risks are associated with globalization and the explosion of
international commerce in the 21st century? How can these risks be minimized
without sacrificing international communication and cooperation?
2. Under what circumstances should travel restrictions be imposed on the general
population in order to implement biosecurity measures? Who has the authority
to implement travel restrictions? What are the ethical and political implications
of such restrictions?
3. How much power do transnational organizations, such as the UN and the WHO,
have with regard to individual governments and the manner in which they
respond to biological crises?
4. Using the case of SARS as an example, when should we consider full disclosure
to the UN and WHO mandatory?
5. Under what circumstances, if any, should transnational organizations such as
the WHO supersede the authority of national governments on matters of
bioterrorism and biosecurity?
Suggestions for Further Research:
Greenfeld, Karl Taro. China Syndrome: The True Story of the 21st Century’s First
Great Epidemic.
US Centers for Disease Control and Prevention. “Severe Acute Respiratory
Syndrome (SARS).” http://www.cdc.gov/sars/
World Health Organization. Global Alert and Response: SARS.
http://www.who.int/csr/sars/en/
WHO Background Guide | SWCHSMUN 2014
Garrett, Laurie. The Coming Plague: Newly Emerging Diseases in a World Out of
Balance.
12
Topic 3: Illegal Organ Trafficking
Background Information
Organ trafficking and illicit transplant surgeries have infiltrated global
medical practice, but despite the evidence of widespread criminal networks as
well as several limited prosecutions in countries including India, Kosovo, Turkey,
Israel, South Africa and the US, it is still not treated with the seriousness this issue
demands.
Since the first report into the matter in 1990, there have been an alarming
number of post-operative deaths of the “transplant tour” recipients from
surgeries gone wrong, mismatched organs, and high rates of fatal infections,
including HIV and Hepatitis C contracted from sellers' organs. Living kidney sellers
suffer from post-operative infections, such as: weakness, depression, some die
from suicide, and some from kidney failure. Organs Watch documented five
deaths among 38 kidney sellers recruited from small villages in Moldova. This
WHO Background Guide | SWCHSMUN 2014
International organ trafficking is a burgeoning trade. According to the
World Health Organisation, around one in ten organ transplants involves a
trafficked human organ, which add up to approximately 10,000 each year.
Kidneys are the most commonly traded organ. A report by Global Financial
Integrity estimates that the illegal organ trade generates between $600 million
and $1.2 billion in profits annually, often funded by patients willing to pay
upwards of $200,000 for a kidney and $1 million for a heart. The United
Nations asserts that people of all ages could become targets but migrants,
homeless people, and illiterate individuals are particularly vulnerable. Children,
especially physically disabled or socially disadvantaged ones, are frequently
targeted. Donor countries usually include impoverished South American, African,
Asian and Eastern European nations, according to a Harvard College study;
meanwhile, recipient countries are usually America, Canada, Australia, the UK and
Japan. Trafficking involves a whole host of offenders, from recruiters who identify
the victims to transporters and hospital or clinic staff. Last year, the Salvation
Army revealed that it had rescued a woman brought to the UK to have her organs
harvested, which was thought to be the first case of its kind in this country.
13
trade involves a network of human traffickers, including mobile surgeons,
brokers, patients, and sellers who meet for clandestine surgeries involving cutthroat deals that are enforced with violence when necessary. Many of the “kidney
hunters” are former sellers, recruited by crime bosses into the tight web of
transplant trafficking schemes.
Distressing stories lurk in the murky background of today’s business of
commercialised organ transplantation, conducted in a competitive global playing
field that involves around 50 nations. The World Health Organisation estimates
that 10,000 black market operations occur annually, a disturbing number
signifying the enormity of this issue. The sites of illicit transplants have expanded
from Asia to the Middle East, Eastern Europe to South Africa, Central Asia to Latin
America, as well as the US. All are facilitated by local criminal networks, but those
run by organised global criminal syndicates are the most dangerous, mobile, and
widespread. They are also the most difficult to trace and to intercept.
In 2008, the climate of denial began to change when The Transplantation
Society and the International Society of Nephrology, held a major summit which
acknowledged organ trafficking as a reality. Moral pressure was then put on
countries actively involved in organised and disorganised international schemes
to recruit paid, living donors. Despite this, criminal networks of brokers and
transplant trafficking schemes are still robust, exceedingly mobile, resilient, and
generally one step ahead of the game. Meanwhile, one economic or political crisis
after another has also supplied the market with countless refugees that fall like
ripe fruit into the hands of organ traffickers. The desperate, displaced and
WHO Background Guide | SWCHSMUN 2014
Until recently this all went unnoticed. There exists considerable resistance
among transplant professionals who consider trafficking to be relatively rare and
a crime that only took place in third world countries. These professionals loathed
the acknowledgement of transplant trafficking schemes in American and South
African hospitals, not to mention the existence of transplant tourism packages.
Bioethicists argue endlessly about the “ethics” of what constitutes a crime or
medical human rights abuse.
14
dispossessed can be found and recruited to sell a spare kidney in almost any
nation.
Ethical Dilemmas of the Organ Trade
Despite the risky costs of traveling abroad for vital surgery, the idea of
impoverished people donating organs to lift themselves out of debt and
afterwards becoming more marginalized by their health condition is a huge
ethical dilemma within the medical tourism industry. Many people who seek the
services that the medical tourism industry provides will never meet their donor
and know anything about that person’s post-operation physical recovery. Some
claim that this industry is just that: an industry that operates to make profit,
without focusing on the healthcare of the donor and the receiver. One person
provides the service and the other pays for it, end of story. Due to the widespread
de-regulation of medical tourism in developing countries, it is becoming an
alarming health and legal concern for the donor, the receiver and the medical
practitioners doing the surgeries. People who travel outside of their country for
surgery are not protected by their own legal system. If something goes terribly
WHO Background Guide | SWCHSMUN 2014
Due to a growing organ shortage and the unpopular reputation of using
cadaverous organs, organs which are procured from dead bodies, the illicit human
organ trade has grown quite popular around the world. Many living in poverty in
developing countries are using the organ trade as an opportunity to make up to
$20,000 from one operation.1 Most of the people who are seeking out illegal
organ traders requiring organ transplants are persons from developed countries,
hoping for reduced medical costs and a much shorter waiting period. This process
bypasses the normal organ waiting period. Usually, organ brokers require those in
need of a transplant to pay a one-time cost of up to $120,000, and may include a
roundtrip flight to a developing country, a stay in a
private hospital and the promise of a safe organ transplant.2
On the other hand, those who are willing to give up their organs for cash are
oftentimes promised much more money than the broker will actually deliver. In
many instances, people selling their organs are also denied proper medical care
after the operation. Due to the risky nature of the trade, and the fact that it is
illegal, organ donors can be promised money, but when it is not received, they
do not a have law to ensure their payment. In addition, many organ brokers use
the market in their favor, and claim that in times when there is a high surplus of
donors, they can lower the amount of money promised to organ donors.3
15
Abolition vs. Regulation
Medical research points to the fact that if people were required or even
given the option of donating their organs when registering for their driver’s
license (as in the U.S.) in countries like India where there is no option available to
them, the business boom of organ trafficking would decrease significantly. In
addition to this, educating more people about the importance of the usage of
cadaverous organs in saving lives is vital to ending the abuses of the trade.
In addition to providing better education, many believe that NGO’s should also
take more action to inform governments to sign the UN Convention Against
Transnational Organized Crime (2000), which ultimately protects humans or their
organs from being trafficked. Governments should also make an effort to educate
all people about the organ trade and the harms associated with being involved in
it.4
On the other side of the debate, some health professionals believe that the
organ transplantation process should be formally legalized, so it can be regulated
internationally. Those in favor of legalizing the organ trade believe that this
measure will make the process much safer, and will prevent dangerous
underground networks from operating for large profits. An important part of this
debate is regulating the “north-south exchange,” and making sure poor people
from the geographic south are not being exploited for the benefit of rich
northerners. This could possibly involve setting up laws that make it illegal to
travel outside of one’s own country for surgical operations involving organ
donation. These types of laws, however, could be extremely hard to enforce, and
this may lead to a separate black market organ trade within countries’ borders.
Past International Involvement
In addition to the UN Protocol on Trafficking, which includes organ trafficking, the
World Health Organization states that “the commercialization of human organs is
a violation of human rights and human dignity.” The WHO also stipulates that the
transfer of human organs should only take place when there is informed consent,
WHO Background Guide | SWCHSMUN 2014
wrong, the patient must learn how to find justice through a foreign legal system,
often extremely difficult as patients are rarely knowledgeable of the foreign
legal system in which they are trying to navigate. Moreover, because the foreign
patient is not considered a citizen, there may be no protection for them in that
system.
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there is a positive tissue and blood match as well as a genetic relationship, and
that cadaverous organs should be used if they’re available above any living
donation.5
The European Convention on Human Rights and Biomedicine of 1997 also states
that no situation should arise where there is financial gain from the use, sale or
trade of body parts. The World Medical Association (WMA) states that,
“Transplant surgeons should attempt to ensure that the organs they transplant
have been obtained in accordance with the provisions of this policy and shall
refrain from transplanting organs that they know or suspect have not been
procured in a legal and ethical manner.”6 While there are many national laws that
prohibit organ trafficking, much of the activity goes unregulated by law, due to
underground networks and the fear in some countries that donors will also be
prosecuted along with brokers.
Recommendations for Creating a Resolution
 The committee may promote the implementation of tougher measures on
those who are involved in the illegal organ trade.
 The committee may suggest better monitoring of hospitals and health
facilities in their country.
 The committee may address the need for human rights campaigns focusing
on the sanctity of bodily parts to be implemented in their country.
 The committee may suggest ways to educate developing countries and the
poor about the risks that are implicated in the organ trade.
WHO Background Guide | SWCHSMUN 2014
When addressing the issue of medical tourism and organ trafficking, delegates
must understand the economic, political, and ethical implications of the trade.
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Questions to Consider:
1. How does the organ trade manipulate poor people in your country and put
them at risk?
2. What are the dangers that come with medical tourism and how does this relate
to international jurisdiction?
3. What can your country do to protect vulnerable people from the organ trade?
4. What preventative measures can/should be taken in order to try and
control/prevent this illegal activity?
5. What standards should be put in place to control this trafficking?
1 “Black Market Organs: Inside the Trans-Atlantic Transplant Tourism Trade,” Lip
Magazine, 24, October 2008,
http://www.lipmagazine.org/articles/featscheperhughes.htm
2 Ibid.
3 Ibid.
4“Vacation, Adventure and Surgery?” CBS 60 Minutes,
http://www.cbsnews.com/stories/2005/04/21/60minutes/main689998.shtml
5 “Coercion in the Organ Trade? A Background Study in Trafficking in Human
Organs Worldwide,” Deutsche
Gessellschaft fur Technische Zusammenarbeit (GTZ) GmBH,”
http://www.gtz.de/en/dokumente/en-svbf-organtrafficking-e.pdf
6Ibid.
WHO Background Guide | SWCHSMUN 2014
References
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"Trafficking for Organ Trade." Trafficking for Organ Trade. N.p., n.d. Web. 30 Mar.
2014. <http://www.ungift.org/knowledgehub/en/about/trafficking-for-organtrade.html>.
"Organ Trade Thrives Among Desperate Syrian Refugees in Lebanon." SPIEGEL
ONLINE. N.p., n.d. Web. 31 Mar. 2014.
<http://www.spiegel.de/international/world/organ-trade-thrives-amongdesperate-syrian-refugees-in-lebanon-a-933228.html>.
Bindel, Julie. "Organ Trafficking: A Deadly Trade." The Telegraph. Telegraph Media
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"Organ Trafficking Q&A: 'British Patients Offered Illegal Kidneys'" The Week UK.
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<http://www.havocscope.com/tag/organ-trafficking/>.
Campbell, Denis, and Nicola Davison. "Illegal Kidney Trade Booms as New Organ Is
'sold Every Hour'" The Guardian. Guardian News and Media, 28 May 2012. Web.
31 Mar. 2014. <http://www.theguardian.com/world/2012/may/27/kidney-tradeillegal-operations-who>.
Cholia, Ami. "Illegal Organ Trafficking Poses A Global Problem." The Huffington
Post. TheHuffingtonPost.com, 24 July 2009. Web. 31 Mar. 2014.
<http://www.huffingtonpost.com/2009/07/24/illegal-organtrafficking_n_244686.html>.
WHO Background Guide | SWCHSMUN 2014
"Organ Trafficking: A Protected crime." The Conversation. N.p., n.d. Web. 31 Mar.
2014. <http://theconversation.com/organ-trafficking-a-protected-crime-16178>.
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"World Socialist Web Site." Dramatic Increase in Worldwide Illegal Organ Trade -.
N.p., n.d. Web. 31 Mar. 2014. <http://www.wsws.org/en/articles/2012/07/orgaj14.html>.
WHO Background Guide | SWCHSMUN 2014
"Organ Trade." Wikipedia. Wikimedia Foundation, 30 Mar. 2014. Web. 31 Mar.
2014. <http://en.wikipedia.org/wiki/Organ_trade>.
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