SKYMUN CHAIR RESEARCH REPORT
Committee: General Assembly 2
Issue: Ensuring the regulation of illegal organ trafficking
Student Officer: Alice Cho, Deputy Assistant President
1. Description of Issue
Ever since the advent of modern medical technology allowed organ
transplant to be possible, the demand for organs (including kidney, liver
cornea and lung) has exponentially increased. In 2012, World Health
Organization (WHO) claimed that an organ is sold once an hour and also
stated that 100,000 organs, legally or illegally, had been transplanted in that
year. The booming of organ trafficking and black markets is credited to the
worldwide shortage of organs, as according to National Kidney Foundation,
there are approximately 123,175 people currently in the waiting list to receive
an organ in the US alone. Given the extreme disparity between supply and
demand, people, especially those living in harsh conditions, are at risk of
being exploited.
Researchers classify the conditions of organ trafficking into three
cases. First, the victims are easily threatened and forced into removing their
organs. Second, the victims are insured to receive a high price for their organs
and agreed to have them removed, but later do not receive the promised price.
Last, people are informed that they are receiving a medical operation when
their organs are being removed during the surgery. All three cases most
commonly take place in developing countries (such as China, India, Pakistan
and Mozambique) and this can be interpreted that many people living in
poverty consider organ trafficking as the only way out of poverty. However as
reported by organizations such as Organ Watch, “no one but the vendors really
benefit from this trade”. It is a lucrative business for the vendors because it
generates profits as much as $1 billion a year as people are paid as little as
$4,500 whereas patients have to pay up to $200,000 for a kidney.
There are several problems that donors face after the operation. First,
they are not paid very well and the money they receive is soon to be spent.
Also, they are not provided with any further post- surgical care leading to
health complication. Operation must take place in a sanitized environment
with a professional surgeon handling it. However if the conditions are not met,
medical complication ranging from immune reactions to infections can arise.
A study in 2002 found that about “86% of Indian organ donors reported
significant declines in their health within 3 years after surgery”. Donors
cannot even make any legal complaint because they previously signed an
affidavit or their social statuses make it hard to do so. This is even worse in
the case of transplant tourism as patient survival is lower. This happens
because the operation is commonly performed by nonprofessional doctors and
even when a certified doctor performs the surgery, he or she does not properly
consider factors including blood type, body size and tissue type when
matching donors and recipients. As for recipients, they only benefit from a
prolonged lifespan. Normally, recipients place themselves into debt in order to
pay for the operation and the costly drug cyclosporine. In addition to this, they
can face health complication because of failed organ matching, unhealthy
donors and consequential health detriments.
The international community has not addressed adequately to the
problem of regulating illegal organ trafficking. Although there are legal
measures that prohibit the crime, the weak enforcement and insufficient
safeguards make them unsuccessful. There are loopholes in legal policies that
allow black markets to thrive and carry out inhumane treatments. For example,
India passed the Transplantation of Humans Organs Act in 1994. This
prohibited the sale of human organs and all transplants but there was an
exception- an exception that allowed donations between relatives. The weak
regulation permitted hospital staffs to violate the act and approve transplants
since non- related donors fabricated the recipient.
Another instance was when South Africa adopted the Human Tissue
Act of 1983, which was enacted to prevent commercial dealings. This Act
contained a clause that violators are sentenced to imprisonment or paying a
fine up to $300. However it granted a medical director or a pathologist of a
hospital the right to perform surgery if the identity of the deceased person is
undetermined thus corrupting the whole act.
From the description of the issue, it is evident that we have a long way
to ensure the regulation of illegal organ trafficking. Organ donation is
encouraged as one organ donor can save up to 8 lives however only with the
environment “in the level of safety, quality and efficacy”, as stated by WHO,
should it be allowed. Since extensive measures are necessary to be taken in
order to have this matter resolved, every nation must pursue concrete actions
towards optimizing the transplant practices.
2.
Definition of Key Terms
Organ Trafficking
Organ trafficking entails the recruitment, transport, transfer, harboring or
receipt of persons, by means of the threat or use of force or other forms of
coercion, of abduction, of fraud, of deception, of the abuse of power, of a
position of vulnerability, of the giving or receiving of payments or benefits to
achieve the consent of a person having control over another person, for the
purpose of exploitation by the removal of organs, tissues or cells for
transplantation. (United Nations Trafficking in Persons)
Transport tourism
Travelling to another country (commonly India and China) for organ
transportation. This form is usually less expensive however there is a higher
risk of failed organ matching, unhealthy donors and consequential health
detriments for recipients. Some institutions in US refuse to provide postsurgical care.
Cadaveric Donor
Known as deceased donors; those who donate their organs after they have
died.
Cyclosporine
It is a drug used when transplant rejection occurs. It is injected with a steroid
medicine and it belongs to immunosuppressive agents, a ground of medicines.
It is a powerful substance that tries to suppress the immune system when a
recipient is taking the organ transplant.
Domino Donor
A person who receives an organ transplants and donates the removed organ to
another person.
Cross matching
A blood test that identifies whether or not the specific donor organ that is to be
transplanted is likely to be rejected by the recipient. If the test is positive, the
transplant should not be performed, as the donor and recipient are
incompatible.
Vendor
It is a person or a group of people that is involved in connecting the donor and
the recipient (mostly referred as trader). Many analysts found that vendors are
only motivated by monetary gain and are the only ones benefitting from organ
trafficking.
Waiting List Management
A system that makes sure the waiting list (list of people waiting to receive
organ transplant) is accurate and confidential.
3. Timeline of Key Events
1968 Uniform of Anatomical Gift Act
This act was drafted by the National Conference of Commissioners on
Uniform State Laws (UCCUSL) in the United States to prohibit trafficking
human organs for profit. It additionally limited the liability of health care
providers who were involved in operations that include removing organs.
1983 Human Tissue Act
This act was enforced to address some common themes concerning organ
trafficking such as defining death, identifying exclusion of certain tissues,
requiring medical assistances’ certificates, highlighting the effect of consent
and categorizing some special provisions.
1984 National Organ Transplant Act
1993~ 2008 <Prosecuted Case>
The Bombay police discovered an illegal kidney center established by Santosh
Raut and arrested him. However Raut managed to escape and continued to be
involved in illegal organ trade. In 2008, police discovered another kidney
transplant center run by Amit Kumar. Through further investigation, it was
revealed that Kumar and Raut were the same perpetrator who had gone by
many aliases. It was also stated by the authorities that Raut conducted about
600 kidney transplants.
1994 Transplantation of Human Organs Act
India passed this act to ban the sale of human organs and regulate organ
transplantations for therapeutic purposes. It was not such an efficient act
because there was a serious loophole (as stated above in Description of Issue).
However according to the Ministry of Health and Family Welfare from the
Government of India it has amended several areas including enhancement of
penalties under the act, prevention of exploitation of minors, establishment of
Advisory Committees for Appropriate Authorities and providing of Swap
Donations of organs.
2007 Human Transplantation Act
2007 <Prosecuted case>
A man in UK tried to sell his kidney online for £24,000 to pay off his
gambling debts. He is known to be the first person convicted under the Human
Tissue Act (2004).
4.
Positions of Key Member Nations and Other Bodies on the
Issue
Iran
Iran is the only country where organ trade is legal. This business is regulated
by 2 Non- Governmental Organization (The Charity Association for the
Support of Kidney Patients and Charity Foundation for Special Disease) that
are supported by the government. These organizations help match donors to
recipients and arrange a reasonable payment settling. There are reports that
claim that this policy offers beneficial aspects as it can eliminate several
happenings of human rights violations and eliminate wait lists for kidney
transplantation. Unfortunately, black markets still exist and they are currently
competing with the legal market.
India
India is one of the few countries that are referred as “organ- exporting
country”. According to WHO, approximately 2000 Indians sell kidney
annually. The government tried to lessen the severity of the situation by
enforcing the Human Organ Transplantation Act of 1994 in order to reduce
foreign recipients and eradicate commercial dealings in human organs.
However it has proven to be ineffective because while the demand has
decreased in some countries, there was an increase of receivers in other places
such as Pakistan and Philippines. There have also been reports that many
underprivileged people from Nepal are tricked and taken into India where they
receive operations involving removal of their organs. Unstable healthcare
policies, insufficient safeguards and lack of education seem to be the biggest
factors that cause this bleak situation.
China
The topic of organ trade in China seems to arise many debates since criminals
subjected with death penalty must donate their organs. Nicholas Bequelin, a
researcher for Human Rights Watch, claimed that about “90 percent of organs
from China are from deceased prisoners”. The international community has
consistently criticized this practice since it is an infringement of the prisoners’
basic human rights. Due to the international pressure, Chinese government has
conceived a resolution to ban all transplants to foreign recipients (also partly
due to 1.5 million Chinese in the waiting list for transplant). Nevertheless
organ trafficking still remains to be a significant issue in China as the central
government provides inadequate funding to hospitals, which raises the risk of
misconduct and enhance bribery systems. Analysts state that fostering
transparency can significantly alleviate the situation as Chinese government
supports the clandestine nature of organ trafficking policy. This can be proven
through a measure implemented in 1984 as Temporary Rules Concerning the
Utilization of Corpses or Organs from the Corpses of Executed Prisoners
expresses that “the use of organs of executed criminals must be kept strictly
secret, and attention must be paid to avoid negative repercussions”.
USA
Although the United States of America prohibit organ trade, the government
encourages their people to donate their organs. The U.S Department of Health
& Human Services highlight the fact that one organ donation can save up to 8
lives. It is complemented for providing normal citizens with information
regarding specific donations, matching methodology and etc.
World Health Organization (WHO)
WHO has collaborated with many NGOs and GOs including The
Transplantation Society, Fairtranplant Foundation and US Food and Drug
Administration to bring forward an optimal management of organ transplant.
The organization has a strong belief that organ transplantation must “follow
legal requirements” and “rigorous selection procedures”. It first began to
prepare the WHO Guiding Principles on Transplantation in the fortieth World
Health Assembly and adopted the resolution WHA44.25 in 1991. These
measures greatly succeeded in influencing practices and legislation around the
world. In addition to this, the Sixty- third World Health Assembly endorsed
resolution WHA63.22 in 2010 that updated the principles and brought further
changes in transplantation practices.
*Organ importing countries: Bolivia, Brazil, China, Iraq, India, Israel,
Republic of Moldova, Pakistan, Peru and Turkey <WHO>
*Organs exporting countries: Australia, Canada, Israel, Japan, Oman, Saudi
Arabia and USA <WHO>
5. Suggested Solutions
Although there are numerous solutions that can tackle the issue at
hand, there are three processes that must be achieved through international
cooperation to ensure the regulation of illegal organ trafficking.
Firstly, more medical and social investigation needs to take place. The
lack of data makes it increasingly challenging to solve the problem, as
researchers are still uncertain about the magnitude of black markets and the
number of organ transplants. Establishment of a laboratory or platform that
enables professionals, policy- makers and researchers to come together must
be implemented so that monitoring international organ trade is possible.
Secondly, governments particularly from developing countries should
propose solutions that can allow people, especially those who are at risk of
being involved in organ trafficking, to access information concerning the
processes involved in organ transplant and aftereffects from operations. The
establishment of education centers and programs should be thus highly
encouraged. Additionally a clause concerning the specifics about how it is
going to be implemented and properly regulated should be included so that the
education remains as a long- term solution. There are many occurrences where
people are deceived into having their organs removed without their knowledge
just because they did not know the word “organ” or “transplant”.
Last but not least, governments should reinforce their laws and
eliminate any loopholes by amending or creating resolutions. As stated above
resolutions might further exacerbate the situation at hand with consideration
upon the Transplantation of Humans Organs Act in 1994 and Human Tissue
Act of. In order to prevent such problems, governments must enhance
transparency as they can easily receive help from international community and
non- governmental organizations.
Cooperation seems to be a big problem. Countries do not agree with
one another on laws concerning enforcements, regulations and penalties. In
some very unfortunate cases, some governments are rather unwilling to
cooperate to stop the illegal organ trafficking because nations greatly benefit
from this business. The international community should tackle these problems
by setting up incentives such as removing financial trade barriers or lowering
trade costs or bank interests.
6. Bibliography in MLA Format
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