ROTTERDAM China and Pakistan, leaders in
worldwide "transplant tourism," are bowing to outside pressure
and cracking down on trafficking in human kidneys taken from
executed prisoners and the poor, experts said on Wednesday.
New laws in both countries, where rich foreign patients
could pay large sums to get kidney transplants unavailable at
home, are starting to hamper this illegal trade that makes up
about 10 percent of all kidney transplants worldwide, they
Kidney failure is increasingly common in rich countries,
often because of obesity or hypertension, but a growing
shortage of transplant organs has fuelled a black market that
exploits needy donors and risks undermining voluntary donation
"This is an enormous step forward," Luc Noel of the World
Health Organization (WHO) told Reuters at a conference on
coordinating European policies for organ transplants.
"Transplant tourism is far from being finished. But there
is now a realization that this is exploitation," he said,
adding transplants with kidneys from impoverished donors were
still common in Egypt, the Philippines and other poor
Trade in human organs is illegal in Western countries but
the fast rising demand for kidneys has led to calls -- mostly
from the United States -- to allow a regulated market for them.
Most doctors, hospital administrators and medical ethicists
at the conference rejected the idea as unethical and a threat
to existing systems for voluntary donations. They also called
on health insurance systems not to reimburse "transplant
Noel said China approved in March a draft law for clearer
guidelines on legal transplants. It had begun limiting
"transplant tourism" last year after charges by human rights
groups -- which it denied -- that it used organs from executed
Pakistan has had no law allowing organ donations from the
deceased -- a major source of replacement organs -- but its
cabinet approved a draft transplantation law in February that
still requires parliamentary approval.
Some commentators link Beijing's change in policy to a
concern for its image before it hosts the Olympics in 2008.
Annika Tibell, head of the ethics committee of the
worldwide Transplantation Society, said Chinese doctors who
used organs from prisoners were banned from joining her group
or attending seminars where they could learn new surgical
Noel said the tightening up in China had had "a domino
effect" in countries that depended on transplant tourism to
solve the problem of increasing kidney failure.
South Korea, which used to depend on China for kidneys, was
reassessing its policies now that Beijing is closing the door
on foreign patients. Saudi Arabia, which sends about 700
patients abroad annually, was also rethinking, he said.
According to Norbert Lameire of the International Society
of Nephrology, the United Arab Emirates sends its kidney
patients to the Philippines for transplants. The health
insurance takes care of the $95,000 fees, $10,000 of which go
to the donor.
Noel said India, which over a decade ago was "the kidney
bazaar of the world," cracked down on its "transplant tourism"
dramatically in 1995 but an internal black market still exists.
According to WHO estimates, China hosted almost 2,000
"transplant tourists" in recent years, using mostly kidneys
from executed prisoners. Pakistan hosted up to 1,500, the
Philippines had up to 200 operations and Egypt 100.