Illicit Organ Sales are a Growing Global Concern

Twice in the last two weeks, transplant experts from around the world have gathered in Europe to discuss the emerging global market in organ trafficking.^[1] At the presentations two regions were in focus the story. One showed the countries that create the demand, where patients have traveled from to receive the illicit organs: Saudi Arabia, Taiwan, Malaysia, South Korea.^[2] The other map depicted the nations that create the supply, the nations from which organs have been sold: China, Pakistan, Colombia, and the Philippines.^[3]

The numbers of supplier and receivers is in the thousands. According to the World Health Organization(WHO), the annual tally of international kidney transactions alone is about 6,000.^[4] The evidence includes reports from brokers, physicians, accounts from Indian villages, surveys of hospitals in Japan, government records in Singapore, backroom operating tables in Egyptian slums.^[5]

Diabetes, hypertension, and other kidney-destroying diseases have spread quickly, creating a demand that is rapidly outgrowing supply.^[6] An estimated 170,000 patients in the U.S. and Europe are on waiting lists.^[7] However, instead of waiting, many patients have set out to recruit their own donors, and those who can afford it have simply bought them.^[8] Globally, people have learned that their organs are assets; Peruvians, Ukrainians, Chinese hospitals, and American inmates have all begun to advertise themselves wherever they can and last year, a South Korean playwright even used his kidney as collateral for a loan.^[9]

Politicians have tried unsuccessfully for years to rein in this market.^[10] The United States banned organ sales two decades ago, India did the same in 1994, and China followed last year.^[11] These rules are not working; if Congress revises its ban on organ sales, as some lobbyists are pushing for, lawmakers in South Carolina even tried to offer prisoners reduced jail time in exchange for organs or marrow.^[12]

This is problem that most likely can not be fixed through legislation alone. This is a problem created by the economics of healthcare. It is a problem made worse by human nature because any time people are forced to wait or face rationing they will find ways to buy more than they're allotted.^[13] Ration medical care abroad, and affluent foreigners will come here, ration organs here, and affluent Americans will go abroad.^[14] If people feel like the organ they might have – at one time – been willing to donate now has value, this reduces the incentive to give it away for free. This is a scarcity driven market, and until the world figures out how to flood the market with freely donated organs, this problem will persist.

As it stands organ trafficking is a federal crime in the U.S. that we have discussed previously, here.

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^[1] William Saletan, Shopped Liver: The worldwide market in human organs., Slate.com, Apr. 14, 2007, available at http://www.slate.com/id/2164177/ (last visited Apr. 17, 2007).
^[2] Id.
^[3] Id.
^[4] Id.
^[5] Laura MacInnis, “Transplant tourism" on rise due to donor shortages, Reuters, Apr 2, 2007, available at http://www.reuters.com/article/scienceNews/idUSL3042128920070402 (last visited Apr. 17 2007). (In Pakistan, 40% of people in some villages are turning up with only one kidney.); see also Saletan, supra note 1. (Two-thirds of the people getting these organs are foreigners, data from the Philippines corroborates this claim, and charts presented at the meetings show the number of "donations" from unrelated Pakistanis skyrocketing.)
^[6] Saletan, supra note 1.
^[7] Tom Heneghan, Human organ trafficking threatens donation schemes, Reuters, Apr 2, 2007, available at http://www.reuters.com/article/healthNews/idUSL0224269220070402 (last visited Apr 17 2007)
^[8] Saletan, supra note 1.
^[9] Id.; see also Nora Boustany, Prison to Playhouse: Director Hopes To Bring N. Korean Exposé to U.S., Washington Post, Page A12, July 19, 2006.
^[10] Saletan, supra note 1.
^[11] Id.
^[12] Id.; Tim Smith, Inmates won't get break for organ gifts, The Greenville News Online, April 6, 2007, available at http://www.greenvilleonline.com/apps/pbcs.dll/article?AID=/20070406/NEWS01/704060329 (last visited Apr 17, 2007).
^[13] Saletan, supra note 1.
^[14] Id.