JULY 19, 2011 VOLUME 5, NUMBER 14 PAGES 341-366 WWW.GLOBALRESEARCHER.

COM

Organ Trafficking
CAN THE SMUGGLING OF HUMAN ORGANS BE STOPPED?

H
eadline-grabbing arrests of kidney brokers and renegade doctors provide glimpses into a global

black market in human organs that is thriving from South America to Asia. The World Health Or-

ganization estimates that 5-10 percent of the 100,000 organs transplanted each year have been pur-

chased illegally, typically from poor people desperate for cash. In China, thousands of organs re-

portedly have been forcibly removed from prisoners to feed a lucrative “transplant tourism” business. The full scope

of the global organ black market remains unknown because transplant doctors and hospitals either don’t know the

organs were trafficked or are complicit in the deals. Critics say hospitals should disclose the source of all transplant

organs so illegal sales can be tracked. Some doctors say legalizing government payments to organ donors — as Iran

has done — is the only way to eliminate

trafficking, but the mainstream medical

community says such payments would only

exploit the poor. Artificial organs eventually

could help satisfy the growing demand for

organs, eliminating the black market.

Since 2000, four members of a Pakistani family have sold

a kidney for about $1,200 apiece to pay off debts to their
employer, who gives them each $12 a week to work in his
Rawalpindi brick factory. Recent reports indicate a
resurgent organ black market in Pakistan, despite a ban
that became law in 2007. Shown displaying their surgery
scars in 2009, are (from right) brothers Mohamed Riiz, 22,
and Mohamed Ijaz, 25, and father, Karm Ali, 65. Ijaz’s wife
Farzana, 20, (seated) also sold a kidney.

PUBLISHED BY CQ PRESS, A DIVISION OF SAGE WWW.CQPRESS.COM

 ORGAN TRAFFICKING
THE ISSUES
• Is the global black mar-
343 ket for organs growing?
• Would legally paying
donors discourage trafficking?
• Should governments and
hospitals do more to crack
down on organ profiteers?
BACKGROUND
The First Transplants
352 A kidney was successfully
transplanted in 1954.
Foreign Variations
356 Some countries make every-
one an organ donor at
death unless they “opt out.”
Coercion and Bans
357 Workers often sell a kidney
to pay off debts.
CURRENT SITUATION
358 Major Criminal Cases
Several trafficking cases
are pending.
Legalizing Payments
360 The transplant community
is debating whether to
sanction reimbursements.
OUTLOOK
Making Trafficking
361 Obsolete
Eventually, artificial organs
could eliminate illicit sales.
SIDEBARS AND GRAPHICS
344 Rich and Poor Collaborate
in Global Kidney Trade
Kidneys usually travel from
poor to rich countries.
Cover : AFP/Getty Images/Nicolas Asfouri
342 CQ Global Researcher
346 China Harvests Prisoners’
Organs
Activists say China executes
“on demand” to provide or-
gans to foreigners.
U.S. Kidney Sellers
348 Receive the Most
Payments can run from $750
to $30,000.
Transplant Gaps Spur
350 Organ Trafficking
Disparity between organ sup-
ply and demand fuels sales.
Chronology
353 Key events since 1901.
Singapore Allows Reim-
354 bursements to Organ
Donors
But is additional cash paid
under the table?
Austria Leads in Per
358 Capita Transplants
Norway has second-highest
rate.
At Issue
359 Would regulated reimburse-
ments discourage organ traf-
ficking?
366 Voices from Abroad
Headlines and editorials from
around the world.
FOR FURTHER RESEARCH
For More Information
363 Organizations to contact.
Bibliography
364 Selected sources used.
The Next Step
365 Additional articles.
Citing CQ Global Researcher
365 Sample bibliography formats.
July 19, 2011
Volume 5, Number 14
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 Organ Trafficking
BY SARAH GLAZER

THE ISSUES
or 23-year-old con-
plant tourism,” in which pa-
tients from, say, the United
States or Saudi Arabia trav-
el abroad for a kidney or

F struction worker Luis

Picado, it seemed like
a way to realize the Ameri-
part of a liver. As far as the
patients are concerned, op-
erations in a reputable hos-
can dream. Returning to his pital in India or Turkey may
home in a slum in Managua, appear perfectly legal, and
Nicaragua, one day in 2009, the hospital may assure the
he told his mother he had patient that the procedure is
met an American man who above-board. But the organ
promised him a job and apart- may have come from an im-
ment in New York if he’d poverished laborer who, un-

AFP/Getty Images/Prakash Mathema

donate one of his kidneys. beknownst to the patient, has
Three weeks later, Picado been promised from several
came out of surgery at a Man- hundred to several thousand
agua hospital bleeding inter- dollars by a broker or un-
nally from an artery doctors scrupulous doctor.
had severed in removing his It’s difficult for interna-
kidney, according to medical tional health organizations
records. Picado bled to death. and law enforcement agen-
Matthew Ryan, the Amer- cies to know which trans-
ican man who received the plants originated from an il-
In a high-profile case of coercive organ donation, transplant doctor
kidney, did not fare much legal sale because medical
Amit Kumar has been charged with illegally removing the kidneys
better. Two months after of some 500 impoverished laborers and farmers in Gurgaon, India. confidentiality rules typical-
receiving Picado’s kidney Some of them allegedly were lured there by false promises of jobs ly hide a donor’s identity
at the same hospital, the and then forced at gunpoint onto the operating table. Several and bar access to medical
68-year-old retired bus su- police officers also were charged with extortion and accepting records. And transplant
bribes in connection with the case, which is still pending.
pervisor from New York died. tourism can be perfectly legal
Prosecutors in Managua are if, for example, a Pakistani-
investigating whether Nicaragua’s law ker for arranging such a sale. In Iran, American goes to Pakistan to receive
prohibiting paying for an organ was such transactions are legal and fund- a kidney as a gift from a cousin there.
broken. 1 ed by the government. 2 The Geneva, Switzerland-based
Nicaragua is just one of the im- The illicit organ trade continues be- World Health Organization (WHO), which
poverished countries — along with cause knowing which transplants vi- oversees global organ transplant activi-
Pakistan, India, Egypt and China — olate the law can be tricky. If a pa- ty, estimated in 2007 that 5 to 10 per-
where people from the United States, tient shows up at hospital with a cousin cent of the 100,000 organ transplants
Japan, South Korea, Persian Gulf na- who says he’s willing to donate a kid- performed worldwide each year — 5,000-
tions and other wealthy countries go ney, for example, the transplant is pre- 10,000 such operations — are illegal. 3
to buy organ transplants. In many cases sumed to be legal in most countries. Most patients seeking transplants in
the patients, most of whom suffer from But the hospital has no way of know- recent years have traveled from Saudi
kidney disease, face the prospect of ing if the patient has written a big Arabia, other wealthy Arabian Gulf
dying while waiting the typical five to check to his cousin to express his countries, Taiwan, Malaysia and South
10 years for a donated organ in their “thanks.” Or, the donor could be a Korea, often because their home coun-
home country. stranger, solicited by a broker and try lacks modern transplant facilities. 4
The global black market in human masquerading as a devoted relative (See map, p. 344.)
organs continues to thrive in many for an agreed-upon sum. No one knows how many Ameri-
countries, even though virtually every The possibility of illegal payments cans travel abroad for transplants (or
nation except Iran has banned buy- becomes more likely, but just as hard how many of the operations are ille-
ing or selling organs or paying a bro- to trace, in cases of so-called “trans- gal). That’s because no one, including

www.globalresearcher.com July 19, 2011 343

 ORGAN TRAFFICKING

Rich and Poor Collaborate in Global Kidney Trade

The illegal trade in kidneys from live donors generally flows from donors in poor, developing countries — such as Bolivia, India,
Romania and China — to patients in rich, developed nations, such as Canada, the United States, Japan and Saudi Arabia.
Affluent patients often travel to poorer countries overseas to buy kidneys because they can face up to 10 years waiting for a
donated kidney in their home countries — if they live that long. On the Internet, medical tourism sites and hospitals offer
cut-rate kidney transplants in India,Turkey and Latin America. In 2010, medical tourism was estimated to be a $100 billion
industry, but no one knows how much of that business is based on illegal transplants.

Countries of Origin for Kidney Buyers and Sellers

CANADA MOLDOVA
ROMANIA

UNITED STATES ITALY TURKEY

OF AMERICA CHINA JAPAN
ISRAEL IRAN
EGYPT SAUDI PAKISTAN
ARABIA
OMAN INDIA
PHILIPPINES

BRAZIL
PERU
BOLIVIA
AUSTRALIA

Countries of origin for those:

Selling kidneys
Buying kidneys

Source: Organs Watch; news reports. Map by Lewis Agrell

U.S. hospitals that treat such patients
on their return, is required to report these
cases, according to Francis Delmonico,
a Harvard Medical School surgeon and
president-elect of the Montreal-based
Transplantation Society, an organization
of transplant specialists.
Yet news reports and occasional
arrests of large-scale traffickers reveal
that ostensibly legal transplants in
hospitals abroad depend on a thriv-
ing organ trade that preys on the
poor. In Egypt, South Africa, Brazil
and the Philippines, “international ca-
bals of doctors and corruptible ethics
boards have slowly transformed slums
. . . into veritable organ farms,” in-
vestigative journalist Scott Carney
writes in The Red Market: On the
Trail of the World’s Organ Brokers,
Bone Thieves, Blood Farmers and
Child Traffickers, a new book about
the worldwide illegal trade in organs
and other body parts. 5
Meanwhile, some governments in
developing countries have a strong in-
centive to look the other way: Medical
tourism for all procedures, ranging from
face lifts to transplants, brought in about
$100 billion in 2010. 6
Popular images of the illegal organ
market abound, but they’re often un-
realistic. An example is the scenario
portrayed in the 2002 movie “Dirty
Pretty Things,” in which a criminal
broker persuades desperate immi-

344 CQ Global Researcher

grants to have one of their kidneys
removed in a hotel room and then
passes the organs in a Styrofoam
cooler to another kidney broker.
“People don’t take out kidneys on
kitchen tables,” says Gabriel Danovitch,
medical director of the kidney trans-
plant program at the David Geffen
School of Medicine at the University
of California Los Angeles. “For trans-
plants to happen you need a decent
hospital and well-trained surgeons.”
Because organs last outside the body
for only a few hours, recipients typ-
ically need to be in the same hos-
pital with the donor.
While rumors abound in develop-
ing countries of people being kidnapped
for their organs, such cases are rare.
However, there have been plenty of
instances of bonded workers, particu-
larly in Pakistan, being coerced into
selling a kidney to pay off a debt. In
Gurgaon, India, an alleged outlaw doc-
tor charged with removing the kidneys
of 500 impoverished laborers and farm-
ers in 2008, some of whom had been
lured there by false promises of jobs
and then forced at gunpoint onto the
operating table. Others were persuad-
ed to sell. 7
In China, human rights activists say
tens of thousands of imprisoned prac-
titioners of the Buddhist spiritual dis-
cipline Falun Gong have been killed
for their organs — largely at military
hospitals, which offer foreigners a trans-
plant in as little as a week. “It means
next Tuesday somebody has to be ex-
ecuted so that an American can get
an organ transplant,” says Delmonico.
(See sidebar, p. 346.)
But in most of the world, experts
say, force is unnecessary. “It’s so easy
to put an amount of money on the
table that will bring in people that
you don’t need to kidnap,” says Luc
Noël, coordinator in essential health
technologies at WHO.
“The rumors and the urban myth
of a person who wakes up in the
hotel bathtub with a big scar and a
www.globalresearcher.com
Poor Sellers vs. Rich Buyers
The typical kidney seller in a developing country such as the Philippines is a
male under age 30 with a family income of less than $500 a year. By contrast,
buyers in developed countries such as Israel are much older and typically have
family incomes above $50,000.
Typical Kidney Buyers and Sellers in the Philippines and Israel
Typical seller Typical buyer
(Philippines) (Israel)
Age: 29 Age: 48
Sex: Male Sex: Male
Annual family Annual family
income: $480 income: $53,000
Education: 7 years Education: University degree
Source: Nancy Scheper-Hughes, “Organs Without Borders,” Foreign Policy, January-February 2005
kidney missing have never been co warns that people who get trans-
proven,” he says. plants overseas can contract an eso-
Often, studies find, a kidney broker teric, new antibiotic-resistant bacteria —
pays much less than he promised, and the superbug NDM-1 — or other in-
the donor, typically poor and desper- fection, such as HIV. 9
ate, suffers both physically and psy- Recently, some transplant surgeons
chologically from lack of follow-up care. have been urging Western govern-
“The seller is always a victim,” says Noël. ments to consider paying donors in
In India’s Tamil Nadu province, Rani, order to eliminate the black market,
the wife of an unemployed fisherman, reduce long waiting lists for donated
agreed to sell her kidney to a broker organs and ratchet down health risks.
to pay hospital costs for her daughter, Organ trafficking could be drastically
who had tried to commit suicide by reduced, says Benjamin Hippen, a trans-
drinking pesticide. Rani was paid $900 plant nephrologist in Charlotte, N.C., if
up front to cover her daughter’s ex- “the incentives that allow it to be prof-
penses and promised $2,600 more when itable” were eliminated. If American and
the operation was over. But when she Western governments paid domestic
awoke, the broker had vanished. Months donors, he maintains, it would satisfy
later, she said the pain in her side pre- demand in the countries sending trans-
vented her from getting the only work plant tourists to poor countries for or-
available to an unskilled woman: day gans. The United States has more than
labor on construction sites. “The bro- 100,000 patients waiting for organs,
kers should be stopped,” she said. “My and Europe has more than 56,000. 10
real problem is poverty — I shouldn’t But proponents of payments remain
have to sell my kidney to save my a minority within the transplant com-
daughter’s life.” 8 munity. Almost every international body
“Transplant tourists” also face risks. opposes paying for organs, arguing that
Being poor and malnourished makes it would violate the existing altruistic sys-
organ sellers more likely to be un- tem and turn human body parts into
healthy, with no incentive to disclose commodities. Poor donors would prob-
their true health conditions. Delmoni- ably lie about serious medical condi-
July 19, 2011 345
 ORGAN TRAFFICKING
tions, putting recipients at risk, oppo-
nents add. And paying donors likely
would reduce the overall organ supply,
they say, because family members would
feel less obligated to donate an organ
for a loved one. Nor would it increase
the supply of organs other than kidneys,
most of which come from cadavers.
“If you used every market incentive
out there, we’d still have a shortage,”
says Arthur Caplan, a professor of
bioethics at the University of Pennsyl-
vania and co-director of a United Na-
tions study on organ trafficking. 11
Yet proponents of a regulated organ
market point out that simply banning
the practice has only sent it into the
shadows. In India, Pakistan, Iraq and
Indonesia, transplants have “been dri-
ven underground, like abortion, to an
underground basement,” says John
Fung, director of the Cleveland Clin-
ic’s Transplantation Center and a sup-
porter of a legalized incentive payment

China Harvests Prisoners’ Organs

Activists say China executes “on demand” to provide foreigners with organs.
hinese government officials have acknowledged since those of executed Chinese prisoners. After Andrew M. Cuomo,

C July 2005 that up to 95 percent of the organs trans-

planted in China were harvested from convicted, exe-
cuted prisoners — allegedly with their consent. 1
Yet in 2006, Canadian human rights activists reported that there
weren’t enough executed prisoners or other donors to account
for 41,500 transplants performed in China between 2000 and 2005.
The report’s authors, human rights lawyer David Matas and for-
mer Canadian Parliament member David Kilgour, concluded that,
rather than coming from executed criminals, most of the organs
came from imprisoned practitioners of the Buddhist spiritual dis-
cipline known as Falun Gong, who were either shot first or died
during the organ harvesting operation. 2
Since the government banned the practice of Falun Gong
and declared it subversive in 1999, hundreds of thousands of
practitioners have been arrested, and those who refused to re-
cant disappeared into slave labor camps, according to Matas and
Kilgour. The Laogai Research Foundation, a Washington-based
advocacy group that exposes human rights violations in China,
estimated that in 2008 between 500,000 and 2 million Falun
Gong were being detained. 3 At least 62,000 were victims of
organ harvesting operations from 2000-2008, according to Matas
and Kilgour and Ethan Gutmann, an investigative journalist. 4
Matas and Kilgour, who were nominated for a Nobel Prize
for their investigation, say the organs were then “sold” to for-
eign transplant tourists. Conducted mainly at military hospitals
with access to prisoners, the transplants funneled $1 billion a
year to the hospitals, which had lost most of their subsidies
from the Communist government, according to Matas.
The activists’ undercover reports include taped conversations
with transplant doctors at Chinese hospitals promising foreign
callers that they could receive a transplant in as little as a week
— a process that usually takes months to years in most coun-
tries. “They’re clearly blood-typing and tissue-typing prisoners”
— to match them to prospective recipients — “and then shoot-
ing them,” says Arthur Caplan, a professor of bioethics at the
University of Pennsylvania.
In 2008, advocacy groups and media reports charged that
some of bodies and organs on display in the popular “Bod-
ies” exhibit that traveled to several major American cities were
then-attorney general of New York, investigated the allegations,
the exhibitor admitted that it had received the bodies from the
Chinese Bureau of Police and that, despite its prior denials, it
could not verify that the human remains used in its exhibits
had not come from executed Chinese prisoners. On May 29,
2008, Cuomo announced a settlement with Premier Exhibitions.
The company agreed henceforth to obtain documentation demon-
strating the cause of death of its bodies and disclose on its web-
site that it could not confirm whether currently displayed bodies
had come from executed prisoners. It also said it would refund
ticket prices to prior visitors who requested it. 5
Perhaps in response to allegations of “execution on demand”
policies and to allay negative publicity during the 2008 Olympic
Games, the Chinese government in 2007 banned the harvest-
ing of organs from living donors without their consent and
outlawed the sale of organs. 6 Many websites advertising cheap
transplants at Chinese hospitals suddenly disappeared. The gov-
ernment also ordered that Chinese patients waiting for organs
be given priority over transplant tourists, and it limited donors
to close relatives.
John Fung, a Chinese-American transplant surgeon at the
Cleveland Clinic who frequently visits Chinese hospitals as a
visiting professor, says since China’s 2007 clampdown he no
longer sees Saudi and Israeli patients in transplant wards. “I
haven’t seen a Caucasian in five years,” he says.
The number of organ transplants did dip in 2007, and some
observers wondered if harvesting of prisoners’ organs was be-
coming a thing of the past. But since 2008, Matas maintains, over-
all transplants have returned to historic highs. Amnesty Interna-
tional estimates that changes in Chinese law have cut in half the
number of criminal prisoners executed. But that just means even
more of the approximately 10,000 annual transplants in China
are coming from Falun Gong who have refused to recant their
beliefs, Matas says. He estimates that the number of transplants
harvested from Falun Gong members has risen from about 7,500
a year before 2007 to about 8,500 today.
Matas acknowledges that “there’s a real downturn in trans-
plant tourism in China. There used to be charters going from
Taiwan to China organized by brokers, but the Chinese [gov-

346 CQ Global Researcher


ernment] stopped them. There were whole wings of hospitals
in northern China that had nothing but Koreans in them.”
But the government crackdown and the scarcity of organs
also have spawned an undercover black market, according to
recent news reports. Each year, China has more than a million
people waiting for replacement organs, but only 1 percent re-
ceive a transplant. 7 A voluntary donation program started by
the government in 2009 has led to only 67 transplants in a
country with cultural traditions that oppose organ donation. 8
Some Chinese-language websites still advertise illegal pack-
ages aimed at Chinese patients, including accommodations,
meals and a kidney transplant. 9 In a highly publicized case
reported this year, a 26-year-old welder, who changed his mind
after agreeing to sell his kidney for $6,000, had his kidney
forcibly removed at a grungy local hospital in Shanxi province.
The brokers’ henchmen forced Hu Jie into the hospital where
the recipient was waiting, and Hu Jie later woke up to find
his kidney gone and $2,000 less in his bank account than the
broker had promised, he said. 10
Despite recent public declarations from the health minister
that the government intends to stop harvesting organs from
prisoners over the next five years, it’s not clear that anything
has changed yet, experts say. “It’s an attempt to answer criti-
cism through a charm offensive, removing websites [advertis-
ing kidney transplants] as evidence for what they’re doing [with-
out] actually improving the situation,” says Matas.
Gutmann, an American investigative journalist whose esti-
mates of the number of Falun Gong harvesting victims echoes
those of Matas, says it’s hard to say what is happening now.
He doesn’t trust Chinese government statistics. “Frankly, I don’t
know if harvesting of Falun Gong stopped, stopped and then
started again, or never stopped at all,” says Gutmann, an ad-
junct fellow at the Foundation for Defense of Democracies, a
think tank in Washington. “My interviews with recent refugees
yield only fragmented clues, and the Chinese health authori-
ties are certainly acting as if they want to put the issue to bed.”
It’s also unclear whether transplant tourism is still thriving
in China. “For the past six months to a year it looks like it’s
picking up again,” says Damon Noto, spokesman for Doctors
Against Forced Organ Harvesting, an international group cam-
paigning against forced organ harvesting in China. For military
hospitals, where the bulk of transplants are done, Noto says,
“their biggest source of income is organ transplant.”
AFP/Getty Images/Greg Wood
Activists in Australia protest the reported practice in China of
killing members of the banned Falun Gong spiritual movement,
detained in labor camps, and harvesting their organs to sell to
foreign transplant tourists. Websites advertising “transplant
packages”disappeared after a government crackdown, but
advocacy groups say prisoners still are being killed for their organs.
Caplan concurs that transplant tourism is a big money-maker
for China and other countries. “You’ve spent a lot of money to be
prestigious by doing transplants, and you need kidneys and livers
to transplant, but the only way you’re going to get them is through
living donor purchase,” he says, or from prisoners in China’s case.
“So the government condemns it but looks the other way.”
— Sarah Glazer
1 David Matas, “Anti-rejection Drug Trials and Sales in China,” speech given at
Doctors Against Forced Organ Harvesting Forum, May 1, 2011, Philadelphia,
Penn., www.dafoh.org/Matas_speech.php.
2 David Matas and David Kilgour, Bloody Harvest (2009).
3 Matas, op. cit.
4 Scott Carney, The Red Market (2011), p. 82. Also see Matas and Kilgour,
op. cit., and Ethan Gutmann, “ ‘How Many Harvested?’ Revisited,” East of
Ethan blog, http://eastofethan.com/2011/03/10/how-many-harvested-revisited/.
5 “Cuomo Settlement with ‘Bodies: the Exhibition’ Ends the Practice of Using
Human Remains of Suspect Origins,” press release, Office of the New York
Attorney General, May 29, 2008, www.ag.ny.gov/media_center/2008/may29a_
08.html.
6 “Ending Abuse of Organ Transplantation in China,” China Uncensored,
Aug. 20, 2010, www.chinauncensored.com/index.php?option=com_content&
view=article&id=249:ending-abuse-of-organ-transplantation-in-china&catid=36:
organ-harvesting-in-china&Itemid=79.
7 Bo Gu, “Chinese man wakes up — minus his kidney,” NBC News, March 31,
2011, http://behindthewall.msnbc.msn.com/_news/2011/03/31/6382271-chinese-
man-wakes-up-minus-his-kidney.
8 Ted Alcorn, “China’s Organ Transplant System in Transition,” The Lancet,
June 4, 2011, pp. 1905-1906.
9 “New Law Targets Organ Traders,” China Daily, Feb. 28, 2011, http://usa.china
daily.com.cn/epaper/2011-02/28/content_12087280_2.htm.
10 Gu, op. cit.

to organ donors. “Once you ban some-
thing and the demand is there, you
no longer have accountability.”
Yet others find the idea of selling
a body part — whether legally or ille-
gally — morally repellant, even canni-
balistic. “It’s not unlike slavery when
you think you can own a part of an-
other person,” says journalist Carney.
As the debate over organ trans-
plants continues, here are some of the
key questions being discussed:
Is the global black market for
organs growing?
Because organ trafficking — the buy-
ing and selling of organs — is illegal,
there are no reliable statistics on the ex-
tent of the practice. From the buyers to

www.globalresearcher.com July 19, 2011 347

 ORGAN TRAFFICKING
India appeared to bounce back, with
U.S. Kidney Sellers Receive the Most about 2,000 Indians selling a kidney
every year, according to the Voluntary
People who illegally sell one of their kidneys can receive from as little as $750 Health Association of India. 12
to $30,000, depending on where they live, according to the most recent Recent reports in the press and
available survey of organ trafficking in selected countries. The asking price for from medical experts indicate a resur-
an American kidney, for instance, is $30,000 — more than in any other gent organ black market in Pakistan,
country — because the buyers are wealthier. Kidneys sold in a developing despite a government ban that took
country — such as India, the Philippines and Iraq — garner less than $2,000. effect there in 2007. Pakistan once
vied with India as the world’s illegal
Compensation for a Trafficked Kidney organ bazaar, performing kidney trans-
(in selected countries) plants for more than 1,500 foreigners
a year. The new law appeared to halt
United States $30,000* the illegal donor trade, but only tem-
Israel $10,000-$20,000 porarily, according to the Sindh Insti-
Peru $10,000 tute of Urology and Transplantation
Turkey $7,500 in Karachi, which provides medical
Brazil $6,000 care to low-income patients. The ban
Moldova and Romania $2,700 is weakly enforced because authori-
India $1,500 ties look the other way, according to
Philippines $1,500
the institute.
At least 450 people in several vil-
Iraq (pre-war) $750-$1,000
lages have sold their kidneys since
0$ 5,000 10,000 15,000 20,000 25,000 30,000
the ban took effect, according to an
(in current $US)
eyewitness account presented at an
* Asking price April press conference by Kishwer
Source: Nancy Scheper-Hughes, “Organs Without Borders,” Foreign Policy, January-February 2005
Zehra, a member of Pakistan’s par-
liament. Typically, these kidney sell-
the surgeons, participants have every in- perts think the trade is decreasing, he ers are bonded agricultural laborers
centive to hide the transaction under says, “My colleagues from the Middle whose indebtedness to their land-
the cloak of a legal operation in a main- East tell me, ‘It’s business as usual.’ ” lords makes them near-slaves. They
stream hospital. Thus, what starts as an Transplant tourism has become sell their organs in a vain attempt to
illegal sale of a kidney in one country “much less visible” since the World escape from lifelong debts but often
often ends up in a transplant operation Health Organization’s 2007 report, and end up worse off, a 2011 report on
that is ostensibly legal in another. “because it’s gone underground” it’s Pakistan’s organ black market said,
WHO — which does not regularly more difficult to estimate the scope of because there is no postoperative care,
collect statistics on this activity — the problem, says WHO’s Noël. “We medicines or follow-up. 13
has not revised its 2007 estimate that speculate it has decreased to some ex- “Entire villages in southern Punjab
5-10 percent of transplants involve il- tent,” despite some high-profile cases, are selling their kidneys out of des-
legally removed organs. “We don’t know such as the alleged 2008 coercion in- peration of debt, poverty and landlord
how many illegal transplants there cident in Gurgaon, India. coercion,” with doctors “at the center
are,” says the Transplantation Society’s Recent bans on organ-selling in such of this trade,” said Adibul Hasan Rizvi,
Delmonico. countries as Pakistan, China and Egypt a physician and president of the Trans-
“I receive anecdotal information,” he may account for more activity occur- plantation Society of Pakistan at an
says, such as when “a colleague tells ring under the radar. For example, April press conference at the Sindh In-
us an American has been here [at a India’s 1994 ban on the organ trade stitute of Urology and Transplantation
foreign hospital] or someone from the caused a drop in the number of for- in Karachi. “Pakistan is being dragged
Mideast comes to a U.S. center for an eign recipients but apparently spurred back to the era of illegal organ traf-
organ transplant” — which would be more foreigners seeking transplants to ficking, spurred on by the unrelent-
illegal if, say, the patient brought along head to Pakistan or the Philippines. ing greed of the medical profession
a “friend” who had actually been paid And after the ban was in effect for a in collusion with the law-enforcing
or promised money. Although some ex- few years, the underground market in authorities.” 14

348 CQ Global Researcher

 Earlier this month, three doctors were
apprehended as they were about to per-
form an illegal kidney transplant for a
Somali man in a private house in the
Pakistani provincial capital of Lahore.
According to law enforcement authori-
ties, 40 kidney operations had been car-
ried out mostly on Arab and Middle East
clients, while most of the kidney sellers
were from poor Pakistani families. 15
Demand for kidneys is growing in
both wealthy and developing countries
for several reasons. Developing coun-
tries are building transplant facilities and
offering transplants for less than they
cost in wealthy countries. New im-
munosuppressive drugs have improved
transplant survival rates, and doctors are
adding older, sicker patients, who now
have a better chance of survival, to
transplant lists. 16 In countries such as
Japan, South Korea and Taiwan, de-
mand for transplants has increased as
the population has grown wealthier. If
China follows the same pattern, its wait-
ing lists for kidney transplants could
double in 15 years. 17
That global growth — in both de-
mand and transplants — is likely push-
ing up demand for trafficked organs,
some observers say. “Why wouldn’t
the criminal market be growing?” asks
journalist Carney. Declining costs for
transplants have been driving up glob-
al demand for them, he writes in The
Red Market.
“We’re seeing people more com-
fortable with medical tourism. And med-
ical tourism is definitely growing,” he
points out, adding that countries such
as India are aiming to reap billions
from the industry. India’s Council on
Medical Research predicts that medical
tourism could generate $2.3 billion in
annual revenue by 2012. 18 India’s med-
ical tourism industry predicts growth
of around 17 percent annually. 19
Would legalizing payments to
donors discourage trafficking?
Offer: $175,000 for your kidney. How
many people would jump at that pay-
www.globalresearcher.com
ment? Answer: Enough to eliminate “To me it’s horrifying that the area
the U.S. waiting lists for organs, Nobel of medicine I’ve devoted my life to
Prize-winning economist Gary S. Beck- may be responsible for atrocities around
er estimated in 2002. Becker proposed the world,” says transplant nephrolo-
paying both living and deceased donors gist Hippen, who has been a promi-
(or their heirs) for any organ. nent advocate of government payments
AFP/Getty Images/Adek Berry
Cash-strapped Indonesians reportedly are selling their organs online, exploiting a loophole in
local laws and fueling a dangerous and illegal trade in human body parts. “I want to sell my
kidney to buy a house for my mother, thanks call me,” reads the online ad. Such ads on
Indonesian personal websites offer kidneys for as little as 50 million rupiah ($5,860).
If governments or health insurance for organs. “I don’t see another way
companies could legally make such to fix that.”
payments, it “would essentially knock Arthur J. Matas, a professor of surgery
out the black market,” he argued. With at the University of Minnesota, calcu-
an increased supply of organs stimu- lated in 2004 that U.S. society could
lated by financial incentives, patients break even by paying $90,000 to a live
would no longer have to travel over- kidney donor, because it would save
seas for a transplant, Becker conclud- the cost of months or years on dialy-
ed. Legalization also would reduce the sis (funded by Medicare, Medicaid or
advantage wealthy patients enjoy over health insurance) while the recipient
poorer patients, who can’t afford to waited for a donated kidney. 21 Today,
jump the queue by paying cash for a he estimates that break-even point could
quick, illegal transplant. 20 be as high as $500,000, if one includes
In recent years, some kidney trans- the benefits from the patient’s improved
plant physicians have embraced the quality of life. He adds, “If everyone
idea of a government-regulated organ could have a transplant in an above-
market. Financial incentives to live board market, who would go abroad
donors would bring in enough kid- to get an illegal transplant?”
neys to satisfy demand, they say, and Matas does not think donors should
save the lives of those who otherwise necessarily be paid in cash, however.
might die while on a waiting list. It “It could be a tax deduction, a small
also would put unscrupulous brokers amount that the donor gets each year
who exploit the poor out of business. to come back for a check-up, college
July 19, 2011 349
 ORGAN TRAFFICKING
plant patients demand healthier, stronger,
Transplant Gaps Spur Organ Trafficking better-off kidney donors, and are will-
ing to pay for a ‘higher quality’ and ‘more
More than 105,000 people were on organ transplant waiting lists in the educated’ organ. Rather than replace the
United States in 2009, but there were fewer than 15,000 donors. Such gaps black market, the government of Iran
between supply and demand in wealthier countries such as the United States has legalized it,” she has argued. 24
help to explain why affluent patients often travel to poorer countries for “A government-regulated program
transplants, fueling the black market in organs. will not end the black market,” argues
Debra Budiani-Saberi, executive director
(No. of people)
No. of Organ Donors and People on of the Cairo, Egypt- and Washington-
120,000
U.S.Transplant Waiting Lists, based Coalition for Organ-Failure So-
100,000 lutions, which works with organ sell-
1989-2009
80,000 ers victimized by the black market
60,000 Donors
trade. “People will go where the price
Waiting list
is cheaper, and it will always be cheap-
40,000 er somewhere.”
20,000 “Under the circumstances, where
0 developing countries have almost no
1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 mechanism of regulation, to think
that the government could run a reg-
Source: “The Gap Continues to Widen,” U.S. Department of Health and Human Services, ulated [market] program is idiotic,”
www.organdonor.gov/DLINK-gapgraph.asp says Farhat Moazam, chairperson of
the Sindh Institute’s Centre of Bio-
tuition or assistance with getting a job,” Besides a fixed government fee of medical Ethics and Culture. She
he says. $1,200, each Iranian kidney donor points out that even in the United
Proponents often cite Iran’s experi- also may receive a “rewarding gift,” States a Brooklyn kidney broker was
ence in paying donors for organs. After negotiated between donor and recip- arrested in a 2009 FBI sting in New
legalizing government payments to ient under the auspices of a patient- Jersey after allegedly arranging for
donors in 1988, Iran claims to have elim- run kidney foundation, which match- purchased kidneys to be transplant-
inated its organ waiting lists and avoid- es donors with compatible recipients. ed at reputable U.S. hospitals for
ed transplant tourism by prohibiting trans- The gifts can run as high as $5,000, years without being discovered.
plantation to foreigners. It also boasts according to Nasrollah Ghahramani, Market supporters Matas and Hip-
good postoperative health for organ re- a transplant nephrologist at Penn pen, however, say they are proposing
cipients, although some studies show State College of Medicine in Hershey, a regulated market only for the Unit-
sellers often experience deteriorating Pa., who practiced medicine in Iran ed States — and perhaps Western Eu-
health. 22 (See Background, p. 357.) for a decade. rope — where law enforcement is
But critics say middlemen continue However, Ghahramani, who visited more trustworthy. And by satisfying
to exploit the poor in Iran, and UCLA’s Iran recently, says Scheper-Hughes’ pic- demand in wealthy countries, the traf-
Danovitch doubts that Iran’s waiting ture of brokers trolling the streets is ficking in poorer countries almost could
list counts every kidney patient who not accurate. “Most people in larger be eliminated, they argue.
needs a transplant. Nancy Scheper- metropolitan areas with access to the However, Danovitch doubts such a
Hughes, an anthropologist at the Uni- media are aware that . . . they can go market could be contained within U.S.
versity of California, Berkeley, who directly to the patient advocacy group” borders. In the age of Twitter, he pre-
studies the organ trade, has reported, to find a match, he says. But he wor- dicts, “Within three seconds flat there
“When the government took over re- ries that under the so-called gift ex- will be twice the U.S. price offered in
sponsibility for managing the black change, the donor and recipient can Singapore or somewhere else.”
market kidney trade, the so-called bro- contact each other. “Nothing says they International bodies such as the WHO
kers and kidney hunters were re- can’t meet and potentially coerce one and U.N. and pillars of the medical
branded as ‘transplant coordinators.’ another into higher or lower bargain- world, such as the U.S.-based Institute
But they’re still just thugs who troll ing” under the table, he says. of Medicine, all oppose the payment
the streets and homeless shelters for That’s exactly what’s happening, says idea, largely on moral grounds. 25 “Most
people to donate on the cheap.” 23 Scheper-Hughes. “More affluent trans- people wouldn’t want to live in a

350 CQ Global Researcher

society where the government paid the
poor to be organ supplies,” Budiani-
Saberi says.
International groups contend that
paying donors would reduce the over-
all organ supply because fewer rela-
tives would donate an organ. But pro-
ponents point out that while donations
dropped sharply after payment was le-
galized in Iran, paid organs more than
made up for the difference. 26
Many opponents of outright payment
say they would support reimbursements
for things such as transportation to the
hospital, accommodations and medical
expenses, which are not always cov-
ered by health insurance in the United
States. In Britain and Europe donor ex-
penses for surgery and follow-up care
are generally covered.

Should governments and hospitals

do more to crack down on organ
profiteers?
Who profits most when organs are

trafficked? “They’re called ‘doctors’ —
and that’s why they’re untouchable,” says
journalist Carney. “You don’t go to a
Mafia don in Bangalore to get a kid-
ney,” he says, “You go to a hospital.”
“It’s mainstream elite hospitals and
doctors,” adds bioethicist Caplan, who
co-chaired a U.N. investigation of traf-
ficking in 2009. “It’s not gangs of
thugs; they’re around, but they’re not
the driver.” 27
Indeed, white-coated doctors are the
real brokers at the end of an illegal
chain, says Carney, either by directly
purchasing organs or just turning “a
blind eye to something they know about.”
When the FBI sting operation in
2009 uncovered a criminal ring that
paid Israelis to donate organs to
American patients, the surgeries were
being performed at reputable New
York City hospitals, according to
Scheper-Hughes, who had investigat-
ed the kidney broker who was ar-
rested. (See Current Situation, p. 360.)
A combination of medical prestige,
corruption and cronyism helped pro-
AP Photo/Mel Evans
Levy Izhak Rosenbaum, of Brooklyn, N.Y, was arrested in 2009 as part of an FBI sting and
charged with conspiring to broker the sale of an Israeli citizen’s kidney — for $160,000 —
for an American transplant patient. Rosenbaum allegedly had been
brokering kidney sales for 10 years. Critics of the organ transplant process
say look-the-other-way hospital policies foster the illegal trade.
tect doctors behind India’s largest re- cedure. Although brokers took a cut
cent organ-selling scandal. In Tamil Nadu of what recipients paid for a kidney
province, a refugee camp for survivors transplant — typically $14,000 — doc-
of the 2004 tsunami had so many peo- tors and hospitals profited the most,
ple selling their kidneys that it became according to Carney. Even though
known as Kidneyvakkam or “Kid- paper trails linked dozens of surgeons
neyville.” After local newspapers began to more than 2,000 illegal transplants,
covering the scandal in 2007, the De- authorities let the doctors off with a
partment of Medical Services discov- lecture, forcing only two small nurs-
ered that 52 Indian hospitals were in- ing homes to close. 28
volved in transplanting sold organs from In Pakistan, rural villagers and bond-
thousands of impoverished refugees. ed laborers view doctors as the like-
Those who sold a kidney were typ- ly purveyors of their kidneys, Farhat
ically offered the equivalent of about Moazam, chairperson of the Sindh In-
$3,000 by brokers, but most received stitute’s Centre of Biomedical Ethics
only a fraction of that after their pro- and Culture, discovered in 2007 while

www.globalresearcher.com July 19, 2011 351

 ORGAN TRAFFICKING
conducting interviews in the country-
side. She was shocked when poor vil-
lagers approached her colleagues wear-
ing physicians’ garb and asked if they
could help with selling a kidney. 29
To the extent there are criminal rings
in Pakistan, Moazam says, “You can
call it a kind of Mafia . . . connected
to certain doctors and certain hospi-
tals.” Although the middlemen take a
cut, black market brokers can be quite
poor themselves, while “the surgeons
and hospitals make a whole lot of
bucks out of it,” she contends.
Several Pakistani transplant surgeons
involved in this illegal activity are well-
known, according to Moazam, but no
physicians have been jailed even
though the law calls for up to 10 years
in prison for selling or buying organs.
“There’s quite a strong lobby among
transplant surgeons in Punjab,” she says.
In Pakistan, police arrested doctors
earlier this month, charging them with
running an illegal kidney transplant
ring in Lahore using kidneys bought
from poor Pakistanis and sold to for-
eign patients, yielding an estimated
$1 million. 30
Carney says hospitals should be re-
quired to provide the identity of every
organ recipient and donor. “It isn’t
legal to sell stolen cars, nor is it legal
to sell ones that are sure to break
down,” he writes. The same standards
should apply to body parts, he says.
Some countries, such as Switzerland,
allow authorities — including foreign
authorities and international organiza-
tions — to examine medical records in
order to expose illegal organ traffick-
ing. “Every country’s transplantation laws
should allow this form of disclosure
and traceability,” Canadian human rights
lawyer David Matas has urged. 31
Yet many members of the medical
community resist revealing donors’
names. Caplan would like to “hold the
transplant centers accountable for
where they get organs” but says this
can be done without violating patient
confidentiality.
352 CQ Global Researcher
Delmonico notes that in Israel,
where religious objections traditionally
keep donation rates low, insurance
companies used to pay for overseas
transplants. But Israel recently banned
insurance payments if the overseas op-
erations were illegal. “I would hope the
U.S. government would take the same
approach,” says Delmonico.
Carney, in his book, cites health in-
surance companies that have touted
transplant operations abroad as cheap-
er than at home. “Their websites say
they will only cover things that are legal
in the [United] States,” he says. But would
they actually cover an illegal transplant?
That’s an open question, he says: “It’s
not difficult in India to make an illegal
transplant look legal.”
In Chennai, India, the committee
responsible for authorizing transplants
admitted to Carney on tape that it was
taking bribes. Even reputable hospi-
tals “won’t look harder than they’re
legally forced to,” he says, partly be-
cause they benefit financially from per-
forming operations with “donated” or-
gans, which may actually have been
purchased under the table.
In the United States, doctors say
that when a patient shows up at the
hospital with a purported friend or rel-
ative wanting to donate a kidney, it is
difficult to determine whether an ille-
gal organ sale has occurred. The hos-
pital’s social workers and psychiatrists
probe the donors about their real mo-
tives, but a question often remains: “Is
the motivation really ‘I want to help
someone’ . . . or get $1,000?” asks New
York University transplant surgeon
Thomas Diflo. 32
“The transplant community can do
a lot to control black markets and ex-
ploitation, but they just haven’t cho-
sen to do it,” says Caplan. He urges
doctors to boycott conferences if they
involve transplant research in China
based on organs from executed pris-
oners. And Danovitch urges journals
not to publish similar articles. “If you
make pariahs of people who engage
in the behavior, you could get be-
havior to change,” Caplan says.
But Carney sees these as only half-
measures. “It seems like doctors don’t
want to reevaluate their own role,” he
says. That will only happen, he says,
if the profession agrees to make the
supply chain transparent.
BACKGROUND
The First Transplants
n unfettered market in human
A tissue and blood was both com-
mon and legal in the United States
and other countries for nearly three-
quarters of the 20th century.
The discovery in 1901 of four sep-
arate blood types ushered in an era
of blood transfusion, permitting more
extensive surgeries. Selling blood was
legal and increasingly in demand in
the United States. After World War II,
blood collection clinics sprang up in
skid row neighborhoods of every major
city, endangering the blood supply with
blood sold by alcoholics, drug users
and others suffering from hepatitis and
other blood-borne diseases. 33
This market approach changed rad-
ically with the publication in 1970 of
a highly influential book by Robert
Titmuss, a British social researcher
and professor of social administration
at the London School of Economics.
In The Gift Relationship: From Human
Blood to Social Policy, he argued that
selling blood and human tissue is ex-
ploitative and that an “altruistic” ap-
proach, in which people donate their
blood, would yield a safer and more
ample supply.
When people can sell their blood,
he argued, the desperately poor lie
about drug use or prostitution and the
Continued on p. 354
 Chronology
1900s-1950s
Sale of blood and organs is
legal in many countries.
1901
Discovery of four blood groups al-
lows transfusion-aided surgery.
Dec. 23, 1954
Doctors in Boston perform first
successful kidney transplant.
• 1984
1960s-1970s
First lung, heart transplanted;
states adopt organ donation laws,
which make it easier for individu-
als to donate their organs after
death, specifying it is a “gift.”
1963
First lung transplant performed in
Jackson, Miss.
1967
First heart transplanted, in South
Africa.
1970
British social researcher Robert Titmuss
publishes The Gift Relationship, urg-
ing altruism as the basis of organ
donation in U.S. and U.K.
1971
All 50 states have adopted the
Uniform Anatomical Gift Act, giv-
ing individuals the right to donate
their organs after death with a
simple document or donor card;
some interpret law as barring in-
centives for living donors.
•
1980s New immuno-
suppressive drug makes organ
www.globalresearcher.com
transplants safer, sparks rise in
demand, raising concern about
distribution and safety of organs.
United States, other countries
ban organ sales.
1983
Anti-rejection drug cyclosporine
approved in the United States. . . .
Reston, Va., doctor announces kid-
ney exchange to buy/sell kidneys,
arousing concern in Congress.
Congress passes National Organ
Transplant Act banning organ sales.
•
1990s India, the
world’s organ bazaar, bans
organ sales; Iran legalizes pay-
ments. European Union (EU) is
empowered to harmonize mem-
ber states’ laws governing
blood, organ distribution.
1994
India bans organ sales; illegal sales
continue.
1998
Iranian government begins paying
living donors for their organs.
1999
Iran claims to have eliminated its
kidney waiting list. . . . EU gets
new powers to harmonize members’
laws governing organs.
• 2011
2000s Medical groups
condemn organ trafficking, Chi-
nese organ harvesting from
prisoners; debate over legalizing
payment for organs heats up.
Organ traffickers are arrested
in India, New Jersey and Istan-
bul, but trafficking continues
in Pakistan, Egypt, China.
2006
Two Canadian human rights lawyers
report China is harvesting organs
from Falun Gong prisoners and sell-
ing them to “transplant tourists.”
2007
WHO estimates 5-10 percent of
organ transplants are illegal. . . .
Pakistan bans organ sales. . . .
China bans organ sales, gives Chi-
nese citizens priority for transplants
over foreigners.
2008
Declaration of Istanbul condemns
organ selling. . . . EU formulates
Organs Directive for members,
emphasizing organ donations must
be unpaid, requiring traceability of
organs.
2008
Amit Kumar, a doctor in Gurgaon,
India, arrested for 500 illegal trans-
plants.
2009
Brooklyn man charged with bro-
kering organ from Israel for U.S.
patient.
2010
Pakistan’s ban becomes law. . . .
Egypt bans trafficking. . . . EU
finds Kosovar politicians ran organ
smuggling ring.
Turkish doctor arrested for alleged
involvement in Kosovo organ
smuggling ring. . . . Pakistan’s ille-
gal trade returns.
Aug. 27, 2012
Deadline for EU states to adopt the
Organs Directive.
July 19, 2011 353
 ORGAN TRAFFICKING
Continued from p. 352
supply is at risk for blood-borne dis-
eases. Based on a comparative study
of blood supplies in England and the
United States, he concluded that Eng-
land, where most blood donations came
from unpaid volunteers, had a safer
supply than did the United States. 34
Titmuss’ altruism concept eventual-
ly became the dominant ethical prin-
ciple, not just for blood but also for
organ distribution in the United States
and most other Western countries. The
first successful kidney transplant was
conducted on Dec. 23, 1954, in Boston,
and the first lung transplant in 1963 at
the University of Mississippi in Jack-
son. On Dec. 3, 1967, newspapers across
the world splashed front-page head-
lines about the first successful heart
transplant, in Cape Town, South Africa,
by surgeon Christiaan Barnard. 35
A few months later the National
Conference of Commissioners on Uni-
form State Laws produced a frame-
work for standardizing organ and tis-
sue donation laws in the United
States, and by 1971 the model Uni-
form Anatomical Gift Act of 1968 was
adopted in nearly identical form by
all 50 states. 36 It made it easier for
people to donate their organs for
medical purposes after death.
In 1983, the Food and Drug Ad-
ministration’s approval of cyclosporine,
a revolutionary anti-rejection drug,
promised improved transplant survival
rates and sparked a huge increase in
transplants. It also spurred concerns
about how to distribute available or-
gans, which fell short of demand.
In 1984 lawmakers passed the land-
mark National Organ Transplant Act
(NOTA), which makes it “unlawful for
any person to knowingly acquire, re-
ceive, or otherwise transfer any human
organ for valuable consideration” — a
vaguely-defined term that has been the
subject of legal debate. A violation of
the ban is punishable by a $50,000
fine, five years in prison or both. 37
But it exempts “reasonable payments”
to donors to cover travel, housing and
lost wages incurred by the donation. 38
Similar bans were adopted in other
countries. The sale of blood and tis-
sue is now illegal in most countries.

Singapore Allows Reimbursements to Organ Donors

But is additional cash paid under the table?
ingapore retail tycoon Tang Wee Sung had a net worth Lawmaker Halimah Yacob expressed fears that foreign la-

S estimated at more than $170 million. He also had end-

stage kidney disease. 1
But even Tang couldn’t count on getting a legal kidney in
Singapore, where the wait for a donated kidney is up to nine
years. In 2008 he was convicted of offering to pay an organ
broker the equivalent of $244,558 for a kidney from an In-
donesian man. 2 Tang served a day in prison and was fined
about $14,000. 3
The highly publicized case spurred a debate in Singapore
over how best to control the illegal organ trade. During a par-
liamentary hearing on proposed legislation, health minister
Khaw Boon Wan said the Southeast Asian city-state should con-
sider legalizing payments to kidney donors. “We may be able
to find an acceptable way to allow a meaningful compensa-
tion for some living, unrelated kidney donors without breach-
ing ethical principles or hurting the sensitivities of others.”
However, Singapore didn’t go quite that far. It did allow
donors to be reimbursed for donation-related costs, such as
medical care, loss of income, travel and lodging. It also ex-
tended the prison sentences of anyone convicted of buying or
selling organs, to up to 10 years. 4
The law, which took effect in 2009, came in for harsh
criticism from some legislators, who charged it would lead
to an organ trading market. The law not only permits for-
eigners who donate an organ in Singapore to be reimbursed
but also allows foreigners to receive a transplant there after
agreeing to pay a donor’s costs.
borers might “become a ready, vulnerable pool of organ donors
to be exploited and abused.” 5
Unlike transplant procedures elsewhere, in Singapore the
prospective donor and recipient apply as a pair for the trans-
plant and usually know one another. The law also permits the
recipient to pay whatever reimbursement costs he chooses,
which must be approved by a three-person ethics committee,
composed of two doctors and a layperson.
Jacqueline Chin, who teaches medical ethics at the National
University of Singapore’s Centre for Biomedical Ethics and has
reviewed eight such cases as a member of a transplant com-
mittee, says the system has flaws. Under the law, the commit-
tee must reject the transplant if it suspects money has changed
hands. If an employee is donating his kidney to his employer,
she says, “Those things get our antennae up.”
But, she observes, “We have no expertise or powers to inves-
tigate” whether there’s been a cash exchange under the table. By
the time a foreign donor-recipient pair shows up on Singapore’s
shores, the recipient has presumably already paid for the donor’s
airfare and possibly promised other compensation.
Ideally, to prevent an under-the-table sale of an organ, there
should be a third party who collects the money from the recip-
ient and passes it on to the donor, Chin says. Currently, Singa-
pore’s National Kidney Foundation offers up to 5,000 Singapore
dollars ($4,100) in lost income to organ donors.
The ethics committee also has no way to enforce the re-
cipient’s promise to pay for the donor’s operation or follow-up

354 CQ Global Researcher

 medical care. “If we have any doubts that the recipient is not
sincere about reimbursing, we’ll not authorize the transplant,”
she says. But what if the recipient just walks away without
paying? “Lately, I’m concerned about this. I ask the hospital
and physicians if they are intending to pursue the donor for
payment.”
Singapore’s system, for all its flaws, is intended to follow
international guidelines specifying that donations should be an
“altruistic” gift, not an exchange for money or valuables. But
sometimes those lines become blurred, especially if the donor
is a poor relation or an employee in a wealthier cousin’s family-
owned business. If the family patriarch dies, the poor employee
“I think Singapore wants to establish a reputation for trans-
plantation expertise,” Chin says. “To do that, you have to do a
lot of operations.”
As for the tycoon Tang, he finally got a kidney. In January
2009 he received one from organized-crime boss Tan Chor Jin,
known as the “One-Eyed Dragon” because he had lost an eye.
Tan, who was hanged for murdering a nightclub owner, re-
portedly donated his kidney voluntarily. 7
— Sarah Glazer
1 “Tang Wee Kit,” Forbes, Aug. 24, 2006, www.forbes.com/lists/2006/79/06singa

might be out of a job, Chin points out. Might not a poor per-
son want to donate an organ to a rich employer “to put some
food on the table, give my children a better education, get
some health insurance?” she asks.
Critics of the new law question why the government didn’t
prohibit foreigners from receiving transplants and reimbursements
in order to crack down on the international organ trade.
Singapore, like Thailand and Malaysia, is heavily com-
mitted to medical tourism — which attracts all types of pa-
tients, not just those seeking transplants. In 2003, Singapore’s
government set up an agency just to attract foreigners to its
up-to-date hospitals, which are some of the finest in Asia.
At some of Singapore’s best private hospitals, foreigners ac-
count for a third of the patients — and up to 40 percent of
revenue. 6
pore_Tang-Wee-Kit_JU3W.html.
2 Peter Ritter, “Legalizing the Organ Trade?” Time, Aug. 19, 2008, www.time.com/
time/world/article/0,8599,1833858,00.html#ixzz1QyTcaZIK.
3 “Tang Wee Sung Gets 1-day Jail,” Channelnewsasia.com, Sept. 3, 2008,
www.channelnewsasia.com/stories/singaporelocalnews/view/373494/1/.html.
4 See “Human Organ Transplant Act (HOTA), FAQs,” Singapore Ministry of Health,
www.pqms.moh.gov.sg/apps/fcd_faqmain.aspx?qst=2fN7e274RAp%2bbUzLd
EL%2fmJu3ZDKARR3p5Nl92FNtJie8pByIMium%2b96IFsmAcEka%2bpIKxFLl%2bbs
TxHVE3%2fpFsXIkii%2bakrP9JvTq0g9m%2fgz6kkbcvQptk23HEACXM9FNn0UQ
qJ%2fPlcO17qN9e7L%2b43g4GT9QiZGWWvdvoB4Vi%2bNy6oZpxAfJtcAR%
2fEIKqmp2YAozrd9VgIg%3d..
5 David Gutierrez, “Singapore to Legalize Financial Compensation for Organ
Donors,” Natural News, July 14, 2009, www.naturalnews.com/026619_Singa
pore_organ_donor_WHO.html.
6 Ritter, op. cit.
7 Gutierrez, op. cit. Also see Jessica Jaganathan and Teh Joo Lin, “Tang gets
kidney, believed to be from ‘One-Eyed Dragon,’ ” The Straits Times (Singapore),
Jan. 10, 2009.

(It remains legal in the United States
for donors to sell blood plasma, a prod-
uct extracted from blood, and women’s
eggs as well as sperm.)
But the law did not eliminate prof-
its from the organ business, Red Mar-
ket author Carney points out. In fact,
the donation requirement allowed U.S.
hospitals to acquire organs virtually for
free while charging up to $500,000 for
their transplantation. That system, plus
medical privacy rules that forbid pub-
lic scrutiny of donors, masks the true
nature of the supply — including il-
legal transactions — “behind a curtain
of ethics,” he writes. 39
NOTA has been challenged only
once in the United States, when Penn-
sylvania in 1994 enacted its Burial Ben-
efit Act, providing funeral expenses from
a state-administered fund for those who
agreed to donate organs after death.
Questions about whether the law vio-
lated NOTA led the state to specify that
the funds should be used to pay only
for food, travel, lodging and lost wages
— already authorized by NOTA. In
European countries, deceased donors’
families commonly are reimbursed for
funeral expenses. 40
In 2003 the first tax incentive to en-
courage organ donation was adopted
in Wisconsin, allowing donors to claim
a $10,000 state deduction to cover lost
wages and expenses for travel, lodg-
ing and medical care. 41 Since then, 15
states have adopted similar laws. 42 By
2008, many states had passed other
laws aimed at offering inducements or
removing disincentives for donating an
organ. At least 30 have provided paid
or unpaid leave for bone marrow or
organ donors who are state employ-
ees. At least eight states have required
companies to provide a leave of ab-
sence for employees who donate. 43
In 2007, questions arose about
whether NOTA’s ban on “valuable con-
sideration” was being violated by so-
called paired donations, in which
donor-recipient pairs who were not a
good transplant match swapped kid-
neys with another incompatible pair
so that each patient received a suit-
able organ. In 2007 the U.S. Attorney
General’s office said the approach did
not violate NOTA. On Dec. 21, 2007,
the Living Organ Donation Act was
signed, clarifying that NOTA did not
outlaw paired donations. 44

www.globalresearcher.com July 19, 2011 355

 ORGAN TRAFFICKING
Foreign Variations
rgan shortages vary dramatically
O across the European Union, a dif-
ference that many experts attribute to
differences in national laws and poli-
cies governing how organs are donat-
ed. For example, deceased-donation rates
range from a low of 14.7 per million
people in Britain to a high of 34.4 mil-
lion in Spain. 45
Activists from India’s main opposition Bharathiya Janata Party demand an investigation of a
kidney black market uncovered in New Delhi in February 2008. Although India banned organ
sales in 1994, police have seen a resurgence in the underground organ market, with about
2,000 Indians selling a kidney every year, according to the Voluntary Health Association of India.
Spain is one of several EU coun-
tries with a policy of “presumed con-
sent,” in which organs are taken after
death unless a person “opts out” be-
fore death or the family objects. By
contrast, Britain — like the United
States — has an “opt in” system, in
which a donor must specify on a dri-
ver’s license or other directive a de-
sire to donate an organ after death.
Many experts suggest countries with-
out presumed consent could eliminate
their organ shortfalls by following Spain’s
example. While Spain’s high donation
rate might be attributed to its presumed
356 CQ Global Researcher
consent law, organ donation rates start- gans Directive, formulated in 2008, the
ed to rise only after Spain created a co- first legally binding international regime
ordinated hospital-based policy of en- imposing legislative requirements on
couraging consensual donation, known
as the “Spanish model.” 46
Under the policy, every hospital ap-
organ donation. Among other mea-
sures, it draws on the Spanish ap-
proach of appointing specially trained
points as donation coordinator a senior coordinators at hospitals to speak with
physician with special training in talk- families about donating. 47
ing with families of dying patients. By However, the directive says little
contrast, in Britain, a very junior staff about organ trafficking except that the
member, typically untrained in how to EU will monitor the situation — a
sensitively approach this difficult sub- vagueness due in part to the lack of
data on how extensive trafficking is
in Europe. 48 That information may be
uncovered by the directive’s require-
ment that members begin verifying
donor identities and the origins of or-
gans — not just within donors’ own
countries but also in organ exchanges
with other countries. 49
Under the directive, EU nations must
ensure that donations are voluntary and
unpaid, although this does not prevent
AFP/Getty Images/Raveendran living donors from being reimbursed for
expenses or loss of income. However,
in an analysis published this year,
Anne-Maree Farrell, a senior lecturer in
law at the University of Manchester’s
Centre for Social Ethics and Policy,
criticized the directive for failing to ac-
knowledge the “longstanding academ-
ic and policy debate” over legalized
payments and other alternative incen-
tives for donations. She blames the EU’s
avoidance of this crucial issue on “a
largely technocratic mindset.” 50
Live donor rates in the EU also vary
ject, raises the issue with the family, widely — low in Spain but much high-
says Margaret Brazier, a law professor er in Scandinavia. Only 17 percent of
at the University of Manchester. organ donations across Europe come
“Perhaps we could avoid radical from living donors. 51 In Britain, live
changes” such as legalizing payments donations have been controversial, part-
to donors, “by just having a thoroughly ly because of concerns about possi-
good system for encouraging consen- ble abuses, according to David Price,
sual donation,” she says, citing Spain professor of medical law at Britain’s
as “the shining example.” De Montfort University in Leicester.
In 1999, the EU gained new pow- But legislation in Britain in 2004 and
ers to adopt measures aimed at “har- 2006 explicitly endorsed such dona-
monizing” member states’ measures tions and regulated them. 52
governing blood, human tissue and Britain and many other European
organ donations. Members have until nations are “actively promoting living
Aug. 27, 2012, to adopt the EU’s Or- organ donation to help boost trans-
plant rates,” according to Price. In
Britain, the National Health Service
now funds transplants of liver sections
from living donors, in addition to kid-
neys. The legal framework also allows
swaps of kidneys between pairs or
within groups of pairs. 53 Under the
Human Tissue Act of 2004, which took
effect in England in 2006, an inde-
pendent agency must approve proce-
dures where there could be abuses,
such as paired swaps or donations by
children or vulnerable adults. 54
Consensus documents from med-
ical professional groups around the
By 1999, Iran said its kidney wait-
ing list had been eliminated. More than
78 percent of kidneys transplanted in
Iran come from living donors unre-
lated to recipients. 56
Coercion and Bans
ven though it banned organ sales
E in 1994, India became a major des-
tination for Western organ tourism in
ied by a research team at The Johns Hop-
kins School of Public Health had sold a
kidney in hopes of paying off debts,
three-quarters were still in debt six years
after the organ was removed. 57
In Egypt, poor kidney sellers who
have been cheated on the price quot-
ed by a broker or who suffer phys-
ical ailments after the surgery are
frequently afraid to report their ex-
ploitation for fear of arrest, accord-
ing to the Coalition for Organ-Failure

Chicago Tribune/McClatchy Tribune via Getty Images/Laurie Goering

world increasingly establish guide-
lines to ensure voluntary and in-
formed consent of donors. They fre-
quently recommend psychological and
psychosocial evaluation of donors to
ensure there has been no pressure to
donate. However, Price points out, there
is no legal requirement in Britain to
follow this guideline. 55
Since the 1980s, many countries
have banned compensation for organs.
Iran’s compensation system evolved in
a war-torn country without the facili-
ties to perform organ transplants for
its citizens with kidney disease. Be-
tween 1967 and 1988, the number of
Iranians on dialysis steadily increased,
but only 100 transplants occurred.
In 1980, the health minister allowed Marsha Payne and her husband James — “transplant tourists” from South Florida —
Iranians to get transplants abroad, paid traveled to New Delhi’s premiere Apollo hospital, where she donated half her liver for James’
liver transplant in 2008. The operation, plus the couple’s 10-week hospital stay, cost the
for by the government. The lack of a uninsured former investment banker $58,000 — a fraction of the $450,000 he was quoted
deceased-donor program meant the in Florida for the same procedure. The $100 billion global medical tourism industry is helping
country had no other source of organ to reduce the cost of transplants and increasing the demand for organs, but it is often
donations. Between 1980 and 1985, more difficult for hospitals to determine whether “donated” organs have been purchased.
than 400 traveled abroad for transplants,
and by 1988 there were long waiting the 1990s, and by 2002 sales through Solutions. The group says men from
lists for overseas transplants. corrupt brokers were commonplace, ac- western Sudan’s troubled Darfur re-
Faced with the rising cost of oper- cording to a widely cited study. The law gion have been recruited for jobs in
ations abroad, the government in 1988 permitted nonfamily members to donate Cairo, where they were forced to work
introduced a plan to subsidize organ an organ if they signed a form saying without pay, accumulated rent debts
transplants at home. Currently the gov- they had not been paid, so brokers per- and then were lured into selling a
ernment pays donors $1,200, which suaded impoverished people to lie. kidney to pay the debts. 58
can be supplemented by payments Frequently, local moneylenders de- Black market sellers are frequently
from recipients for associated expens- manded that debtors sell a kidney to pay financially and physically worse off.
es. After the program began, the num- off debts and refused additional credit to Of 32 Pakistani laborers who sold a
ber of transplant teams in Iran jumped those who still had both kidneys. Al- kidney to pay off debts to their land-
from two to 25. though 91 percent of organ sellers stud- lords, none received the amount they

www.globalresearcher.com July 19, 2011 357

 ORGAN TRAFFICKING
were promised, and most remained
in debt after the sale, according to a
study by Moazam, of the Sindh In-
stitute’s Centre of Biomedical Ethics
and Culture. Three years later, all
complained of symptoms related to
their operations, and all said they could
not work as hard as before. 59 Simi-
lar after-effects, including high rates of
depression and worsened financial sit-
uations, have been found among organ
sellers in India and the Philippines.
Strikingly, most sellers in Iran have
experienced deteriorating health, and
many have expressed regrets similar
to those of illegal sellers in other coun-
tries, according to several recent stud-
ies. Many said they’d been stigmatized
by their families and communities for
selling a kidney. 60
In 2008, the international Transplan-
tation Society and the International So-
ciety of Nephrology, meeting in Istan-
bul, adopted the Declaration of Istanbul
on Organ Trafficking and Transplant
Tourism, a document condemning poli-
cies “in which an organ is treated as
a commodity, including by being bought
or sold or used for material gain.” 61
Since then, Pakistan and Egypt have
banned organ-selling, but the bans have
only “curbed” the organ trade, accord-
ing to the Coalition for Organ-Failure
Solutions’ Budiani-Saberi. They have “by
no means ended it.”
In Egypt, organs traditionally were
distributed through sales, although
most recipients were not foreigners.
As recently as 2009, some 80-90 per-
cent of living kidney donors in Egypt
had no family link to the recipients.
In February 2010, Egypt banned organ
trafficking, and, for the first time, per-
mitted transplants from deceased
donors. 62
But the law has not been aggres-
sively enforced, according to Budiani-
Saberi, whose organization works with
Egyptian victims of organ trafficking.
And with the current vacuum in the
government following this spring’s
ouster of President Hosni Mubarak,
358 CQ Global Researcher
In Pakistan, reports of organ sales
Austria Leads in Per by impoverished people surfaced in
Capita Transplants April, and again just this month in the
arrest of several Lahore doctors charged
Austria has the world’s highest per with transplanting purchased kidneys,
capita organ transplant rate, with despite the ordinance criminalizing
95 transplants each year for every organ-selling. 64
million residents. Kidney transplants The Chinese government’s 2007 reg-
are the most common. Most trans- ulations prohibiting organ trafficking and
removal of organs from the living with-
plants are performed in the United
out their consent were aimed at dis-
States, followed by China, say couraging transplant tourism. The gov-
experts who caution that Chinese ernment also began giving Chinese citizens
statistics are unreliable. priority for organs and in 2009 limited
donors to close relatives. 65
Top 20 Organ Transplanting
Countries, 2011
(based on number of transplants
per million population) CURRENT
Austria
Norway
United States
95.24
91.88
90.38
SITUATION
Portugal 87.55
Spain 86.16 Major Criminal Cases
Belgium 83.80
France 71.94 everal high-profile cases against
Sweden 71.61 S organ-traffickers are pending around
the world, including those against:
Netherlands 64.85
• Alleged renegade doctor Amit
Canada 64.45 Kumar, in Gurgaon, India, who is
Switzerland 62.11 in jail awaiting the resolution of his
United Kingdom 61.47 trial. 66 He is charged with illegal-
Croatia 60.23 ly removing the kidneys of some
Denmark 59.45 500 day-laborers, farmers and rick-
shaw drivers. 67 Several police of-
Ireland 58.00 ficers also have been charged with
Czech Republic 57.62 extortion and accepting bribes. 68
Germany 57.45 • Brooklyn, N.Y., resident Levy Izhak
Italy 56.81 Rosenbaum, arrested in 2009 on
Malta 55.00 charges of conspiring to broker
the sale of a human kidney for
Australia 53.62
transplant at a cost of $160,000 to
Source: Global Observatory on Donation an American buyer. According to
and Transplantation, World Health Organiza- the complaint, filed in the U.S.
tion, www.transplant-observatory.org District Court of New Jersey, Rosen-
baum had been brokering kidney
enforcing the transplant law is not a sales for 10 years. He allegedly
high priority, she observes. “Traffick- instructed an undercover buyer to
ing could flourish again, because it’s pretend to be a relative or friend
a vulnerable moment,” she warns. 63 Continued on p. 360
 At Issue:
Would regulated reimbursements discourage organ trafficking?
yes
BENJAMIN HIPPEN, MD
TRANSPLANT NEPHROLOGIST
CHARLOTTE, N.C.
WRITTEN FOR CQ GLOBAL RESEARCHER, JULY 2011
r egulation probably would discourage trafficking. But issu-
yes no
ing broad generalizations about illegal, underground
organ trafficking in developing countries is a hazardous
proposition. Published information about the workings and out-
comes of organ trafficking around the world is piecemeal and
often second- or third-hand. The information we do have indi-
cates that it typically involves the transfer of organs from the
very poorest to the comparatively very rich, and that those pur-
chasing organs on the black market do so because the opportu-
nities for transplantation in their native country are limited.
For the last decade, the core strategy of most transplanta-
tion opinion leaders has been to aggressively condemn organ
trafficking; identify and apply public pressure on high-level
government functionaries in the worst-offending countries and
encourage the development of robust deceased-donor pro-
grams in the developing world.
It’s impossible to know whether this strategy has had any
meaningful impact on the prevalence of organ trafficking,
though there is ample room for doubt. Pakistan, for instance,
passed the Human Organ Tissue Transplant Act (HOTTA) to
great acclaim and trumpeted its success in the media and in
at least one bioethics journal last year. Although the law
banned the sale of organs, reports now are surfacing of a
resurgence of illegal underground trafficking.
More specifically, this anti-trafficking strategy fails to address
the fundamental social and economic allure of organ trafficking:
desperation. When a person’s very life depends on a new
organ, he suddenly finds himself willing to pay exorbitant
sums to individuals he knows nearly nothing about; risk his
life (and the lives of others); violate established laws in a
country where he is a visitor, and undertake a major surgical
procedure in sometimes substandard conditions.
The flourishing of organ trafficking in developing countries
is caused by the manifest failure of organ procurement poli-
cies in developed countries to meet the growing demand for
organs. It is the current system that is, and has been, morally
complicit in the existence of organ trafficking. It is time to ac-
cept that this strategy has been insufficient to the challenge.
A regulated market may or may not cure much of what
ails global organ transplantation. But, correctly structured, such
a market would assuredly remove the incentives for recipients
of means to provide key economic support for organ traffick-
ing. And, it is a reasonable hypothesis that, absent this crucial
economic support, organ trafficking will wither and die.
no
www.globalresearcher.com
GABRIEL DANOVITCH, MD
MEDICAL DIRECTOR, KIDNEY TRANSPLANT
PROGRAM, DAVID GEFFEN SCHOOL OF
MEDICINE, UNIVERSITY OF CALIFORNIA
LOS ANGELES
WRITTEN FOR CQ GLOBAL RESEARCHER, JULY 2011
t
he 2008 Declaration of Istanbul on Organ Trafficking and
Transplant Tourism (www.declarationofistanbul.org) and the
Guiding Principles endorsed by the World Health Organi-
zation (WHO) have helped to reduce the venal exploitation of
vulnerable organ donors intrinsic to organ trafficking. The wide-
spread endorsement of these pronouncements represents an un-
precedented consensus against all forms of organ commercialism.
Though organ trafficking still occurs, distinct and measured
progress has been made in countries previously designated as
“hotspots” by the WHO. Plus, several countries that traditionally
have “exported” transplant tourists have taken measures to re-
duce the trade. For example, Japan passed brain-death laws
that enable it to start addressing its citizens’ transplant needs,
and Israel prohibited insurance reimbursements for citizens
who travel abroad for transplants.
Commercialization of organ (typically kidney) donation has
been shown to undermine the very fabric of the organ trans-
plant endeavor, which is based on mutual benefit and trust —
both in the diagnosis of death and in the welfare of living
donors and their recipients. The outcome for kidney sellers is
worse than for altruistic donors — from both a medical view-
point and a psychosocial one. Recipients are also put at greater
risk as the mutual caring that underlies successful living donor
transplantation is displaced by financial considerations.
Furthermore, a “regulated organ market” is an oxymoron. In
Iran, where such a system has been in place since 1970,
“under the table” payments to “supplement” the regulated gov-
ernment payment are near universal. The transplant communi-
ty has documented the inferior outcomes for vulnerable
donors and is struggling to unburden itself from a system that
has hampered the development of related living donation and
voluntary deceased donation.
Moreover, it is facile to think that commercial organ dona-
tion would somehow “solve” the organ donor shortage. Expe-
rience has shown that paid donation comes at the expense of
and not in addition to voluntary donation.
Countries and regions must strive to become self-sufficient
in answering their citizens’ transplant needs. We must redouble
our efforts to prevent end-stage organ failure and do our utmost
to remove the economic, educational, legal and cultural disin-
centives to organ donation, so both the living and deceased
can manifest the humanity that is the core of a safe, successful
and effective organ transplant endeavor.
July 19, 2011 359
 ORGAN TRAFFICKING
Continued from p. 358
of an Israeli donor-seller he would
bring to New York City for the
transplant operation. Rosenbaum
was arrested as part of an FBI
sting that charged 44 people —
including New Jersey politicians
and rabbis — with a variety of
crimes including international
money laundering. 69 A trial date
has not yet been set.
Police escort Turkish doctor Yusuf Ercin Sonmez to a court in Istanbul, Turkey, on Jan. 12, 2011.
He was arrested in January and charged with organ trafficking at a Kosovo clinic in 2008
and has been implicated in an organ smuggling ring based in Kosovo in 1999.
• Yusuf Ercin Sonmez, a Turkish
doctor arrested in January for al-
leged involvement in an organ
smuggling ring based in Kosovo,
described in a recent Council of
Europe * investigation.
According to the 2011 report, Koso-
var politicians stole organs when the
Kosovo Liberation Army was fighting
Serbian forces in the late 1990s. Their
criminal faction detained Serb pris-
oners in Albania and killed them in
order to extract organs for shipment
abroad, the report alleges.
* The council is an organization of 47 coun-
tries in Europe that seeks to ensure human
rights and democratic principles.
360 CQ Global Researcher
It further claimed that Kosovo Nadey Hakim, surgical director of the
Prime Minister Hashim Thaci, a for- transplant unit at London’s Hammersmith
mer Kosovo Liberation Army leader, Hospital, said he became interested in
headed the faction that controlled il- a regulated market after presenting a
licit criminal enterprises, including the news program on organ trafficking for
organ trafficking. Thaci has denied the a British television station. Since then,
charges. The report suggested the organ he says, more colleagues have begun
trafficking continued after the war, and to support the idea.
that there was a link between the ring “Instead of abusing patients in
and the Kosovo clinic where Sonmez Third World countries and offering
was working in 2008. 70 them peanuts for their kidneys, we
ought to legalize organ payments in
the United Kingdom so at least it’s
well-organized,” he says. But he would
pay only British donors.
Despite the renewed interest, the
debate so far has been more theoret-
ical than legislative. In the United States,
in 2008 former Sen. Arlen Specter, then
a Republican from Pennsylvania, draft-
ed a bill that would have allowed fed-
eral, state or local governments to pro-
vide donors with in-kind rewards. 72
AP Photo/Ibrahim Usta However, the bill — expected to face
fierce opposition from medical groups
— was never introduced.
Nevertheless, the once-taboo idea of
providing donors with financial incen-
tives, or at least reimbursement, appears
to now have the support of a sizable
proportion of American transplant doc-
tors, according to a 2009 survey by the
Society of Transplant Surgeons. It found
that most members support providing
living donors with coverage for lost wages,
Legalizing Payments guaranteed health insurance and an in-
come tax credit. For deceased donors
roposals to allow payments for or- the poll showed support for paying
P gans are being vigorously debated
in Europe and the United States.
funeral expenses. But most oppose pro-
viding lump-sum cash payments. 73
“There has been in general a willing- UCLA’s Danovitch notes that U.S.
ness to look at the issue again,” says organ donation rates have been de-
Brazier, the British law professor. clining slightly in recent years, which
The Nuffield Council on Bioethics, he blames on the recession. People
an influential British think tank, is worried about holding onto their jobs
scheduled to release a report this fall are reluctant to take time off from
considering various incentives to en- work, another reason to consider re-
courage organ donations, including imbursing them for lost wages and
cash payments, priority on the trans- other expenses, he says.
plant waiting list for previous donors In China, with its low donation rate,
and payment of funeral expenses of the health minister has said the gov-
deceased donors. 71 ernment should consider providing
funeral costs, tax rebates, medical in-
surance, hospital costs or tuition waivers
for donors’ family members. 74
than politically charged market pro-
posals. “You’re not going to get a so-
lution to the needs of people in organ
failure by arguing about markets,” he
says, noting that millions of patients
Otherwise, he says, the poor half
of the world will continue selling or-
gans to the wealthier half.

OUTLOOK aren’t even on a transplant list “because

Making Trafficking
Obsolete
ome experts think medical advances
S — such as the use of regenerative
medicine to produce artificial organs —
could kill the black market in organs
by reducing the need for transplants.
Although the use of artificial organs
on a mass basis may not happen for
at least another decade, many experts
say, surgeons in Sweden have just given
a cancer patient a new windpipe,
made with stem cells from the pa-
tient’s bone marrow, the BBC report-
ed on July 7. It was the first trans-
plant of a synthetic organ that did not
require a donor. 75
“Thanks to nanotechnology, this new
branch of regenerative medicine, we
are now able to produce a custom-
made windpipe within two days or one
week,” said Paolo Macchiarini, chairman
of the Hospital Clínic at the University
of Barcelona in Spain, who led the
transplant team. “This is a synthetic wind-
pipe. The beauty of this is you can
have it immediately. There is no delay.”
In addition, “This technique does not
rely on a human donation.” 76
He said many other organs could
be repaired or replaced in the same
way. Other research aims to use stem
cells to repair defective organs or cre-
ate hearts and livers from a patient’s
own cells by growing cells on plastic
or natural scaffolds. 77
“If we pushed, we could see cell re-
placement in 10 years,” says bioethicist
Caplan, which he says will be far more
effective in ending organ trafficking
there’s no transplant center where they
live in Bolivia or Mozambique.”
1
Notes
Other experts see an even simpler Michael Smith, “Kidneys at Hub of Deadly
way to reduce black market demand: ‘Transplant Tourism,’ ” Bloomberg News, in The
better disease prevention so patients News Tribune, May 15, 2011, www.thenews
tribune.com/2011/05/15/1665819/kidneys-at-hub-
don’t need a replacement organ. A
of-deadly-transplant.html.
growing epidemic of obesity and the 2 For background, see Barbara Mantel,
resultant growth in diabetes is a major “Organ Donations,” CQ Researcher, April 15,
driver of the increasing demand for
kidney transplants.
2011, pp. 337-360.
3 Yosuke Shimazono, “The State of the Inter-
In addition, “there are about to be national Organ Trade: A Provisional Picture
several dramatic improvements in treat- Based on Integration of Available Information,”
ing hepatitis C — a major cause of Bulletin of the World Health Organization, De-
end-stage liver disease,” which could cember 2007, pp. 901-980, www.who.int/bulletin/
“dramatically reduce the need for liver volumes/85/12/06-039370/en/#. Also see, Coun-
transplants,” says UCLA’s Danovitch. cil of Europe/United Nations, “Trafficking in
“Entire villages in southern Punjab are selling their
kidneys out of desperation, . . . debt, poverty and
landlord coercion. Pakistan is being dragged back to
the era of illegal organ trafficking, spurred on by the
unrelenting greed of the medical profession in
collusion with the law-enforcing authorities.”
— Adibul Hasan Rizvi,
President, Transplantation Society of Pakistan
Waiting times for heart transplants Organs, Tissues and Cells and Trafficking in
have already declined, he points out, Human Beings for the Purpose of the Removal
of Organs,” 2009, www.un.org/apps/news/story.
because treatment of heart failure has
asp?NewsID=32521&Cr=&Cr1=.
improved over the past five to 10 4 D. A. Budiani-Saberi and F. L. Delmonico,
years. “Prevention,” Danovitch main- “Organ Trafficking and Transplant Tourism,”
tains, “is the best way and the only American Journal of Transplantation, 2008,
solution” to stem the shortage-driven p. 927, www.cofs.org/COFS-Publications/Budi
black market and the inevitable flow ani_and_Delmonico-AJT_April_2008.pdf.
of organs from poor to rich countries. 5 Scott Carney, The Red Market (2011), p. 65.

www.globalresearcher.com July 19, 2011 361

 ORGAN TRAFFICKING
6 Smith, op. cit.
7 Amelia Gentleman, “Poor Donors Duped by
Organ-Transplant Racket in India,” The New York
Times, Jan. 9, 2008, www.nytimes.com/2008/01/
29/world/asia/29iht-kidney.3.9573650.html.
8 Carney, op. cit., pp. 69-70. Note: Names
have been changed in Carney’s book to pro-
tect the privacy of interviewees.
9 See Robert C. Moellering Jr., “NDM-1: A
Cause for Worldwide Concern,” The New Eng-
land Journal of Medicine, Dec. 16, 2010, www.
nejm.org/doi/full/10.1056/NEJMp1011715.
10 Anne-Maree Farrell, et al., Organ Short-
Asian-Countries-amongst-Favorites-for-Medical-
Tourism.htm.
20 Gary S. Becker and Julio Jorge Elías, “In-
troducing Incentives in the Market for Live and
Cadaveric Organ Donations,” presented at the
conference, “Organ Transplantation: Economic,
Ethical and Policy Issues,” University of Chica-
go, May 16, 2003. An earlier version was pre-
sented in 2002, http://home.uchicago.edu/
gbecker/MarketforLiveandCadavericOrganDo
nations_Becker_Elias.pdf.
21 Arthur J. Matas and Mark Schnitzler, “Pay-
ment for Living Donor (Vendor) Kidneys,” Amer-
science/trafficking-the-traffickers-undercover-
ethnography-in-the-organs-trafficking-under
world/147/.
33 Carney, op. cit., p. 9.
34 Critics have pointed out that a few years
after Titmuss’ book came out, new tests were
introduced for hepatitis C, hepatitis B and
later HIV, and transfusion-related diseases
plummeted. See Sally Satel, When Altruism
Isn’t Enough (2008), p. 103.
35 Ibid., p. 131.
36 Ibid.
37 Ibid., p. 114.

age: Ethics, Law and Pragmatism (2011), pp.
195, 229.
11 Council of Europe/United Nations, op. cit.
12 Shimazono, op. cit.
13 “Resurgence of Pakistan’s Organ Bazaar.
Can You Still Deny? Continued Violation of
Transplant Law in Pakistan,” Sindh Institute of
Urology and Transplantation, April 29, 2011,
www.siut.org/news-events/news/resurgence-
of-pakistan.
14 Ibid.
15 Asif Chaudhry, “Probe into illegal kidney
ican Journal of Transplantation, Feb. 25, 2004,
www.medscape.com/viewarticle/468104_1.
22 Council of Europe/United Nations, op. cit.
Also see Ghods and Savaj, op. cit.
23 Carney, op. cit., pp. 81-82.
24 Nancy Scheper-Hughes, “A World Cut in
Two,” British Medical Journal, June 21, 2008,
www.bmj.com/content/336/7657/1342.full/reply
#bmj_el_197479.
25 Council of Europe/United Nations, op. cit.
Also see Institute of Medicine, “Organ Do-
nation: Opportunities for Action,” May 2006,
38 Ibid., p. 135. Also see http://history.nih.gov/
research/downloads/PL98-507.pdf.
39 Carney, op. cit., pp. 13-14.
40 Farrell, op. cit., p. 29.
41 Ibid., p. 118.
42 For recent state laws see, www.kidney.
org/transplantation/livingdonors/pdf/LDTax
Ded_Leave.pdf.
43 Satel, op. cit., p. 140.
44 Farrell, op. cit., p. 211.
45 Ibid., p. 229.
46 See Monica Navarro-Michel, “Institutional

transplants Surgeons made $1m from 40 clients,”
Dawn, July 7, 2011, www.dawn.com/2011/07/
07/probe-into-illegal-kidney-transplants-surgeons-
made-1m-from-40-clients.html.
16 Ahad J. Ghods and Shekoufeh Savaj, “Iran-
ian Model of Paid and Regulated Living-Un-
related Kidney Donation,” Clinical Journal of
the American Society of Nephrology, Novem-
ber 2006, pp. 1136-1145, http://cjasn.asn
journals.org/content/1/6/1136.full. Also see
Mantel, op. cit.
17 Ted Alcorn, “China’s Organ Transplant Sys-
www.iom.edu/Reports/2006/Organ-Donation-
Opportunities-for-Action.aspx.
26 Ghods and Savaj, op. cit.
27 Council of Europe/United Nations, op. cit.
28 Carney, op. cit., p. 65.
29 Farhat Moazam, et al., “Conversations with
Kidney Vendors in Pakistan: An Ethnographic
Study,” Hastings Center Report, May-June 2009,
pp. 29-44, www.thehastingscenter.org/Publica
tions/HCR/Detail.aspx?id=3472.
30 Chaudhry, op. cit.
31 David Matas, “Anti-rejection Drug Trials and
Organisation and Transplanting the ‘Spanish
Model,’ ” in ibid., pp. 151-170. Presumed con-
sent legislation can be found in countries
with some of the highest rates of deceased-organ
donation (Spain, Portugal, Belgium, France) and
some of the lowest (Bulgaria, Greece, Lithuania).
47 Farrell, op cit., pp. 238-239. The Directive
establishes minimum guidelines but does not
affect EU countries’ existing national laws on
the donation or medical use of organs.
48 Ibid., p. 236.
49 Ibid., p. 238.

Sales in China,” speech at the Doctors Against 50 Ibid., pp. 240-243.

tem in Transition,” Lancet, June 4, 2011, pp.
1905-1906, www.thelancet.com/journals/lancet/
article/PIIS0140-6736(11)60794-0/fulltext?ver
sion=printerFriendly.
18 Carney, op. cit., p. 142.
19 See “Asian Countries amongst Favorites for
Forced Organ Harvesting Forum, May 1, 2011, 51 Ibid., p. 234.
Philadelphia, Penn., www.dafoh.org/Matas_ 52 See David Price, “Promoting Organ Do-
speech.php. nation: Challenges for the Future,” in ibid.,
32 Diflo quotes from a discussion session at p. 256.
a New York Academy of Sciences Anthro- 53 Ibid., pp. 256-7.

pology Session, “Trafficking the Traffickers,” 54 Ibid., pp. 257-258.

Medical Tourism,” press release, RNCOS,
Oct. 6, 2008, www.thirteen.org/forum/topics/ 55 Ibid.
April 21, 2011, www.rncos.com/Press_Releases/
56 Ghods and Savaj, op. cit.
57 Ibid., p. 55. Also see Madhav Goyal, et al.,

About the Author “Economic and Health Consequences of Selling

Sarah Glazer, a London-based freelancer, is a regular con-
tributor to CQ Global Researcher. Her articles on health,
education and social-policy issues also have appeared in
The New York Times and The Washington Post. Her recent
CQ Global Researcher reports include “Radical Islam in Eu-
rope” and “Social Welfare in Europe.” She graduated from
the University of Chicago with a B.A. in American history.
a Kidney in India,” Journal of the American
Medical Association, 2002, pp. 1589-1592.
58 Debra Budiani-Saberi and Amr Mostafa,
“Care for Commercial Living Donors: the ex-
perience of an NGO’s outreach in Egypt,”
Transplant International, 2010, pp. 1-7, http://on
linelibrary.wiley.com/doi/10.1111/j.1432-2277.
2010.01189.x/pdf. For background, see Karen
Foerstal, “Crisis in Darfur,” CQ Global Researcher,

362 CQ Global Researcher

Sept. 1, 2008, pp. 243-270.
59 Moazam, et al., op. cit., pp. 33-34.
60 Budiani-Saberi and Mostafa, op. cit., pp. 3, 4.
61 Satel, op. cit., pp. 50-51. Also see www.de
clarationofistanbul.com and Budiani-Saberi and
Mostafa, op. cit.
62 Budiani-Saberi and Mostafa, op. cit.
63 For background, see Roland Flamini, “Tur-
moil in the Arab World,” CQ Global Researcher,
May 3, 2011, pp. 209-236.
64 “Resurgence of Pakistan’s Organ Bazaar.
Can You Still Deny? Continued Violation of
Transplant Law in Pakistan,” op. cit. Also see
Chaudhry, op. cit.
65 “Ending Abuse of Organ Transplantation in
China,” China Uncensored, Aug. 20, 2010, www.
chinauncensored.com/index.php?option=com_
content&view=article&id=249:ending-abuse-of-
organ-transplantation-in-china&catid=36:organ-
harvesting-in-china&Itemid=79.
66 “Kidney Racket Case,” indianexpress.com,
June 8, 2011, www.indianexpress.com/news/
kidney-racket-case-cbi-wants-modification-in-
hc-order/800842.
67 Gentleman, op. cit.
68 “Court Grants Bail to Accused Police In-
spector,” Hindustan Times, Sept. 23, 2008, www.
hindustantimes.com/special-news-report/News-
Feed/Court-grants-bail-to-accused-police-inspec
tor/Article1-339821.aspx.
69 “Two-Track Investigation of Political Cor-
ruption and International Money Laundering
Rings Nets 44 Individuals,” Press Release, U.S.
Attorney, District of New Jersey, July 23, 2009,
www.fbi.gov/newark/press-releases/2009/nk07
2309.htm. Also see USA v. Levy Izhak Rosen-
baum, Criminal Complaint Mag No. 09-3620,
U.S. District Court, District of New Jersey.
70 “Turkish doctor suspected of human organ
trafficking arrested,” CNN, Jan. 12, 2011, http://
premium.edition.cnn.com/2011/WORLD/europe/
01/12/kosovo.organs/index.html?iref=topnews.
Also see “Trafficking Investigations Put Surgeon
in Spotlight,” The New York Times, Feb. 11, 2011,
www.nytimes.com/2011/02/11/world/europe/
11organ.html?pagewanted=1&_r=2&emc=eta1.
71 “Organ Donors Could Be Rewarded Under
Plans to Boost Registration,” The Times, April 20,
2010, www.timesonline.co.uk/tol/life_and_style/
health/article7102299.ece. Also see www.nuffield
bioethics.org/human-bodies.
72 Satel, op. cit., p. 153.
73 J. R. Rodrigue, et al., “Stimulus for Organ
Donation: A Survey of the American Society of
Transplant Surgeons Membership,” American
Journal of Transplantation, 2009, pp. 2172-2176,
www.globalresearcher.com
FOR MORE INFORMATION
Centre for Biomedical Ethics, National University of Singapore, Clinical Research
Centre, Block MD11, #02-0110 Medical Drive, Singapore 117597; (65) 6516 7201;
http://cbme.nus.edu.sg. Academic center that tracks organ trafficking and legislation
to curb it.
Coalition for Organ-Failure Solutions, 5 Sakr Kouraish, Apt. 1, Zone 7, Nasr City,
Cairo, Egypt; U.S. phone: (330) 701-8399; www.cofs.org. Nonprofit international
health and human rights organization dedicated to combating organ trafficking.
Declaration of Istanbul on Organ Trafficking and Transplant Tourism;
www.declarationofistanbul.org. A website providing up-to-date news about organ
trafficking hosted by signers of the 2008 Declaration of Istanbul, a proclamation
issued by transplant specialists condemning organ selling.
Doctors Against Forced Organ Harvesting, P.O. Box 58123, Washington, DC,
20037; (202) 510-3894; www.dafoh.org. International group of doctors campaign-
ing to end China’s use of prisoners for organ harvesting.
Falun Dafa Information Center, P.O. Box 577, New York, NY 10956-9998;
(845) 418-4870; www.faluninfo.net. Organization provides information about the
persecution of Falun Gong practitioners in China, including deaths from organ
harvesting.
Global Observatory on Donation and Harvesting, www.transplant-observatory.
org/pages/home.aspx. Hosted by the World Health Organization and the Spanish
National Transplant Organization (www.ont.es); tracks news and data on organ
trafficking and transplantation activities worldwide.
The Hastings Center, 21 Malcolm Gordon Road, Garrison, NY 10524-4125; (845)
424-4040; www.thehastingscenter.org. Bioethics center that has published reports
and articles about the ethics of organ donation.
Laogai Research Foundation, 1734 20th St., N.W., Washington, DC 20009; (202)
408-8300; Founded by Harry Wu, a survivor of the Chinese slave-labor camps
known as laogai; provides information about the camps and other Chinese
human rights abuses including organ harvesting from executed prisoners.
Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi 74200,
Pakistan; (92-21) 9215752 & 9215718; www.siut.org. Provides transplants and med-
ical care for low-income patients; monitors Pakistan’s resurgent organ trade.
The Transplantation Society, International Headquarters, 1255 University St.,
Suite 605, Montreal, QC, Canada H3B 3V9; (515) 874-1717; www.tts.org. Interna-
tional group of transplant physicians and specialists.
World Health Organization, Clinical Procedures, CPR/EHT/HSS, Essential Health
Technologies, Avenue Appia 20, 1211 Geneva 27, Switzerland; 41 22 791 21 11;
www.who.int/transplantation/en/. Web site of the WHO unit responsible for pro-
moting ethical donation and transplantation.
http://deepblue.lib.umich.edu/bitstream/2027. 75 Michelle Roberts, “Surgeons Carry out First
42/74730/1/j.1600-6143.2009.02741.x.pdf. Synthetic Windpipe Transplant,” BBC News,
74 “China Considers Financial Incentives to
July 7, 2011, www.bbc.co.uk/news/health-140
Promote Organ Donation,” Reuters, April 25, 47670.
2011, www.reuters.com/article/2011/04/25/us- 76 Ibid.
china-organs-idUSTRE73O1HX20110425. 77 Farrell, op. cit., p. 22.
July 19, 2011 363
 Bibliography
Selected Sources
Books
Carney, Scott, The Red Market: On the Trail of the World’s
Organ Brokers, Bone Thieves, Blood Farmers and Child
Traffickers, William Morrow, 2011.
An investigative journalist spent five years tracing the routes
of illegal organs and other body parts from the original sellers
through brokers to recipients.
Farrell, Anne-Maree, David Price and Muireann Quigley,
Organ Shortage: Ethics, Law and Pragmatism, Cambridge
University Press, 2011.
Academics from Britain and elsewhere discuss financial in-
centives for organ donation and the donation experience in
the United Kingdom, European Union and United States.
Matas, David and David Kilgour, Bloody Harvest, Seraphim
Editions, 2010.
Two Canadian lawyer/human rights activists were nomi-
nated for a Nobel Prize for this investigation concluding that
thousands of Falun Gong practitioners in China have been
killed for their organs.
Satel, Sally, When Altruism Isn’t Enough: The Case for
Compensating Kidney Donors, AEI Press, 2008.
Experts argue for legalizing payments to organ donors to
increase supply. The book is based on a conference spon-
sored by the conservative American Enterprise Institute.
Articles
Alcorn, Ted, “China’s Organ Transplant System in Transition,”
Lancet, June 4, 2011, pp. 1905-1906.
Alcorn describes China’s still-paltry efforts to adopt a voluntary
organ-donation system and crack down on transplant tourism.
Gu, Bo, “Chinese man wakes up — minus his kidney,”
March 31, 2011,MSNBC, http://behindthewall.msnbc.msn.
com/_news/2011/03/31/6382271-chinese-man-wakes-up-
minus-his-kidney.
Twenty-six-year-old Hu Jie, who changed his mind about
selling a kidney, describes how his kidney was forcibly re-
moved by a broker’s henchmen, a widely publicized story
signaling a renewed black market in China.
Gutmann, Ethan, “China’s Gruesome Organ Harvest,” The
Weekly Standard, Nov. 24, 2008, www.weeklystandard.
com/Content/Public/Articles/000/000/015/824qbcjr.asp.
An investigative journalist and fellow at the Foundation for
Defense of Democracies, an advocacy group in Washington,
describes large-scale organ harvesting from Falun Gong pris-
oners while still alive, confirmed by his interviews with es-
capees from Chinese labor camps.
364 CQ Global Researcher
Interlandi, Jeneen, “Not Just Urban Legend,” Newsweek,
Jan. 10, 2009, www.newsweek.com/2009/01/09/not-just-
urban-legend.html.
A reporter describes the organ trafficking investigations of
anthropologist Nancy Scheper-Hughes.
Moazam, Farhat, et al., “Conversations with Kidney Vendors
in Pakistan: An Ethnographic Study,” Hastings Center Report,
May-June 2009, www.thehastingscenter.org/Publications/
HCR/Detail.aspx?id=3472.
The chair of the Centre of Biomedical Ethics and Culture
in Karachi and her team interviewed 32 Pakistani laborers
who sold a kidney to pay off debts to their landlords.
Shimazono, Yosuke, “The State of the International Organ
Trade: A Provisional Picture Based on Integration of
Available Information,” Bulletin of the World Health Or-
ganization, December 2007, pp. 901-980, www.who.int/
bulletin/volumes/85/12/06-039370/en/#.
Based on an analysis of more than 300 articles and re-
ports, the article concludes that, conservatively, about 5 per-
cent of all organ transplants worldwide in 2005 involved
black market transactions. The World Health Organization
used the article as the basis of its estimate that 5-10 percent
of transplants each year involve illegal sales.
Smith, Michael, “Kidneys at Hub of Deadly ‘Transplant
Tourism,’ ” The News Tribune, May 15, 2011, www.thenews
tribune.com/2011/05/15/1665819/kidneys-at-hub-of-deadly-
transplant.html.
A Bloomberg News reporter describes the illicit market for
organ transplants in Nicaragua and around the world stimulated
by the growing “transplant tourism” business.
Reports and Studies
“Resurgence of Pakistan’s Organ Bazaar. Can You Still
Deny? Continued Violation of Transplant Law in Pakistan,”
Sindh Institute of Urology and Transplantation, April 29,
2011, www.siut.org/media-siut/data-files/resurgence-of-
pakistan-organ-trade.pdf.
A Karachi medical center reports a resurgence of Pakistan’s
illegal organ trade since a law criminalizing organ selling took
effect in 2007.
“Trafficking in Organs, Tissues and Cells and Trafficking in
Human Beings for the Purpose of the Removal of Organs,”
Council of Europe/United Nations, 2009, www.coe.int/t/dghl/
monitoring/trafficking/docs/news/OrganTrafficking_study.
pdf.
A WHO estimate that 5-10 percent of annual worldwide
kidney transplants involve trafficking is conservative, according
to this comprehensive report.
 The Next Step:
Additional Articles from Current Periodicals
Black Market
Bryant, Lisa, “EU May Investigate Kosovo PM for Organ
Trafficking,” Voice of America, Dec. 15, 2010, www.voa
news.com/english/news/europe/EU-May-Investigate-Kosovo-
PM-for-Organ-Trafficking-111952224.html.
The European Union plans to investigate allegations that Koso-
vo’s prime minister has sold human organs on the black market.
Ogilvie, Jessica Pauline, “A Kidney Market At What Cost?”
Los Angeles Times, March 28, 2011, p. E1, articles.latimes.
com.
The unregulated, underground market for human organs
in developing countries has had catastrophic effects for both
donors and recipients.
Simon, Alina, “New Law to Plug Black Market for Organs,”
New Straits Times (Malaysia), Oct. 5, 2010, www.nst.com.
my/nst/articles/14tissue/Article/.
The Malaysian Health Ministry is drafting a new law in-
tended to ensure that organ and tissue transplantation is
conducted without turning to the black market.
China
“China to Launch Crackdown in Illegal Organ Transplants,”
Xinhua (China), April 18, 2011, news.xinhuanet.com/
english2010/china/2011-04/19/c_13834757.htm.
The Chinese Ministry of Health is launching a nationwide
campaign to target illegal organ transplants performed by
unqualified medical institutions.
Kamm, John, “Is Mercy Coming to China?” The Washing-
ton Post, Aug. 16, 2010, p. A13, www.washingtonpost.com/
wp-dyn/content/article/2010/08/15/AR2010081502150.html.
The executive director of the Dui Hua Foundation, a San
Francisco-based human rights group, says capital punishment
has reached astonishing levels in China largely to harvest or-
gans from executed prisoners.
Varma, K.J.M., “China to Amend Organ Transplant Rules to
Encourage Donations,” Press Trust of India, Jan. 10, 2011.
China is set to amend its organ transplant regulations to
build a national donation system that relies less on obtaining
organs from executed prisoners.
Demand
Callahan, Maureen, “Invasion of the Body Snatchers,”
The New York Post, June 12, 2011, p. 28, m.nypost.com.
The growing demand for organs such as kidneys has led
to profitable trading rings in the United States, Brazil, Egypt,
Israel, Japan and South Africa.
www.globalresearcher.com
Smith, Lewis, “Sale of Human Organs Should Be Legalised,
Say Surgeons,” The Independent (England), Jan. 5, 2011,
www.independent.co.uk/life-style/health-and-families/health-
news/sale-of-human-organs-should-be-legalised-say-surgeons-
2176110.html.
Many leading British surgeons are calling for the legaliza-
tion of organ sales in order to meet growing demand.
Widhiarto, Hasyim, “When Disease Creates Demand,”
Jakarta (Indonesia) Post, Oct. 25, 2010, www.thejakarta
post.com/news/2010/10/25/when-disease-creates-demand.
html.
An estimated 80,000 people in Indonesia are waiting for
kidney transplants, leading many to wonder whether illegal
organ trafficking is occurring in the country.
Laws and Regulations
“Relaxed Rules May Lead to More Organ Donations,”
Yomiuri Shimbun (Japan), Aug. 11, 2010, www.yomiuri.
co.jp/dy/national/T100810004970.htm.
The relaxation of requirements for organ donations would
raise the number of annual donors in Japan for the foresee-
able future, according to the Japan Society for Transplantation.
Rahn, Kim, “NK Defector in Legal Dispute Over Organ
Transplantation,” Korea Times (South Korea), May 23, 2011,
www.koreatimes.co.kr/www/news/nation/2011/05/113_87
535.html.
A South Korean law designed to prevent organ trafficking
is preventing a North Korean defector from receiving a trans-
plant, even though he has found a donor.
CITING CQ GLOBAL RESEARCHER
Sample formats for citing these reports in a bibliography
include the ones listed below. Preferred styles and formats
vary, so please check with your instructor or professor.
MLA STYLE
Flamini, Roland. “Nuclear Proliferation.” CQ Global Re-
searcher 1 Apr. 2007: 1-24.
APA STYLE
Flamini, R. (2007, April 1). Nuclear proliferation. CQ Global
Researcher, 1, 1-24.
CHICAGO STYLE
Flamini, Roland. “Nuclear Proliferation.” CQ Global Researcher,
April 1, 2007, 1-24.
July 19, 2011 365

KANCHHA BUDHATHOKI
Garment factory worker
Nepal
Misled
“He [a fellow worker] said
he would find me a good
job in India. When we reached
New Delhi, we went to a
hospital and they tested my
blood. Another day they gave
me alcohol then they gave
me an injection. I became un-
conscious and when I woke
up I was in hospital and they
had already taken one of my
kidneys.”
Nepali Times, June 2011
JOHN KAMM
Executive Director, Dui
Hua Foundation, China
Not just a deterrent
“While many have thought
the death penalty is invoked
to deter crime, there is an-
other reason capital punish-
ment reached such astonish-
ing levels in China. For years Transplants and ethics
organs were harvested from
executed prisoners.”
News Journal (Delaware)
August 2010
L R
ALITHA AGHURAM and regions now and thus
Director, Multi Organ ensure
Harvesting Aid Network organ transplants and save
India
Only in times of need
“Ninety-nine percent of us
will accept an organ transplant would
if we need one to live, but
not even one of every 10 of Press Trust of India, January
us are signed up to donate.” 2011
India Today, August 2010
Voices From Abroad:
JOSE OLIVEROS
Catholic Bishop, Philippines
Preserving dignity
“Human organ sale or
trade, by its very nature, is
morally unacceptable. It is
contrary to the dignity of the
human person, his or her
authentic autonomy and the
essential equality of all per-
sons. The dignity of the
human person as the image
of God includes not only his
or her soul but his or her
corporeal being. Hence, our
body ought not to be treat-
ed as a commodity or ob-
ject of commerce, which
would amount to the dis-
possession or plundering of
the human body.”
Philippines News agency
July 2010
H J
UANG IEFU
Vice Health Minister
China
“With the amendment,
China will be a step clos-
er to building up a national
organ donation system,
which is being run as a
pilot project in 11 provinces
the sustainable and
healthy development of
more lives. An ethically
proper source of organs for
China’s transplants that is
sustainable and healthy
benefit more pa-
tients.”
ISMAIL MERICAN
Health Director-General
Malaysia
Related donors only
“If living donation is to be
carried out, it should come
from genetically, legally or emo-
tionally related donors. . . . Un-
related donation is not a pre-
ferred solution to increase the
donor pool.”
New Straits Times (Malaysia)
November 2010
LIU RENWEN
Law Researcher, Chinese
Academy of Social Sciences
China
Harmful to society
“Some poor people sell their
own organs for a small amount
of money. Although it might
be voluntary, they are not aware
of the health risks. What’s
more, the illegal organ trade is
harmful to society as a whole.”
Chinadaily.com.cn, February
2011
DENG LIQIANG
Legal Affairs Director,
Chinese Medical Doctor
Association, China
Illuminated
circumstances
“The scarcity of available
human organs is a global
phenomenon. It is just more
obvious in China because of
the number of illegal organ
trades due to poverty.”
Anchorage (Alaska) Daily
News, February 2011
CagleCartoons.com/Ares