Unwilling Child Donors (HIIN=16)

With the higher demand for organ transplants, in recent decades, the legitimate supply side has not kept pace. In consequence, a black market for human organs, has opened up. There is limited information on the trade, whether for adult, childrens' or fetal parts.

In LDCs, occasional reports note that children have disappeared - and then reappeared - minus eg a kidney. They are also abducted and subsequently found dead, minus all their transplantable organs. The trade in these is lucrative. Transplantation is the last treatment option for children, eg, with end-stage cardiac or liver failure. Organs from child donors are in very short supply, so increasing demand exacerbates the problem. See https://www.hiqa.ie/sites/default/files/2017-11/Priority-1-Transfer-options-HTA-Nov2017.pdf

In 1983, the new immunosuppressant drug, cyclosporine, increased the potential donor pool. Used for research too, the body parts of young or old, can be auctioned. This commodifies human life. Embryos and fetuses {called the POC (Products of Conception) by the Irish Government}, however, are usually obtained from abortion or by killing the 'spare embryos' from in vitro fertilization. In the US (>1m abortions pa), scientists also create human embryos just for research. In abortion, the humanity of the fetus is set aside. In research, the necessity of using human fetuses is affirmed. See http://www.lifeissues.net/writers/kac/kac_11fetalresearch.html and https://www.osce.org/secretariat/103393?download=true

In 1983 also, US physician H. Barry Jacobs attempted to establish the International Kidney Exchange. His proposal, to procure organs from impoverished people, was met with (perhaps unbelievable) shock and disapproval. In 1988, because of reports of kidnapping and organ theft, the European Parliament denounced alleged US involvement, adopting a motion 'condemning the trade in organs of Third World babies'. US officials denied the charges.

The World Health Assembly is the decision-making body of the WHO. In 1989, the WHA issued Resolution 42.5, to combat the organ trade. Dr Ursula Lehr (West German Health Minister) said for brokers to take advantage of Third World poverty, buying human organs for a pittance and reselling them to wealthy patients, was repugnant. In 1993, the European Parliament passed a Resolution on Prohibiting Trade in Transplant Organs. The document read:

"...whereas there is evidence that fetuses, children and adults, in some developing countries, have been mutilated and others murdered, with the aim of obtaining transplant organs for export...""

The Bellagio Task Force Report, in 1997, on Securing Bodily Integrity for the Socially Disadvantaged in Transplant Surgery, provided information on the organ trade from transplant surgeons, specialists, rights activists and academicians. They asserted that there was a need for an 'Organs Watch' committee. As stated in the UN Palermo Protocol of 2000, the basis for most national laws on human trafficking and organ trafficking is defined as follows:

"Trafficking in persons shall mean the recruitment, transportation, transfer, harbouring or receipt of persons..., for the purpose of exploitation. Exploitation includes the prostitution of others or other forms of sexual exploitation, forced labour or services... servitude or the removal of organs."

The European Union feels that there is a need for action in this field. It provides some funds eg to ISPCAN - International Society for the Prevention of Child Abuse and Neglect. This body has a mission - to prevent cruelty to children - in every nation. Notably, ISPCAN is the only international non-profit organization which speaks of preventing the use of unwilling child organ donors. European organizations, in the Transplant Industry, could well now pursue prevention targets.

A WHA resolution adopted in 2004 (WHA57.18) urged Member States to "take measures to protect the most vulnerable groups from 'transplant tourism' and the sale of tissues and organs". As data on these practices are not collected, resolute action against the international organ trade cannot be taken.

The EU has addressed child trafficking for sex and other forms of slavery. A small, trafficked child is worth between €4,000 to €8,000 but, in some cases, up to €40,000. Some children are taken, by criminal gangs, as a form of debt repayment. Denmark, Lithuania, Sweden and Slovakia have all reported that children have been forced to commit crimes. While most are exploited for sex, around 12% end up in the 'other' category, which includes organ removal, forced begging and the drugs trade. Wealthy people buy organs in the black market, ignoring the plight of their donors. In 2018, the EU Commission published findings on this, in various EU countries. https://ec.europa.eu/home-affairs/sites/homeaffairs/files/what-we-do/policies/european-agenda-security/20181204_data-collection-study.pdf

The most common way to buy organs is for potential recipients to travel abroad for transplantation ('transplant tourism'). Several websites offer all-inclusive 'transplant packages'. The price of a renal transplant package ranges from $70,000 to $160,000. However, if brokers be involved, the WHO estimates the charge can be as much as $100,000 to $200,000. https://euobserver.com/justice/133482

Organs are also procured at 'organ bazaars' in Turkey, Pakistan and India, where destitute locals sell their body parts to foreign traders. Third countries, where transplantation is performed, has seen the growth of regional transplant hubs. South Africa and Brazil are now favoured transplantation centres. Current attempts to curtail organ trafficking are inadequate. There is a need to signal a fundamentally new approach tackle the issues of both organ removal and the larger problem of trafficking in organs, tissues and cells (OTC). https://lawdigitalcommons.bc.edu/cgi/viewcontent.cgi?article=3324&context=bclr

Estimated values on the black market are: Corneas (€30,000), Lungs ($150,000), Heart ($130,000), Liver ($98,000), Kidney ($62,000). Global Financial Integrity estimates conservatively that, worldwide, the illegal organ trade generates about $840m to $1.7bn annually. GFI estimates that 10% of all organ transplants including lungs, heart and liver, are done with trafficked organs. The WHO estimating that 10,000 kidneys are traded annually on the black market. See https://www.mdpi.com/2076-0760/5/4/69/htm, https://www.wired.com/2011/01/ff_redmarkets/ and http://www.ghnservices.com/treatment/low-cost-liver-transplantation-india/

In 2003, Italian undercover police were contacted by three Ukrainian women, one a pregnant sex-worker. They were asked if they wanted her 'five-month parcel'. But there was to be an auction. Others attended, the heart and liver being of particular interest. The price went from €50,000 up to €350,000, the police observing that the sale was nothing new. Generally, women and children form 79% of victims (UN Office on Drugs and Crime (UNODC), Global Report on Trafficking in Persons).

In 2004, Sisters of the Brazilian mission of the Servants of Mary Immaculate, in Mozambique, reported that victims, who had escaped from an organ trafficking ring, showed them dead children with missing organs. Soon after the nuns spoke out, one of them was found beaten and strangled to death. In 2016, the Nuns repeated their request for an investigation, but no action was taken.