Experts meet in Vienna to address the trafficking of persons for the removal of organs

28 to 30 June 2010,

Vienna, Austria

From 28-30 June 2010, United Nations Office on Drugs and Crime (UNODC) hosted an expert group meeting (EGM) to address trafficking in persons for the purpose of organ removal. The key purpose of the meeting was to develop materials to assess this form of trafficking. The EGM saw the participation of experienced experts from different regions of the world, of various professional backgrounds including; medical health care, criminal justice, law enforcement and academia.

The EGM gathered expert input on the crimes pertaining to this particular form of trafficking, the actors involved, the modus operandi of traffickers, the existing legal frameworks of Member States, case studies and appropriate measures to respond and prevent these crimes.

The meeting was made possible by funding received from the government of France.

Background

Trafficking in persons for the purpose of removal of organs is a form of human trafficking in which an individual is exploited for bodily organs. The most common organs sought for in the 'organ market' are kidneys, followed by livers for purposes of transplantation. Such practices have increased exponentially in recent decades with the growing demand for live-donor organ transplants. This demand is attributable to an increasing differential between rates of end-stage renal disease (ESRD) and deceased donor organ donation.

This form of trafficking in persons follows patterns similar to other forms of human trafficking (e.g. exploitation of vulnerable populations), but intrinsically contains significant differences. Some of the actors and modus operandi of this crime stand in sharp contrast to other forms of trafficking in persons, e.g. the requirement of medical professionals, the matching of an organ recipient, the duration of exploitation and the subsequent release of the victim. Knowledge of these practices is not well known and, resultantly, the response globally has been, at best, uneven.

Relevant Facts

Organ transplantation is a global practice, with kidney transplants carried out in more than 90 countries. ^[1]

Approximately 100,800 solid-organ transplants are performed every year worldwide: 69,400 kidney transplants and 20,200 liver transplants. ^[2]

Non-availability of adequate numbers of donors is a global issue. ^[3]

In most Member States, one or more influences prevent the sufficient supply of transplantation therapies and lead to pressure for non-altruistic living donation. ^[4]

46% of transplanted kidneys and 14.6% of transplanted livers come from living donors. ^[5]

10% of global transplants are estimated to involve trafficked organs. ^[6]

The majority of known persons who sell organs are motivated by desperation to escape an impoverished situation. ^[7]

The United Nations Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children criminalizes trafficking in persons for the purpose of the removal of organs.

The World Health Assembly urges Member States:
- "to take measures to protect the poorest and vulnerable groups from 'transplant tourism' and the sale of tissues and organs" ^[8] and
- "to oppose the seeking of financial gain or comparable advantage in transactions involving human body parts, organ trafficking and transplant tourism, including by encouraging healthcare professionals to notify relevant authorities when they become aware of such practices in accordance with national capacities and legislation". ^[9]

Definitions from the Declaration of Istanbul on Organ Trafficking and Transplant Tourism ^[10]
- Organ trafficking is the recruitment, transport, transfer, harbouring, or receipt of living or deceased persons or their organs by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability, or of the giving to, or the receiving by, a third party of payments or benefits to achieve the transfer of control over the potential donor, for the purpose of exploitation by the removal of organs for transplantation.
- Transplant commercialism is a policy or practice in which an organ is treated as a commodity, including by being bought or sold or used for material gain.
- Travel for transplantation is the movement of organs, donors, recipients, or transplant professionals across jurisdictional borders for transplantation purposes. Travel for transplantation becomes transplant tourism if it involves organ trafficking and/or transplant commercialism or if the resources (organs, professionals and transplant centres) devoted to providing transplants to patients from outside a country undermine the country's ability to provide transplant services for its own population.

[1] Bulletin of the World Health Organization 2007;85:955-962

[2] Based on activity data analysed from 2008 for 104 countries, representing nearly 90% of the worldwide population. http://www.who.int /transplantation/gkt/statistics/en/index.html.

[3] http://www.searo.who.int/en/Section10/Section17/Section1976.htm.

[4] WHO Consultation on the Ethics, Access and Safety in Tissue and Organ Transplantation: Issues of Global Concern (2003 :Madrid, Spain)

[5] Based on activity data analysed from 2008 for 104 countries, representing nearly 90% of the worldwide population. http://www.who.int /transplantation/gkt/statistics/en/index.html.

[6] WHO proposes global agenda on transplantation: http://www.who.int/mediacentre/news/releases/2007/ pr12/en/index.html.

[7] WHO bulletin, Volume 82, Number 9, September 2004, 639-718

[8] World Health Assembly resolution WHA 57.18

[9] World Health Assembly resolution WHA 63.22

[10] The Lancet, Volume 372, Issue 9632, Pages 5 - 6, 5 July 2008