This is the second in a two-part series on the international organ black market and how bad actors use various methods to buy and sell body parts.
Organ black markets thrive in certain regions based on laws, bad actors and unethical approaches to organ transplants more broadly—and law enforcement collaboration at the international level is the only way to stop it, experts say. Newsweek.
A Newsweek previous investigations have uncovered global market trading organs through social media channels like Telegram and the Dark Web. Some traffickers operate openly in public areas, facilitated by the harvesting of organs carried out by coercion or exploitation.
The United Nations Office on Drugs and Crime (UNODC) estimates that there will be around 700 victims of trafficking for organs between 2008 and 2022. But the numbers are difficult to decipher based on personal and online sales combined with “transplant tourism,” according to the World Health Organization (WHO). estimated in 2018 that 10,000 kidneys – the most trafficked organ – are sold annually on the black market.
Transplant tourism refers to individuals who travel abroad to more easily obtain easily accessible organs for transplantation, from poorer or desperate people who would sell body parts such as kidneys, liver lobes or corneas in countries with less laws and regulations; or from richer, more developed countries with long waiting lists.
The role of government
Francis Delmonico has been at the forefront of organ transplantation for more than 50 years, becoming an international figure in the fight against the illegal black market that exists in certain parts of the world.
He carries many titles: former surgeon at Harvard Medical School at Massachusetts General Hospital; former president of the non-governmental organization The Transplantation Society, which is present in more than 100 countries; organ donation and transplantation advisor to WHO since 2006; and medical director of the New England Organ Bank since 1995.
He has traveled to more than 70 countries, including China, Iran, Nepal, Sudan and Canada, to prevent human trafficking while touting proven transplant procedures.
In 2005, Delmonico and colleagues found that human trafficking accounts for approximately 10 percent of all annual kidney, liver and heart transplants. Black market transactions are still common today in the Indian subcontinent, Africa and the Middle East, Delmonico noted, aided by doctors from other countries who may travel to Egypt or elsewhere if a deal is negotiated.
He and other international transplant experts called the shortage of organs “the main cause of organ trafficking and transplant tourism—practices that pose severe risks to the health of individuals and communities and to the idea of national self-sufficiency.”
“Organs should be donated voluntarily,” Delmonico said Newsweek. “A living donor should not be financially compensated as a motivation for organ donation. And also, deceased donation should be a voluntary situation because otherwise it is not a market.”
His views were echoed by other health professionals during the 77th World Health Assembly held earlier this year in Geneva, Switzerland, where delegates approved a broad resolution to increase the availability and ethical access of human cells, tissues and organs.
Delmonico has visited cities like the Philippine capital of Manila, where he said family donations are rare and organs are routinely purchased.
He and other medical experts have succeeded with Pope Francis and the Vatican “to overcome (the crime against humanity) that is organ trafficking.” He warned that by 2023 India “is poised to become a major force in global organ transplantation as the burden of kidney failure is increasing in this region.”
National embassies are also involved, Delmonico added, as are those in Nepal and surrounding countries that will send organ donors to India where organ “payoffs” lead to “big business” for sellers and doctors. Other aspects that come into play apart from valid tenders include visas that are granted as part of pre-defined agreements.
A September 2022 research paper published by a Nepali medical practitioner notes that “strict laws” have been put in place to regulate national human organ transplants, warning of “a human trafficking racket that lures rural people from this low-income country into the illegal organ trade” who benefited from the general public’s lack of awareness.
The South Asian country is home to what has been described as the “Kidney Valley,” an area where citizens will sell their organs out of financial desperation.
The US Embassy in Nepal did not respond to a request for comment.
“When you finally get to see the people who have been victims, I think you’ll have the only human sense to say, blaming someone else for a kidney is not something I want to participate in or lead,” Delmonico said. “And that’s just a common human being. You don’t want to see someone being exploited for a kidney that could be dangerous, where you could die.”
“Transplantation is a noble act,” Delmonico added. “I have been in this for 50 years has been demanding but a rewarding career saving lives, improving people by giving them new organs. The nobility is something that has energy for me in all the places I have been.”
In China, doctors and officials make huge profits by selling organs from executed prisoners—with some hospitals even advertising heart transplants for prices in the six figures. In 2005, Delmonico entered China when he received a call from Jiefu Huang, China’s former vice minister of health.
In 2007, Chinese officials passed law-based regulations on organ transplants that led to “difficult reforms,” Huang said, resulting in “remarkable achievements.” Delmonico said the Chinese have made positive steps to drastically reduce illegal sales.
Newsweek Chinese officials were reached for comment.
Human trafficking and open advertising
Christina Bain, director of Babson College’s Initiative on Human Trafficking and Modern Slavery, began linking organ transplants to human trafficking about a decade ago.
“It’s all one for me because you can’t have organs without humans, organs. Organs can travel. But you still have to have humans, and humans are still in the moment of exploitation, which is the definition of human trafficking,” said Bain Newsweek.
Illegal or unethical transplants are aided by an inconsistently regulated online world, said Michael Falls, manager of data collection and technology at the Anti-Human Trafficking Intelligence Initiative.
He provides Newsweek with many examples of organ sales being advertised on the Dark and Clear Webs, the latter being accessible to the general public.
Sites on the Clear Web openly advertise the sale of organs for tens of thousands of dollars, seemingly without consequence from online platforms, with made-up names such as organ-city.com and realhumanbodypartsforsale.com.
Newsweek reached out to both websites for comment.
Another website called activescienceparts.com, based in Mary Esther, Florida, currently lists human lungs, livers, kidneys and livers for sale for $40,000, $85,000, $70,000 and $50,000 respectively.
On its website, Active Science Parts International, Inc. says it is “committed to providing legal and ethical natural specimens and replicas” to the professional, medical and educational communities.
Kidneys are now available for sale “from the world’s most trusted medical experts,” according to the website’s description.
The company did not respond Newsweek‘S repeated attempts to comment.
“You can almost trace it back to the beginning of Bitcoin,” Falls said. “It’s like AI now; they started using AI for bad purposes. It’s kind of the same way with any new technology: (illicit actors) jump right in because they know there’s bound to be less regulation.”
Cut out the middleman
More international partnerships took place in 2008 with the Declaration of Istanbul (DOI), created to further influence government compliance. The main sponsors are The Transplantation Society and the International Society of Nephrology.
Thomas Müller, a nephrologist-or kidney specialist-in Zurich, Switzerland, is the chairman of the Declaration Mission of the Istanbul Custodian Group (DICG), which supports traditional methods and ethics of transplantation while fighting against organ trafficking, transplant tourism and transplant commercialism. . Nearly 80 countries participated.
“Just working with one country will not work,” Müller said Newsweek. “You have to work together, (to) see where the donors are coming from, where the recipients are coming from. You have this hotspot that was there in the past, but now it’s been magnified.
“So, it’s not one country or two countries, (it’s) neighboring countries. Now, you can have a place where there are quite a lot of cases that are donors from different regions, recipients from different regions, organizations. Located in other regions, then experts surgeons and nephrologists came again from other regions, and they did it in other countries.
He said the focus is on Eldoret, Kenya, where the DOI is looking at donors from former Soviet Union republics like Tajikistan or Azerbaijan or from wealthier Western countries. Meanwhile, a surgeon and a nephrologist went to Eldoret from India and operated in a private hospital.
“(Kenyan officials) don’t know about it,” Müller said. “But there is really building trust. We are invited to speak more directly about this. And they are really shy, Kenyan friends, and they ask for help so that we write a letter to the ministry of health … and then slowly they act in the hospital this is in Eldoret.
“But the process is very long, and it doesn’t stop at all. We heard that it is starting again. It is profitable for the hospital. Not only the doctors but it is really profitable for the hospital.
India’s Ministry of External Affairs called Newsweek to the country’s Organ and Tissue Transplantation Rules that came into effect in 2014, which include rules and laws that individuals and entities must comply with. The National Organ & Tissue Transplantation Organization of India also posted an update on its activities “for proper regulation of organ transplantation in India, including prevention of related illegal activities.”
He didn’t answer NewsweekThe question is whether national laws have been broken on the black market.
Research published in 2023 in Kidney International Reports by US transplant surgeon Ronald Parsons and Indian doctor Priyadarshini John warns that the global increase in chronic diseases makes people look for more options.
“Not surprisingly, patients continue to explore any means necessary, often outside the country or continent, to gain access to a kidney transplant resulting in the growth of ‘transplant tourism,'” the report read.
Müller and his colleagues returned to Kenya in October after identifying doctors who performed unethical transplants.
“I’m very optimistic that we can interfere there effectively, but I’m quite realistic knowing that they then go to another hospital,” Müller said, adding that intermediaries in these scenarios are often the most difficult to trace.