Date : 18/12/2023

Relevance: GS Paper 3 – Science and Technology

Keywords: Altruism, Illegal organ trade,

Context-

Organ transplantation in India presents a dichotomy of uplifting altruism and disheartening scandals. Ordinary Indians display acts of spontaneous solidarity, donating organs to strangers in moments of grief. Scientific breakthroughs continue to push the boundaries of transplantation, exemplifying the synergy of solidarity, science, and healthcare teamwork. However, a darker side emerges with scandals involving the buying of organs, exposing vulnerable individuals to exploitation. The illegal organ trade persists, fueled by the global demand and the normalization of body commodification. The collision of morality, ethics, and market medicine raises profound challenges.

Organ Transplant Scenario in India

• In India, the landscape of organ transplantation has witnessed a substantial surge, with the number of procedures escalating from 4,990 in 2013 to 15,561 in 2022—a growth of more than threefold. Kidney transplants are the most prevalent, followed by liver, heart, lung, pancreas, and small bowel transplants.
• In the year 2022 alone, a remarkable 12,791 living donor transplants and 2,765 deceased donor transplants were carried out. Notably, only 1,743 organs, constituting 14% of the total, were sourced from deceased donors. The predominant source of organs, particularly for kidney and liver donations, was living donors.
• The distribution of deceased organ donations in 2021 was concentrated in 15 states, with the top five states contributing to over 85% of the total.

Need for increased Organ donations in India

• India ranks third globally in the number of organ transplants performed, yet there remains a significant disparity between the demand for organs and their availability. The surge in lifestyle-related ailments has intensified the need for organs, particularly hearts and lungs, which are predominantly sourced from deceased donors.
• With approximately 1.5 lakh individuals succumbing to road traffic accidents annually in India, a considerable portion of them could serve as potential organ donors. Expanding the pool of deceased donors holds immense potential for meeting the escalating demand.
• Beyond addressing the urgent need for organs, transplantation plays a pivotal role in alleviating the strain on the healthcare system. By mitigating the necessity for prolonged hospital stays, repetitive surgeries, and extended treatments, organ transplantation contributes to overall healthcare efficiency.
• Regrettably, India's organ donation rate stands at a mere 0.52 per million population, a stark contrast to the significantly higher rate observed in Spain at 49.6 per million. Bridging this gap is crucial for ensuring a more robust organ donation infrastructure.
• A compelling aspect of organ donation lies in its ability to save multiple lives with a single donor. The capacity to contribute various organs and tissues amplifies the positive impact that each donor can have on the lives of those in need. Thus, fostering a culture of organ donation emerges as a critical imperative to meet the surging demand and enhance the overall well-being of the population.

The Private Sector's Role and the Rise of Medical Tourism:

• India's transplantation landscape has expanded exponentially, primarily driven by the private sector's focus on tertiary care.
• Corporate hospitals, equipped with advanced technology and well-trained personnel, have made transplantation, especially beyond the kidney, accessible to a previously underserved section of the population.
• Simultaneously, the corporate health sector capitalizes on medical tourism, attracting patients from South Asia, Central Asia, and Africa.
• While this brings revenue, it also introduces unique challenges in post-transplant care, cross-border relationships, and distinguishing between paid and voluntary donations.

Challenges in Medical Tourism for Transplantation:

• Medical tourism seems advantageous, with India's healthcare expertise benefiting patients globally.
• However, the challenges are evident, especially in the transplantation realm. V
• ery sick patients travel to a foreign country, facing language and cultural barriers. Post-transplant care becomes intricate, and establishing genuine relationships between donors and recipients becomes crucial.
• The certification process to rule out coercion or payment by embassies is questioned, and conflicts of interest within Indian Authorization Committees raise concerns.

Ethical Quandaries and Healthcare Trust:

• As hospitals deploy marketing teams to attract foreign transplant patients, informal referrals based on monetary commissions become the norm.
• Detecting paid donations is deemed challenging, raising questions about the awareness and ethical stance of transplant doctors.
• Trust in the healthcare system is essential for the success of deceased donation after death initiatives.
• Instances of foreigners receiving transplants under questionable pretexts have undermined this trust, impacting organ donation rates.

Conclusion

While scientific progress advocates for deceased donation after death, the challenges posed by medical tourism, ethical concerns, and the monetization of healthcare create a complex scenario. Citizens are urged to altruistically donate organs, yet they may question this appeal when faced with potential scandals. As a society, India is collectively tested by the difficult questions posed by every news story on organ transplantation, emphasizing the need for a balanced and comprehensive approach to address these complex issues.

Source- Indian Express