Last year there were more than 10,000 people in the UK awaiting a life-saving transplant, with less than two thirds receiving it. With this statistic, it’s not totally unreasonable to see why those in desperate need may seek that organ from a willing participant in exchange for money. Welcome to the world of transplant tourism, where the rich buy organs from the poor.

In India, there is a place the locals dub ‘kidney village’ due to the high quantity of its inhabitants who sell a kidney for up to $800 dollars - the equivalent to a year’s salary. In the village of Sultan Pur More in northern Punjab the situation is similar. And again in the Philippines…

National Geographic’s Lisa Ling, who visited ‘kidney village’, explained, “When you encounter folks who are so poverty-stricken, it's a gruesome option for them, but it is an option."

'In India, there is a place the locals dub ‘kidney village’ due to the high quantity of its inhabitants who sell a kidney for up to $800 dollars - the equivalent to a year’s salary'

Whilst there are no concrete statistics available on the number of organs that pass through the black-market, the World Health Organisation has suggested that they account for up to ten percent of all transplants. When we consider that leaps in medical science are keeping people healthier for longer, and as a consequence less organs are becoming available, the flourishing black-market trade becomes easier to understand, however gruesome it may be.

Some may ask what is wrong with this process. If it is reasonable to offer people financial compensation for taking part in a clinical drugs trial or to provide IVF to women in return for donating their eggs, than why can’t we sell a kidney? Where do we draw the line, and how do we set it in stone?

“Human organs are not spare parts”, said Dr Howard Zucker, WHO Assistant Director-General of Health Technology and Pharmaceuticals. “No one can put a price on an organ which is going to save someone’s life.”

It is common knowledge that the human body can function fine with just the one kidney, so selling one may not seem particularly dramatic. But there’s always the risk that the donor will develop problems with the lone one left, or that the circumstances the operation is conducted under are not up to standard. There’s also the issue of after-care – a huge necessity that is often overlooked and ignored by those involved in the black-market sale of an organ, according to WHO.

'It has not gone unnoticed that the majority of live, non-related donors are from developing countries, perhaps as their poverty has made them the most vulnerable to steal or buy organs from'

“Live donations are not without risk, whether the organ is paid for or not. The donor must receive proper medical follow-up, but this is often lacking when he or she is seen as a means to making a profit”, explains Dr Luc Noel of WHO. 

A practice on the increase since the 1990’s, advances in medical science have given us better surgical techniques, improved tissue-typing and greater immune-suppressing drugs which have led to a growing market and organised trafficking rackets. In 2003, an international ring was captured by police; with it came reports that recipients may have paid $100,000 for a body part (generally, with only a fraction of that received by the donor). In some places even darker stories of organ harvesting have emerged, where parts are taken from people –dead or alive – without consent.

 It has not gone unnoticed that the majority of live, non-related donors are from developing countries, perhaps as their poverty has made them the most vulnerable to steal or buy organs from. Reports show that many are coerced into providing an organ, they are often not paid the amount promised and left with no legal rights to claim assistance afterwards. In 2002, the Journal of the American Medical Association found that in over 300 Indians who had sold their kidneys, 96% had done so to pay off debts. This drastic choice didn’t help the people in question, all as three quarters remained in debt, and nearly nine out of ten said their health had worsened.

This illicit trade has been labelled a “growing phenomenon” by the WHO, who called on MDs not to teach surgical techniques in regions known for their black-market trade in organs in a bid to stem the knowledge and skills equipping those involved. However, some argue that a regulated market in human organs is the way forward – claiming that its illegality pushes the market further underground.
 
Many governments from developing areas have been working to stamp out this practice by prohibiting the sale of body parts, with the wealthier countries also playing their part by working on legislation against transplant tourism, such the Canadian bill requiring all organs received to be traced back to the donor along with assurances that no money has changed hands. Speaking as he introduced the measure, MP Mr Wrzesnewskyj said, “Stealing someone else’s life to save your own, just because you have the money - that is fundamentally immoral.”
 
Whilst it’s great that countries are joining together to stop this black-market, perhaps what is needed is a reform of the organ donor register to reduce demand, along with greater poverty reduction assistance for the poorest of countries. Maybe this will prevent the most vulnerable of people from believing it is this is a reasonable way to earn some much-needed cash.