A Pakistani law ostensibly aimed at curbing trafficking in human kidneys is unlikely to end a business that has turned the country into the world's "kidney bazaar", a health expert said. Hundreds of rich foreigners come to Pakistan every year and buy kidneys from live, impoverished donors.
Powerful interests intent on maintaining the "transplant tourism" business might be able to exploit a loophole in the legislation that allows for organ donations without paying money. "What they're doing with this so-called law is allowing commercial transplant," said Jaffar Naqvi, chief executive of Pakistan's Kidney Foundation.
"Frankly speaking, I'm very disappointed," Naqvi, one of Pakistan's most prominent kidney experts, told Reuters. Kidney failure is increasingly common in rich countries, often because of obesity or hypertension, but a growing shortage of transplant organs has fuelled a black market that exploits needy donors and risks undermining voluntary donation schemes.
Trade in human organs is illegal in Western countries but not in Pakistan. Pakistan also has no law allowing organ donations from the deceased - a major source of replacement organs. The cabinet approved a draft law on transplants in February. The legislation is in committee and will then need parliamentary approval.
Minister of State for Health Shahnaz Shaikh said the proposed legislation was aimed at ending the kidney trade. "We think that the sale of kidneys is not right and not good for the public," she said on Thursday.
The legislation had a clause saying that a kidney donor should be a relative of the patient, she said. But it had another clause, saying a kidney could be donated by someone, who was not a relative, but not for money, she added.
STRONG LOBBY Naqvi said that second clause, allowing "altruistic" kidney donations, was a loophole that would ensure the trade continues. "You are allowing it if you say for emotional reasons I can give my kidney to you. How do you know that you have not paid me? We are not a very transparent society."
"I feel very strongly this should be condemned. It's being condemned all over the world except here," he said. Naqvi said he had unconfirmed figures showing 13 centres in the city of Lahore alone had reported more than 2,000 transplants last year from bought kidneys.
Patients from Europe, Saudi Arabia and India paid 500,000 rupees for a new kidney, he said. Donors were paid 20,000 to 60,000 rupees ($300 to $1,000) and often got no medical care after giving up a kidney.
Pressure to protect the business would scupper efforts to introduce an effective law, he said. "They are all in cahoots and they do not allow a rational, ethical law to be passed," he said.
Naqvi said he had been trying to get a law permitting organ donations from dead people introduced since the 1980s, after getting the approval of Islamic scholars for such donations. "The lobby for commercial transplant is very, very strong and they did not allow the bill to be passed," he said.
But Shaikh said there was no law allowing transplants from dead people for technical reasons. "We don't have the infrastructure to save the organ in the right time," she said. Shaikh said she wanted to see donors limited to relatives but the shape of the final law still had to be determined.
"A very powerful lobby is working against this bill ... They have influence on different people in the government and in the opposition, they have a lobby. Let's see how it goes," she said.
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