There is understandable moral indignation at the kidney racket. The Centre has promised a CBI inquiry. The Indian Medical Association (IMA) seems to want one too. The health minister has promised an amendment to the Transplantation of Human Organs Act (THOA) of 1994 in the budget session. According to media reports, the amendment will increase punishments for those indulging in illegal trade and make THOA simpler. To quote the minister, “A major mass-media campaign will soon be organised in the country to bring about a behavioural change so that people are willing to donate organs.” Organ transplants aren’t about kidneys alone, there can be transplants of livers, hearts, lungs, pancreases, small bowels and even skin. Transplants save lives, and advances in medical technology and drugs like cyclosporine in the 1970s have made the acceptance of foreign objects easier. IMA estimates India has 200,000 patients (80,000 renal) who need organs, not just kidneys. Add to that foreign demand, since organ transplants have become difficult in developed countries.

But donation is problematic. Partly because of Western and WHO pressure, spliced with reports in the late 1980s and early 1990s that

India and China had become the kidney transplant centres of the world, we had the Transplantation of Human Organs Act. Perhaps one should quote Anatole France — “the Law, in its majestic equality, forbids the rich, as well as the poor, to sleep under the bridges, to beg in the streets, and to steal bread.” THOA banned all commercial transactions involving organs. It only allowed organs to be removed from brain-stem dead people, that is, cadavers. Incidentally, these brain-stem dead people are still “alive” on life support systems. That makes it even more difficult to find donors. THOA only allowed donations by relatives, that is, spouse, son, daughter, father, mother, brother or sister. And since organs couldn’t be donated to anyone outside the immediate family, foreign recipients were effectively prohibited. Note that spouse isn’t a blood relationship, and marriages catering to transplant needs can’t be precluded. On medical grounds, near relatives may also not be accepted as donors. The authorisation committee can clear other cases, but that’s not easy.

... contd.