Table of Contents - CASMUNC IXcasmunc.weebly.com/uploads/5/8/9/3/58930805/vmun-2017_who_1_… · 2005 - First “domino” transplant surgery is performed at John Hopkins Hospital

World Health Organization VMUN 2017 Background Guide 3

Table of Contents

The Organ Trade .......................................................................................................................... 4 Overview ................................................................................................................................................. 4 Timeline .................................................................................................................................................. 5 Historical Analysis ................................................................................................................................. 6 Current Situation ................................................................................................................................... 7 Past UN/International Involvement ...................................................................................................... 9 Possible Solutions and Controversies .................................................................................................... 9 Bloc Positions ....................................................................................................................................... 11

United States ...................................................................................................................................................... 11 Australia/Singapore .......................................................................................................................................... 11 China .................................................................................................................................................................. 11 India .................................................................................................................................................................... 11 Iran ...................................................................................................................................................................... 12 European Union ................................................................................................................................................ 12

Discussion Questions ........................................................................................................................... 12 Further Research .................................................................................................................................. 12 References ............................................................................................................................................. 13

Drug Affordability and Patents ................................................................................................. 15 Overview ............................................................................................................................................... 15 Timeline ................................................................................................................................................ 15 Historical Analysis ............................................................................................................................... 16 Current Situation ................................................................................................................................. 17 Past UN Involvement ............................................................................................................................ 18 Possible Solutions ................................................................................................................................. 19 Bloc Positions ....................................................................................................................................... 20

United States ...................................................................................................................................................... 20 India .................................................................................................................................................................... 21 China .................................................................................................................................................................. 21 EU ....................................................................................................................................................................... 22 Sub-Saharan Africa ........................................................................................................................................... 22

Discussion Questions ........................................................................................................................... 22 Further Research .................................................................................................................................. 22 References ............................................................................................................................................. 23


World Health Organization Topic A

The Organ Trade Overview Over the past 60 years, organ transplantation has been used as a medical intervention for organ-failure and is considered one of the greatest medical discoveries of the 20th century. Unfortunately, today many patients die before receiving a transplant due to a lack of organ availability. The discrepancy between the supply and demand of organs is rife across the globe. Most donations come from living or deceased people who have elected to be organ donors; however, despite the rise in number of organ failure most people are reluctant to become organ donors themselves, resulting in a shortage of organs. Consequently, certain patients, especially from developed countries, will travel to foreign countries to illegally buy organs in hopes to save their lives. This is also known as transplant tourism. The World Health Organization estimates that 5-10% of kidney transplants, the most common transplant procedure, are from organ trafficking. Furthermore, according to Global Financial Integrity, the illegal organ trade generates $600 million to $1.2 billion in profits annually, with desperate patients paying up to $200,000 USD for a kidney. Organ trafficking is considered an organized crime. Major players include recruiters, transporters, hospital/clinic staff, medical professionals, contractors, brokers and other middlemen.1

1 “Trafficking for Organ Trade,” UN.GIFT, October 13, 2010, accessed July 2016, http://www.ungift.org/knowledgehub/en/about/trafficking-for-organ-trade.html.


Organs are usually harvested illegally and trafficked in one of three way: victims are coerced into giving up an organ, victims agree to sell their organ but are defrauded, or victims of vulnerable or impoverished populations are treated for a supposed illness (which may or may not be a legitimate concern) and have organs are removed without the patient’s permission. Trafficking in the organ trade is prohibited under the UN Protocol to Prevent, Suppress and Punish Trafficking in Persons, and almost every country in the world has outlawed the sale and trade of human organs. The organ trade thrives on the notion of the rich wanting immortality and the poor needing money. Whereas countries that import organs are generally economically and socially advanced, those countries that tend to export organs are often impoverished and underdeveloped. WHO has disapproved of the unregulated commercialization of the organ trade that exploits the poor and increases health inequalities, all while posing great risks to patients at either end of the deal. Timeline 16th century - Italian surgeon Gaspare Tagliacozzi developes the “Italian method” for reconstructive rhinoplasty (nose surgeries) by taking a flap of skin from the arm and attaching it to the face until the skin healed over the nose and could be cut off the arm.2 This is an improvement to the “Indian method” as there was a lesser chance for rejection and the skin resembles a nose-like shape. Early 20th century - Several attempts are made for animal-to-human kidney transplantations (xenotransplantation), including pig, monkey, and goat donations. All patients die shortly after their surgeries.3 1906 - First successful cornea transplant is performed.4 1936 - First attempts made for human-to-human kidney transplant by Ukrainian doctor, Yu Yu Voronoy, all of which fail. 1954 - First successful human-to-human organ transplant completed by surgeon Joseph Murray at the Brigham Hospital in Boston, Massachusetts. Richard Herrick receives a kidney from his identical twin brother. 1960s - First successful transplants are completed for lung, pancreas, liver, heart, and bone marrow. 1976 - Cyclosporine is discovered to suppress immune system and decrease chances of organ rejection. 1984 - United Network for Organ Sharing is established by U.S. Congress to monitor all organ transplants in the US. 1993 - Continuous organ shortages impell doctors to resort to xenotransplantation, the usage of animal organs in humans. Limited success occurs with baboon-to-human and pig-to-human transplants. 1999 - During the Kosovo War, Kosovo Albanians associated with the Kosovo Liberation Army allegedly kidnap, kill, and harvest the organs of up to 300 victims, all of Serbian descent. The UN prompted investigations the claims against the Albanians, but the charges were later dropped due the lack of substantial evidence.5 2 “Gaspare Tagliacozzi (1545-99),” Science Museum, accessed July 2016, http://www.sciencemuseum.org.uk/broughttolife/people/gasparetagliacozzi. 3 “Organ Transplants: A Brief History,” history.com, February 21, 2012, accessed July 2016, http://www.history.com/news/organ-transplants-a-brief-history. 4 “History,” UNOS, 2015, accessed July 2016, https://www.unos.org/transplantation/history/. 5 “Were Mental Patients Organ Trafficking Victims?,” NBC News, November 13, 2008, accessed July 2016, http://www.nbcnews.com/id/27700612/ns/health-health_care/t/were-mental-patients-organ-trafficking- victims/#.V4FPi_krKM8.


2006 - Former Canadian Secretary of State David Kilgour and human rights lawyer David Matas reports on the alleged “on demand” executions of imprisoned Falun Gong practitioners and other prisoners of conscience in China with the intent to harvest organs for the transplant industry. Accusations still occur today. 2005 - First “domino” transplant surgery is performed at John Hopkins Hospital. Kidneys are interchanged amongst 6 donor-recipient pairs in a simultaneous 12 patient procedure. 2008 - A multi-billion-dollar rupee kidney transplant racket is exposed in Gurgaon, India, run by Amit Kumar, who went under the alias Dr. Santosh Raut. For a decade, an estimated 600 kidneys were harvested, mainly from beggars, and transplanted to foreigners from Greece, Canada, United Kingdom and the US. Kumar is arrested and charged.6 2009 - A Swedish newspaper reports that the Israeli army killed Palestinian captives with the purpose of harvesting their organs.7 2014 - Spain, a leading country in legal organ transplants, reports its first recorded organ trafficking case.8 Historical Analysis Since the early 20th century, scientists have been making medical breakthroughs and improvements on organ replacement methods. This has prolonged the lives of many, but contentious debate on the ethics of organ transplantation has ensued. The illegal nature of the organ trade makes it difficult to survey organ purchasing activities. Governments have struggled to create legal frameworks that ensure the wellbeing of both the recipient and the donor. WHO has clearly established their position towards ethical organ transplants, but no firm action towards signing a binding international treaty has taken place. While the origins of the organ trade is not clear, it is plausible that trade of human organs arose during the rapid in the 1980s when organ transplants became more accessible. The lack of information on organs inhibits. The several cases of exposed organ rackets are a small glimpse of the highly profitable illegal organ trade. China A Chinese law passed in 1984 allowed for organs of executed prisoners to be harvested. Involuntary organ procurement has been and continues to be illegal, but many reports have covered up nonconsensual organ harvests from living prisoners with the intent to sell. The original reports by Canadians David Kilgour and David Matas surfaced in 2006 and accused China of harvesting and selling the organs of political prisoners, namely Falun Gong practitioners, to sustain its billion-dollar organ trade.9 Falun Gong practitioners were imprisoned by the Chinese Communist Party since 1999; strangely, an influx of international organ buyers also occurred during the same time. In 2005, China stated that 95% of organ donations came from death row inmates, but firmly refuted organ harvesting from live or political prisoners, like Falun Gong practitioners. Doctors Against Forced Organ Harvesting (DOFAH) has estimated that 100,000 - 200,000 organs of Falun Gong practitioners have been harvested in China since 2000. 6 “India’s Black Market Organ Scandal,” TIME Magazine, January 2, 2008, accessed July 2016, http://content.time.com/time/world/article/0,8599,1709006,00.html. 7 Boudreaux, Richard. “Article about Organ Harvesting Sparks Israel-Sweden Tiff.” August 24, 2009. Accessed July 2016. http://articles.latimes.com/2009/aug/24/world/fg-israel-sweden24. 8 Al Goodman, “Lebanese Mayor Arrested in Spain, Accused of Attempted Organ Trafficking,” CNN (CNN), March 12, 2014, http://www.cnn.com/2014/03/12/world/europe/spain-lebanon-mayor-organ-allegations/. 9 “Ending Abuse of Organ Transplantation in China,” August 17, 2010, accessed July 2016, http://www.david-kilgour.com/2010/Aug_19_2010_01.php.


The Philippines In 1949, the Philippines passed an act to “legalize permissions to use human organs” which was updated through the Organ Donation Act of 1991 to allow family members to speak in place of a deceased for domestic organ donations. International donations were to be approved by the Department of Health, but in 2008, the Philippines banned all international kidney donations to prevent foreigners from receiving transplants. In the early 2000s, the Philippines become infamous for its transplant services for wealthy foreign patients. United States The sale of human organs has been outlawed in the United States since 1984 under the National Organ Transplant Act. Under the same act, a national network, the Organ Procurement and Transplantation Network (OPTN), was established for the distribution of organs and data collection on organ donors and recipients. The United Network for Organ Sharing (UNOS) was assigned the national contract in 1986 and continues to serve as the nation’s sole administer for OPTN. Current Situation Since the first successful surgery 60 years ago, organ transplants have saved thousands of lives each year. Over 100,800 organ transplants occur annually, but 10% of these operations are performed illegally through the black market. The organ trade refers to the buying and selling of human tissues and organs, excluding blood, semen, sperm, eggs and hair, all of which can be bought legally. In 2007, WHO estimated that the organ trade occurs in over a dozen countries covering all continents. Organ transplants are effective medical interventions for end-stage organ failure, especially for kidneys. Although there are several other methods, transplants are the preferred treatment for organ failure as a long term solution. Deceased donations can last up to 12 years and living donations up to 25 years. Unfortunately, over the past few decades, organ shortage has increased rapidly with the rise of kidney diseases and a continued lack of organ donation.10 The average waiting time to receive a kidney is 2 to 5 years; however, a considerable portion of these patients never receive transplants and thus die of organ failure.11 For this reason, many people become desperate and resort to transplant tourism, which is defined as “the movement of organs, donors, recipients or transplant professionals across jurisdictional borders for transplantation purposes” (Declaration of Istanbul, 2008). Consequently, law-abiding patients contribute to organ trafficking and other unethical practices of organ procurement while trying to save their own lives. WHO has stated that the black market of human organ “exploits the vulnerable” and “complicates legitimate organ donation efforts.” The organ trade is undoubtedly dependent on economic ambition which “leads to increased inequality” (WHO, 2007). Targeted victims for organ trafficking come from vulnerable populations - illiterate, unemployed, and impoverished. In hopes to get out of debt, many people sell their organs, and while they are rewarded with a few thousand dollars, this money - more often than - is used to pay off medical costs for complications from the organ procurement surgery, leaving donors at equal or lower poverty levels.

10 “Dilemma over Live-Donor Transplantation,” World Health Organization, January 2007, accessed July 2016, http://www.who.int/bulletin/volumes/85/1/07-020107/en/. 11 “The Waiting List,” Kidney Link, 2014, accessed July 2016, http://www.kidneylink.org/TheWaitingList. aspx.


The cost of organs in one country does not correspond to the cost in another. Livers costs can range from $98 000 to $130 000 and kidneys from $2000 to $200 000.12 13 Illegal transplants are also far cheaper than legal transplants. The average liver transplant in the United States costs over $500 000, but in India, the same procedure costs a tenth of the price. While this may seem like a bargain, these types of transplant often result in grave complications. Many patients return to their home countries and do not receive any postoperative care, including vital prescription medications for immunosuppressants that reduce the chances of organ rejection. Illegal transplants have significantly higher risks than legal operations like the transmissions of HIV and hepatitis B and C. Other risks for donors include haemorrhaging, chronic pain and even death. Donating organs is meant to be altruistic and viewed as an honour, but the organ trade muddles this perspective. Organ commercialism monetizes the human body and regards it as a commodity. Dr. Luc Noël succinctly says that the organ trade “put[s] a price on the integrity of the body and human dignity.” Donations should be considered as charitable. They should only be accepted if family members or donor themselves are well-informed on the process and consent, and if the health and safety of the donor was not compromised. However, even in a regulated state, experts claim that only the poor will give up their organs as they are more desperate need to make quick money. National governments have been called on to create policies to increase organ donations from the deceased as well as to start initiatives to prevent medical conditions and diseases that require organ transplants. Furthermore, the World Health Assembly governed by World Health Organization requires member-states to “to protect the most vulnerable from transplant tourism and the sale of tissues and organs,” but the nature of the organ trade makes it difficult to directly address. Organ transplants may save many lives, but it simultaneously ruins the lives of many others. 12 “Psst, Wanna Buy a Kidney?,” The Economist, November 16, 2006, accessed July 2016, http://www.eco nomist.com/node/8173039?story_id=8173039. 13 “Black Market Kidneys, $160, 000 a Pop,” CBS News, July 27, 2009, accessed July 2016, http://www.c bsnews.com/8301-504083_162-5190413-504083.html.


Past UN/International Involvement The WHO Guiding Principles on Human Cell, Tissue and Organ Transplantation was created in 1987 and later endorsed by the World Health Assembly (WHA) in 1991 to serve as a legal framework for organ and tissue donations worldwide. The eleven Guiding Principles were later updated in May 2010 and endorsed by the WHA through resolution WHA63.22 in light of changes to donation and transplantation practices. Currently endorsed by over 100 countries, the Declaration of Istanbul was established during the 2008 Istanbul Summit on Organ Trafficking and Transplant Tourism, led by the Transplantation Society and the International Society of Nephrology. The Declaration addresses the unethical practices of organ sales and emphasized strong condemnation on all transplant activity that solicits financial gain or comparable advantage for exploiting poor or vulnerable people and benefiting wealthy organ-seeking patients. Clear definitions for organ trafficking, transplant commercialism and travel for transplantation were provided in the Declaration to avoid ambiguity. The Declaration also clarifies the difference between travel for transplantation and transplant tourism. Travel for transplant, the movement of organs, donors, recipients or transplant professionals across jurisdictional borders for transplantation purposes, can be ethical if the transplant activity does not engage in organ trafficking or transplant commercialism and the resources (organs, professionals, transplant centres, etc.) used in the foreign country do not jeopardize the country’s own citizens to receive transplant services, otherwise it would be considered to be transplant tourism. This allows patients to undergo transplantation in a foreign country if receiving a donation from a genetically related family member or receive deceased-donor donations from foreign countries if officially coordinated through bilateral or multilateral organ sharing programs. The Declaration also encourages countries to enforce programs to prevent organ failures to reduce the need for transplantation as well as to increase deceased organ donation by minimizing misconceptions through education. Other proposals ensure the wellbeing of the donor after donation, allowing for legitimate financial reimbursements associated to donating an organ as it is considered to be a part of the recipient's care, but direct payment for the organ is not allowed. While the Declaration of Istanbul is not legally binding, it has had considerable influence on the international community by instigating Israel, China, and the Philippines to develop regulations that restrict transplant tourism. Asserting that “access to information is [the] key” to encourage public organ donation, WHO called for a Global Knowledge Base on Transplantation (GKT) to create a database. The GKT relies on WHO to work with national transplantation organizations, scientific and professional transplantation societies to develop information on transplant activity, pertinent laws and regulations, threats to the safety and ethics of transplantation, and xenotransplantation. Possible Solutions and Controversies Holding the doctors accountable Organ trafficking is dependent on corrupt health professionals as organ procurement cannot happen without their aid, and consequently, organ transplants cannot occur without organ procurement. Under the law, doctors are required to protect and ensure the wellbeing of their patient, and still, many turn a blind eye to suspicious conduct or even perform the medical procedures themselves. Illegal organ transplant surgeries are condemned across the board, but more often than not, prosecuted offenders go without punishment entirely.14 If doctors risk losing their medical license for unethical and immoral behaviour, including the failure to report suspicious activities, organ trafficking could decrease immediately. Potential problems can occur with organ rackets performing surgeries without the aid of trained professional, which would become another problem the WHO

14 “Organ Trafficking: More Than Just a Myth,” November 11, 2014, accessed July 2016, https://www.law.utah.edu/organ-trafficking-more-than-just-a-myth/.


would have to address, but health professionals are the backbone to the organ trade. Hindering health professionals will hinder the organ trade as well. Legalize organ trade and open international free market The organ trade produces millions of dollars in yearly profit, and rackets heavily profit off the lack of governance. By opening a free organ market, it would give to open floodgates to more revenue to stimulate economy and even possibly strengthen international fiscal relations. The public would be enticed to donate organs and the discrepancy between patients and donors will diminish, like in Iran. However, despite enforced regulation and strict surveillance from the Iranian government, corruption in the legal organ trade will still exist. A disproportionate number of donors are poor and desperate for money. WHO has said, “payment ... for organs is likely to take unfair advantage of the poorest and most vulnerable groups” This solution is heavily opposed by WHO and the World Medical Association as non-altruistic donations can be deemed unethical, but it can be possible through proper administration and organization. Currently, Iran is the only country with a legal organ market, but it cannot be considered as a model system. Scientists reported that Iran’s system has too many independent components which has proved to be difficult when collecting information on long-term outcomes for selling-donors.15 Even so, after sorting through these policy flaws, a legal organ trade can be the best solution to reduce organ trafficking while improving economic ties. The organ trade is an untapped industry that can be used to benefit all parties through proper legal guidelines and codes. Increasing deceased organ donations with an opt-out donation program Spain is considered to be the top country for organ donation as their citizens believe that organ donation is not a privilege but an obligation. The altruistic attitude of the nation could derive from their “opt-out” donation program - presumed consent that upon death, the body will used for donation purposes unless otherwise expressed. Countries like Austria, Belgium, Luxembourg, Norway, Poland, and Sweden all presume consent for organ donation and have 25 to 30% higher donor rates than “opt-in” countries where donors must give explicit consent for organ donation.16 Citizens in countries with presumed consent consequently wait less than countries without presumed. Furthermore, while live organ donations are used, it is preferred to use deceased organs donations as it erases complications for the benefactor. Patients participate in illegal organ trades as a last hope out of frustration, but such sentiments can be eliminated with increased deceased organ donations. This solution does not call for direct action against the illegal sales but rather focuses on improving on the current organ donation system to curb black market. Financial compensation An alternative to opening a free market is allowing financial compensation for organ donors. The current donor system heavily relies on altruistic donors giving their kidney. However, donors require to give up more than just an organ. Even in cases where zero medical complications occur, donors will spend up to $5000 and remain in bed rest and out of work for six weeks.17 Many people are willing to be living kidney donors to the hundreds of thousands of patients on the waiting list but cannot afford high medical costs and loss of income. The current system facilitates donations from the wealthy and puts a disadvantage on those at lower

15 Saeed Kamali Dehghan, “Kidneys for Sale: Poor Iranians Compete to Sell Their Organs,” The Guardian (The Guardian), May 28, 2012, https://www.theguardian.com/world/2012/may/27/iran-legal-trade-kidney. 16 Alberto Abadie and Sebastien Gay, “The Impact of Presumed Consent Legislation on Cadaveric Organ Donation: A Cross-Country Study,” Journal of Health Economics25, no. 4 (July 1, 2006), accessed July 2016, doi:10.1016/j.jhealeco.2006.01.003, http://www.sciencedirect.com/science/article/pii/S016762960 600004X. 17 Samantha Olson, “Organ Transplant's Problem In America: 30 Years Since The National Organ Transplant Act Was Passed”Medical Daily (Medical Daily), September 29, 2014, http://www.medicaldaily.com/organ-transplants-problem-america-30-years-national-organ-transplant-act-was-passed-305578.


socioeconomic levels, which becomes exceptionally problematic when people cannot afford to donate to family members. The Declaration of Istanbul does not view financial compensation to be a reward for the donor as donors do not make a profit. Covering all medical costs for the consenting donor would certainly encourage more live donations while continuing the altruistic values of organ donation. This solution benefits all parties-- the patients who currently wait years for organ donations, the willing family members who could not afford donating otherwise, and the vulnerable populations targeted by organ trafficking. Bloc Positions United States Similar to the worldwide trend, the discrepancy between available donors and needing patients is immense, with over 77 000 people on the active waiting list (UNOS, 2016 ). The United States has launched several campaigns and created financial incentives through tax breaks to increase organ donation, particularly for kidney, but still statistics show 22 people die daily waiting UNOS, 2016 ). This results in thousands of citizens travelling to foreign countries in search of a vital organ, also known as transplant tourism.18 Even though it may be illegal to sell organs, the US has not shown to punish citizens once they received the illegally bought organs through the Black Market. The US is considered to be a major organ-importing country, along with Australia, Canada, Great Britain, Japan, Oman, and Saudi Arabia.19 Australia/Singapore Australia and Singapore, along with the rest of the world except Iran, have laws in place against the trade or sale of organs; however, both countries have made changes in recent years to provide monetary compensation for live donors. The financial burden of associated medical costs and lost of earnings often impede willing people from donating, including those with sick family members. These initiatives were established in hopes decrease the financial burden and increase number of live donors, and in both countries, kidney disease advocacy groups welcomed the legal changes; nevertheless the public questioned the morality and ethics of these actions even though under WHO’s Guiding Principles, compensation for organ donations is acceptable. China Many Chinese citizens often die before receiving an organ transplant since, according to traditional Chinese belief, bodies are to be buried or cremated whole in order to be reincarnated as a whole. This discourages both live and deceased organ donation. While the reports on the Falun Gong prisoners were circulating, China did not acknowledge any accusations of illegal organ harvesting; however, in January 2015, China announced its cessation of organ harvesting from executed prisoners, but did not refer to living prisoners of conscience, like the Falun Gong practitioners. China established a new voluntary system for organ donation in 2014, but this system cannot account for the hundreds of thousands of organs procured before 2015. China sells most of their organs to the transplant tourists from the US, Japan and other Asian countries. Other major organ-exporting countries include Bolivia, Brazil, Iraq, Israel, the Republic of Moldova, Pakistan, Peru and Turkey. India Since 1994, commercial kidney sales have been illegal in India and are heavily enforced. An estimated 200,000 people need kidney transplantation every year, yet the Multi Organ Harvesting Aid Network (MOHAN), an advocacy group for legal organ donations, estimates that there are fewer than 1 donor per every million people.

18 Susan Scutti, “Organ Trafficking: An International Crime Infrequently Punished,” Policy/Biz (Medical Daily), July 9, 2013, http://www.medicaldaily.com/organ-trafficking-international-crime-infrequently-punished-247493. 19 WHO, December 2007, accessed July 2016, http://www.who.int/bulletin/volumes/85/12/06-039370/en/.


An overall lack of transplantation knowledge exists in India which fuels the lack of willingness to donate. Contradictingly, many Indians give up their kidney for an average $1000 - $2000 to pay debt, many of whom are illiterate are and live in great poverty. The government of India has been strict with its organ trade laws and punished the guilty brokers and doctors. Even still, the organ trade is prevalent throughout the country. Iran Currently, Iran is the only country in the world that has legalized the commercial trade of human organs. Even though laws only allow for the sale of kidneys, Iran has resolved the problem of organ shortage and eliminated its waiting list for a kidney transplant in 1999. There are several requirements to be eligible to be a donor, including age and consent from next of kin, but the reward is payment from both the recipient and government for an average total of $2000 to $4000. Transactions are organized by one of two government-regulated charity organizations: The Charity Association for the Support of Kidney Patients (CASKP) or the Charity Foundation for Special Diseases (CFSD). However, the problem transitioned from a shortage of organs to an abundance of organs. The competition to sell a kidney is immense, with many kidney being traded without report in attempt to expedite the process. Critics have disapproved of Iran’s laws on organ trade, but others believe Iran did well by implementing a “system of incentives” as they would have faced a large black market and organ trafficking problem like neighbouring Pakistan. If patients cannot afford a live donation, they can resort to deceased-organ donations which both the kidney and surgery are free of cost. European Union The European Union has been very clear to ensure the health and safety of both donors and recipients of organ transplantation. In 2007, the European Commission adopted the Communication on organ donation and transplantation to act against the current shortage of organs and system inefficacy. The Commission adopted a directive the following year on the standards of quality and safety of human organs intended for transplantation which also called for Member States to collaborate. When allegations against China and their abuses in organ harvesting emerged, the European Parliament strongly condemned their actions. Other multilateral bodies in Europe have taken similar stances on organ transplantation, including the Council of Europe who launched the first international legally binding anti-organ trafficking treaty, the Convention against Trafficking in Human Organs. Europe as a whole objects to unethical practices of organ transplantation; however citizens from non-EU European states have been found to take part in the organ trade, namely the Republic of Moldova and Great Britain. Discussion Questions

1. Could the commercialization of organs be be ethical? 2. Should organs be treated like a commodity? 3. How can the international community help prevent transplant tourism? 4. How can organ-exporting countries avert citizens illegally selling their organs for a quick buck? 5. Illegal organ transplantations are still occurring today. How could WHO ensure the safety of donors

even in this situation? 6. More often than not, organ traffickers are let loose due to varying national laws on commercial organ

transplants and transplant tourism. How could WHO work with other UN agencies to ensure perpetrators are held accountable?

Further Research The United Nations Global Initiative to Fight Human Trafficking (UN.GIFT) website: http://www.ungift.org/knowledgehub/en/about/trafficking-for-organ-trade.html


Documentary on the procuring and selling of the organs of Falun Gong prisoners Human Harvest, directed by Leon Lee Documentary on the organ trade in real life Tales From The Organ Trade, directed by David Cronenberg Table of transplant tourism websites with organ prices http://www.who.int/bulletin/volumes/85/12/06-039370-table-T1.html Article with more infomation on organ trafficking http://www.ajkd.org/article/S0272-6386(09)01177-9/pdf References Rudge, C., R. Matesanz, F. L. Delmonico, and J. Chapman. "International Practices of Organ Donation." British Journal of Anaesthesia. Oxford University Press, 2012. Web. July 2016. Shimazono, Yosuke. "The State of the International Organ Trade: A Provisional Picture Based on Integration of Available Information." World Health Organization, Dec. 2007. Web. July 2016. WHO GUIDING PRINCIPLES ON HUMAN CELL, TISSUE AND ORGAN TRANSPLANTATION (n.d.): n. pag. World Health Organization. Web. July 2016. "Transplant Tourism: Philippines Still Fighting Organ Trafficking | IMTJ." International Medical Travel Journal, 10 July 2010. Web. July 2016. Dehghan, Saeed Kamali. "Kidneys for Sale: Poor Iranians Compete to Sell Their Organs." The Guardian. Guardian News and Media, 27 May 2012. Web. July 2016. Major, Rupert WL. "Paying Kidney Donors: Time to Follow Iran?" McGill Journal of Medicine : MJM. McGill University, Jan. 2008. Web. July 2016. Dehghan, Saeed Kamali. "Kidneys for Sale: Poor Iranians Compete to Sell Their Organs." The Guardian. Guardian News and Media, 27 May 2012. Web. July 2016. Staff, Science X. "European Nations Sign World's First Organ Trafficking Treaty." N.p., 24 Mar. 2015. Web. July 2016. "Organs." European Commission, n.d. Web. July 2016. <http://ec.europa.eu/health/blood_tissues_or gans/organs/index_en.htm>. Bundhun, Rebecca. "India’s Dire Need for Organs Still Fuels a Deadly Trade" The National, 5 June 2016. Web. July 2016. Bland, Ben. "Singapore Legalises Compensation Payments to Kidney Donors." British Medical Journal, 7 Nov. 2008. Web. July 2016. Fan, Jiayang. "CAN CHINA STOP ORGAN TRAFFICKING?" The New Yorker, 10 Jan. 2014. Web. July 2016. "New Perspectives on China's Transplant Numbers: Unethical Organ Procurement from Prisoners of Conscience - DAFOH." Doctors Against Forced Organ Harvesting, 28 Mar. 2016. Web. July 2016. "CHINA: Government Cracking down on Organ Trade" International Medical Travel Journal, 26 Feb. 2009. Web. July 2016. Nullis-Kapp, Clare. "Organ Trafficking and Transplantation Pose New Challenges." World Health Organization, 1 Sept. 2004. Web. July 2016. Garwood, Paul. "Dilemma over Live-donor Transplantation." World Health Organization, Jan. 2007. Web. July 2016. Wilkinson, Stephen. "The Sale of Human Organs." Stanford University. Stanford University, 17 Oct. 2011. Web. July 2016. Scutti, Susan. "Illegal Organ Transplants Are On The Rise Around The World." Medical Daily, 26 Sept. 2014. Web. July 2016. Campbell, Denis, and Nicola Davison. "Illegal Kidney Trade Booms as New Organ Is 'sold Every Hour'" The


Guardian. Guardian News and Media, 27 May 2012. Web. July 2016. Resnick, Brian. "Living Cadavers: How the Poor Are Tricked Into Selling Their Organs." The Atlantic, 23 Mar. 2012. Web. July 2016. Wisse Schacter, Abby. "The Case for Legal Organ Sales." Reason, 11 Nov. 2011. Web. July 2016. Pokharel, Sugam. "Nepal's Organ Trail: How Traffickers Steal Kidneys." CNN. Cable News Network, 15 July 2015. Web. July 2016. Bindel, Julie. "Organ Trafficking: A Deadly Trade." The Telegraph. Telegraph Media Group, 1 July 2013. Web. July 2016. Small-Jordon, Dianne. "Organ Harvesting, Human Trafficking, and the Black Market." Decoded Science, 23 Mar. 2016. Web. July 2016. Scheper-Hughes, Nancy. "Human Traffic: Exposing the Brutal Organ Trade." New Internationalist, May 2014. Web. July 2016. Kelleher, Gavin. "China's Illegal Organ Harvesting Trade Is Still Booming." VICE, 3 Dec. 2014. Web. July 2016. Ancoq, AC. "Philippine Law on Donations of Human Organs." J Int Bioethique, 3 Sept. 1992. Web. July 2016. Conde, Carlos H. "Philippines Bans Kidney Transplants for Foreigners." The New York Times. The New York Times, 29 Apr. 2008. Web. July 2016. "European Nations Sign World's First Organ Trafficking Treaty" Japan Times RSS. N.p., 26 Mar. 2015. Web. July 2016. "Trafficking for Organ Trade." Trafficking for Organ Trade. UN.GIFT, n.d. Web. July 2016. "Gaspare Tagliacozzi (1545-99)." Science Museum, n.d. Web. July 2016. "Organ Transplants: A Brief History." History Channel, 21 Feb. 2012. Web. July 2016. "History." United Network for Organ Sharing, n.d. Web. July 2016. Associated Press. "Were Mental Patients Organ Trafficking Victims?" NBC News, 13 Nov. 2008. Web. July 2016. Robinson, Simon. "India's Black Market Organ Scandal." Time. Time Inc., 01 Feb. 2008. Web. July 2016. Boudreaux, Richard. "Article about Organ Harvesting Sparks Israel-Sweden Tiff." Los Angeles Times. Los Angeles Times, 24 Aug. 2009. Web. July 2016. Goodman, Al. "Lebanese Mayor Arrested in Spain, Accused of Attempted Organ Trafficking." CNN. Cable News Network, 12 Mar. 2014. Web. July 2016. Matas, David. "Ending Abuse of Organ Transplantation in China." David Kilgour, Member of Parliament, 17 Aug. 2010. Web. July 2016. "The Waiting List." KidneyLink, n.d. Web. July 2016. <http://www.kidneylink.org/TheWaitingList. aspx>. "Psst, Wanna Buy a Kidney?" The Economist, 16 Nov. 2006. Web. July 2016. Martinez, Edecio. "Black Market Kidneys, $160,000 a Pop." CBS Interactive Inc., 27 July 2009. Web. July 2016. Dehghan, Saeed Kamali. "Kidneys for Sale: Poor Iranians Compete to Sell Their Organs." The Guardian. Guardian News and Media, 27 May 2012. Web. July 2016. Abadie, Alberto, and Sebastien Gay. "The Impact of Presumed Consent Legislation on Cadaveric Organ Donation: A Cross-country Study." Journal of Health Economics, July 2006 Web. July 2016. Olson, Samantha. "A Discussion Of Organ Donation Is A Discussion Of Inequality." Medical Daily, 29 Sept. 2014. Web. July 2016.

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Table of Contents - CASMUNC IXcasmunc.weebly.com/uploads/5/8/9/3/58930805/vmun-2017_who_1_… · 2005 - First “domino” transplant surgery is performed at John Hopkins Hospital