There is an acute shortage of data on the casualties and victims of this dark trade, making it difficult for decision making organs to develop appropriate measures to curb the issue. The World Health Organization passed a resolution WHA 57.18 calling member states to take measure towards the protection of the poorest and vulnerable groups from transplant tourism and the commercialization of tissues and cells (Assembly, 2014). Available data indicate that the highest donors are aged between 35-47, most of whom young women that are breadwinners in their single mother families (Assembly, 2014).
Responses from the United Nations have included the Protocol to Prevent, Suppress and Punish Trafficking in Persons, especially among women and children who form the bulk of the vulnerable groups. Women still remain the highest donors according to the World Health Organization since they are weak and vulnerable thus easily exploited by unscrupulous organ merchants across the world (Assembly, 2014).
Poverty remains the main propeller that pushes the poor and vulnerable to venture into the unknown business of organ trafficking, and most end up being exploited by merchants whom guise themselves as timely angels to rescue the vulnerable from the wrath of poverty.
Pakistan, Iran, India, Kosovo, Moldova, and Philippines are some of the nations with a high poverty index and not surprising to see that data available indicates that most patterns of organ trafficking occur around the Far East Belt where most of these nations lie (Lita, 2007). The problem of poverty is closely tied with illiteracy. Most poor donors do not have knowledge surrounding the legal and ethical considerations they ought to undertake before moving into the dangerous field on organ donation.
Trade brokers either do not bother to educate the masses on the likely dangers.
The principle on non-malfeasance was developed through the medical world following the concept of the Hippocratic Oath. The Hippocratic Oath is the oath administered on all doctors worldwide that binds them to professional ethics which includes upholding the long-standing tradition of ensuring least harm to patients while undergoing treatment (Lita, 2007). This principle was developed to curb increased danger exposed to patients while undergoing treatment and while holding medical experiments by doctors. The practice has received global acknowledgment across medical practitioners and remains a key principle guiding medics across the world in carrying out their medical duties. Whether most of the surgical operations within poverty-stricken communities jealously protect the medical principles developed globally to guide practitioners, is something that draws huge debates and doubts (Ambagtsheer, 2017).
Human security within local limits is at risk. Most states focus mostly on combating illegal trade in firearms, and ammunition, ivory trade among others, ignoring the ever-present menace of human trafficking that jeopardizes human lives. Immigration is increasingly becoming a global problem. It is reported that up to 5 Million immigrants cross to Europe from Africa and the Middle East, while others are forcefully smuggled into some regions to be used as donors for scarce organs in the market (Lita, 2007). The United Nations Charter and the Universal Declaration on Human Rights of 1948 assure every human being the right to dignity, security, and belonging, by the virtue of being human (Walker, 2013).
Tales of stolen kidneys are rampant in the Middle East, The Americas, and Africa. Young boys and girls are seduced into voyages in guise for better working condition. Most of these people end up being abducted and subjected to torture and inhuman treatment and eventually, their organs are forcefully harvested without their consent (Campion-Vincent, 2001).
The global social justice index varies regionally. Attainment of global social justice has been on the international agenda for long. Regions with very low social justice index struggle with basic social needs including access to housing, water, food, and medical services. Yet, most of these vulnerable individuals own precious commodities seriously sought after by those from regions of high social justice indexes. Global bioethics discussions have recently focused on emerging trends in violation of human dignity from organ trafficking.
The imbalance between social justice indexes has birthed a phenomenon referred to as supply-demand mantra in organ transplantation. The global queue for organ transplant patients outnumbers the global bank for organs available (Paige C. Cunningham, 2010). The unavoidable end of this has been the development of the organ black market. This black market has no regulations, just like the firearms black markets in South America. Where a market lacks regulations, customs and trade usages to ethically guide merchants abuse sets in. The exploitation in the black market cannot be overstated. Disparities in pay are quite high. Research shows for example that a patient for a kidney transplant in India or in Manila parts with up to $180,000, which includes the funds for the organ and for the surgical operation and rehabilitation. The organ itself may cost $25000. However, the donor receives a paltry $ 1250-$2500. Brokers and doctors share the remainder of the loot (Paige C. Cunningham, 2010).
Organ transplantation from these two societies portrays a stark picture of ‘rewarding’ on one hand and ‘gifting’ on the other. The donor is simply rewarded for their donation and the quantum of the reward does not form the discussion in most social spaces. The donor on his side is seen as a benevolent giver. In Pakistan for example, donation of an organ may simply be rewarded by the supply of bags of rice, a bounty for the exchange of a serious commodity that guarantees another life. The power play between the donor and the recipient comes into sharp focus.
Doctors, nurses and other medical clinicians play a great role in the discourse surrounding organ trade. In the performance of their duties, medical doctors are guided by ethical standards developed over the years by medical associations globally. The Hippocratic Oath administered on every qualified doctor ties down a doctor to uphold professional conduct at all times during their practice.
In carrying out their mandate, doctors have been brought into sharp criticism for encouraging organ trade. Hospitals globally are developing attractive packages for organ tourism and hiring doctors to see the same programmes succeed. A doctor owes every patient a duty of care and professional etiquette. This duty extends to giving sound advice on the legal and ethical channels for obtaining organs. Doctors in Costa Rica, Mexico, India, and Philippines have been accused of running a secret organ trade business through organ brokers in the black market (Dauber, 2017). Doctors are mandated, legally and ethically to provide sound medical advice, to both the patients as well as donors to enable the two parties to make independent and well-informed decision without any form of coercion.
Despite strict medical ethics guidelines, medical doctors find themselves influenced by financial motivation in carrying out their professional duties. Doctors also face huge challenges balancing between their duties to the patients due to third party interferences. Organ trade has evolved from the traditional medical issue to a commercial entity. Doctors, therefore, find themselves stranded between medical issues and factors of commerce influenced by middlemen and brokers. The traditional Doctor-Patient relationship therefore suffers.
It is reported that doctors also assist in obtaining forged and fake transplant documentation. Doctors collide with brokers in obtaining consent from donors, especially those that do not have the capability of understanding the transaction at hand due to illiteracy levels (Waness, 2011). Other medical professionals engage in organ trade in order to gain the prowess and attract more clients. Once a doctor has successfully performed a transplant, he gets more work from his repute. Many end up misusing the stage to engage in organ trade in order to fulfil their career and financial needs.
There is a need for continued appraisal among medical professionals and medical ethics sensitization to enable doctors to play their part effectively without jeopardizing their career nor jeopardizing the health of their patients. There is also the need to develop more stringent national legislation to provide a legal framework guiding doctors in carrying out their mandate. States must also endeavour to sensitize the public on the need and importance of medical ethics and why they should insist on proper medical procedures.
The need to develop solutions to curb the menace of organ trafficking cannot be overstated. Organ trafficking cannot exist without human trafficking. Human trafficking emanates from the cross-border movement of vulnerable individuals who are lured by fake economic gain stunts from brokers who run the trade of organ trafficking.
The global community has recognized the danger the trade exposes vulnerable persons too. The United Nations General Assembly, The World Health Organization, medical bodies and associations globally have united to fight the war against human trafficking and organ trafficking. Some global initiatives developed to involve the Istanbul Declaration on Organ Trafficking and Transplant Tourism.
The declaration was developed to address growing concerns around global shortages in organ transplantation. The declaration takes cognizance of the ethical issues surrounding organ trade in a market that is affected by global economies of scale. The declaration contains provisions for ensuring donor and patient safety. The declaration drew consensus from all participants on the need to have a regulatory framework to govern organ donation and organ transplantation. The declaration builds it pronouncements from the Universal Declaration on Human Rights and other international Treaties and statutes that protect human rights. Of importance, the declaration takes cognizance of the importance of organ donation and transplant. The legacy of donation must not be to impoverish the donors of organs and enrichment of patients, but rather a celebrated medium of gifting life from one person to another, as members of the human race, economic gains notwithstanding.
Organ trafficking is a subset of human trafficking; one cannot exist without the other. The global community through the United Nations Office on Drugs and Crime approaches the menace of human trafficking as a human right issue and imposes criminal sanctions on such actions. Similarly, the United Nations Convention against Transnational Organized Crime lays a framework for the protection of the poor and vulnerable from exploitation through trafficking. The Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children were developed to cater specifically for women and children, who form the bulk of the vulnerable members of the societies and easy targets for organ traders (Joshua Aransiola, 2014).
The United Nations Office on Drugs and Crime in conjunction with other United Nations-affiliated human rights groups have periodically developed regulations as well as instruments to tackle the increasing patterns of crime especially human trafficking. The International Police, Interpol, has been tasked with the work of tracking down and combating human trafficking, especially in regions posting high trends of human rights abuses arising from trafficking. These areas include the Southern American Belt, the West African region and the Middle and the Far East regions.
The International Criminal Court in its enabling Statute, the Rome Statute has the inherent jurisdiction to handle cases that include genocide and crimes against humanity. Human trafficking ranks among crimes against humanity. The International Criminal Court assists the United Nations Office on Drugs and Crime in combating
Transnational threats are best handled through cooperation among states. Organ and human trafficking does not affect a single country only. Its effects are felt globally, just like terrorism, trafficking has evolved from locally organized crime to a global monster that claims human lives. The doctrine of common but differentiated responsibility comes into play. Member states to the United Nations Charter have common but differentiated responsibilities in combating the crime of human trafficking (Crime, 2010). Nations with high rates and patterns of trafficking have a greater responsibility of developing sound and effective national legislation as well as cooperating with neighbouring states to combat the menace through regional treaties and agreements (Crime, 2010).
Information sharing among states remains an important element that has been lacking for long. Most measures developed recently are incumbent on the available data provided by nations and regional blocs including the Asia-Pacific region, the European Union, The African Union, and the Americas (Crime, 2010). Such information has become easy to access due to increased cooperation among governments which take cognizance of the threat of human trafficking as well as organ trade to regional growth as well as local development.
Protection of human rights has never been a one-man show. States under the ambit of the United Nations have periodically cooperated to combat menaces that are attaining jus cogen status. Terrorism, Genocide, human trafficking, drug menace are some of the international crimes that have called for international cooperation and assistance in combating such menaces.
The United Nations Office on Drugs and Crime has established a Voluntary Trust Fund for victims of human trafficking for organ harvesting and other related crimes. The fund provides assistance at the grassroots level to victims of dubious merchants who abuse human rights by violence against such victims in pursuit of essential organs. The funds trickle down through Non-Governmental Organizations, civil society groups as well as internationally recognized UN Agencies including the World Health Organization and other affiliate groups.
Human health is a vital aspect of human life. Medical advancement in the field of medicine including organ transplant was develop to enable patients with organ problems to have a better life. Organ transplant around the world developed and in its wake, a lot of ethical issues have arisen. The process that was once developed to purely save human lives has mutated quickly into a commercial procedure that has led to a number of human rights violations. Human trafficking became rampant in a bid to supply the huge demand for human organs. Organ trade developed under unregulated markets leading to abuse of donor rights.
Organ trade has also created inequalities in access to medical services. Most poor patients are not able to access organ transplants due to the high costs of medical procedures along with the prices of acquisition of such organs. International assistance and cooperation have been developed in a bid to attain a consensus in the fight against organ transplant while at the same time enabling genuine patients to access medical care globally. International organizations including the World Health Organization, the United Nations General Assembly, the United Nations Office on Drugs and Crime have collaborated to come up with internationally accepted standards and regulations to regulate organ transplantation. These standards have purely been developed from a human rights approach in order to guarantee the protection of human rights amidst the need to enable patients to access medical treatment.