Manila // A recent announcement by the Philippine health secretary that he was "open" to lifting a two-year-old ban on Filipinos donating their organs to foreigners is raising concerns that such a move might lead to state-sanctioned organ trafficking. A number of non-governmental organisations have expressed alarm over Dr Enrique Ona's comments, saying that lifting the ban will reopen the doors to what was once a thriving underground business that exploited the poor.
A respected surgeon and former head of the National Kidney and Transplantation Institute, Dr Ona said in an interview recently that he was opposed to the total ban on organ transplants. "It robs patients of the chance to live longer and better lives," he told local television ABS-CBN. "We have expats who have lived here for years," he said. "Suppose a Filipino wants to donate them a kidney, does that mean they can't receive it? Right now, it's a total ban. It has to be a government-regulated system. We will change the total ban on foreigners."
Dr Ona said his position is that such donations should be allowed but under strict government control. Dr Antonio Paraiso, head of the government's renal-disease control programme, said the ban was imposed to stop organ brokers from exploiting donors and clients by "short-changing one and overcharging the other". He said Dr Ona has now reopened the debate over whether the supply of organs from living donors can be done in an ethical and regulated market.
With millions of Filipinos living on less than US$1 (Dh3.67) a day, the Philippines had become one of the world's hotspots for organ harvesting. Foreign recipients paid up to $30,000 for a kidney while the donor would be lucky to get $2,000. Until the ban, the Philippines was ranked by the World Health Organisation as among the top five global destinations to buy a cheap kidney. The Philippines Against Child Trafficking, one of the leading campaigners against organ trafficking, said in a statement that the ban was imposed "in response to the thriving black market sale of organs ? many of them coming from teenagers."
In 2007, 536 foreigners received kidneys from living Filipinos compared with just one in 2002, according to data from the Philippine Renal Registry. A year after the ban the number fell to 34. Wency Dizon, the supervising co-ordinator of the government's organ procurement agency, said the 34 received organs from relatives. Seven thousand Filipinos die of renal failure every year, according to government data.
In June, the government established the country's first national organ-donor register. "But it is a hard sell in this predominantly Roman Catholic country," Mr Dizon said "The donor has to be declared brain dead first before we can take organs. It's a cultural thing. Unless the donor is declared brain dead, the family still lives in hope of a miracle," he said. "That goes for all classes of Filipino from the rich to the poor.
Between 2005 and 2008, about 15 kidneys from cadavers became available annually, he said. "Last year there were 30 and we have more than 1,000 people nationally waiting for kidney transplants," he said. Under the law Filipinos can receive kidneys from living donors as long as they are relatives or from a close friend. Three years ago the former justice secretary Raul Gonzales received a kidney from his driver.
To increase the supply of organs, Dr Ona said he is receptive to the concept of compensated donations in the "context of gratitude, not in the context of sales". Dr Ona has said he is in favour of "walk-in donors" or living non-related donors who can donate a kidney even though they are not related to the patient. He is open to giving a gratuity package to donors of about $3,000. "You don't allow it for people who just want to sell their kidneys. You have to look at their intentions and their situation. It's not as simple. Whether you are rich or poor, a person has the capacity to be charitable," he said.
Dr Alberto Chua, of the Philippine Society of Nephrology, said he is opposed to any reversal of the ban. He said offering a gratuity package to living, non-related donors would restart an organ market in the Philippines. "If I was a tricycle driver who only earns 3,000 pesos (Dh245) a month, maybe I would sell my own kidney to get $3,000," he said. @Email:kwilson@thenational.ae
