No country is left unaffected by the black market organ trade and organ trafficking. However, some States are known more for having doctors that will illegally transplant, while others are more known for citizens seeking out illegal transplants. In one study of black market organ trades and transplantation, people sought organ transplantation in China, Iran, the Philippines, India, Pakistan, Turkey, Peru, Egypt, and Thailand. The prevalence of black market organ trades in these countries stems from having doctors willing to perform the transplants, brokers willing to set up the deals, and citizens willing to sell their organs illegally.

The same study revealed the standard demographics of these willing organ sellers: the average age of a seller was 33.6 years old; the average income was $15.4 USD; they consistently had large amounts of debt; 90% were illiterate; they averaged 5.5 dependents; 66% were bonded laborers. The combination of these factors drove these individuals to perpetuate organ trafficking. The trade has grown such that World Health Organization estimates 1 of every 5 kidney transplants is a black market transplant.

The controversy over the black market organ trade, beyond its blatant illegality, lies in the fact that precedence allows for the sale of other body parts without legal implications. For example, women are permitted to sell their eggs and be surrogates.

Additionally, the intersection of the black market trade with human trafficking causes more controversy and categorizes this topic under the jurisdiction of the UNODC. The trafficking of humans for the ultimate use of their organs is internationally prohibited by the Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, supplementing the United Nations Convention against Transnational Organized Crime.

One of the first documented cases of the black market organ trade was uncovered in 1993 when Bombay police discovered a black market kidney ring. Since then, various attempts at legislation internationally and by individual countries have sought out the elimination of organ trafficking. Generally, though, the legislation for organ transplantation is on a country-by-country basis with international law only having the jurisdiction to curtail subsequent problems such as human trafficking for the organs and the relationship to organized crime.

Iran is the only country that allows, to some extent, a paid system for organ donors. All other countries have put into place some legal persecution for the black market organ trade, though it thrives despite these legal limitations.

For example, Pakistan is one of the countries with the most illegal transplantations, with recipients coming from around the world and buying upwards of 2,000 organs per year. In Bangladesh, the brokerage of the organs occurred through public newspapers. And despite the fact that India has a system in place that requires hospitals to ensure that all organ donations are made completely willingly rather than as part of a black market deal, there are still illegal transplantations. It is obvious, then that despite best attempts to eliminate organ trafficking in individual countries, it still thrives on a global

In fact, just in 2013, a girl was found trafficked to the United Kingdom for the harvest and sale of her organs. With regards to the actual functioning of the organ trade, it is generally facilitated by brokers that tend to be involved in organized crime rings and/or human trafficking.

The people behind the trade have been described as “a new international network of body Mafia ranging from the sleazy (and sometimes armed and dangerous) underworld kidney hunters of Istanbul and Cesenau, Moldova to the sophisticated but clandestine medical tourism bureau of Tel Aviv and Manila to the medical intermediaries posing as religious or charitable trusts and patient's advocacy organizations' founded in downtown Philadelphia, Brooklyn, and Chinatown New York City.

The brokers of the deals are guilty of numerous international crimes extending beyond those previously mentioned, and including the forging of passports and legal documents. The trade ultimately violates any number of international laws with its existence.

Moving forward with the development of legal implications for participants in organ trafficking on an international scale will have to account for both national sovereignty and the necessity for global responses to the black market organ trade. The intersection of organ trafficking with human trafficking and organized crime requires additional international attention. Without the cessation of organ trafficking, not only will there continue to be mass international deaths from unsanitary procedures and the harvesting of organs, but also it will completely undermine the system in place for those that await organ transplantations legally.

Past International Action

The lack of access and availability are definitively the driving factors in the criminal Organ Trafficking. Countries around the world struggle to find efficient and ethical means of providing the sufficient number of organs to suffering patients. Sometimes, initiatives that had a positive effect in one realm of society also produced negative externality in another. In Australia, a national road safety initiative greatly reduced the number of automobile accidents, but this also dropped the number of organ donors from 14 pmp (per million of population) in 1989 to 8-9 pmp in 2000. Most developed nations have national agencies dedicated to the legal procurement of organs from organ donors.

The National Organ Transplant Act of 1984 contracted the United Network for Organ Sharing in the United States, and, in efforts to buttress the already existent European agencies, the European Commission created the Directive on the Quality and Safety of Human Organs for Transplantation –a document that all EU member states are required to implement by 2012. Most of these countries, as well as many other developing nations, have passed legislation that also criminalizes the illegal trade of organs.

The 1994 Transplantation of Human Organs Act in India, Pakistan's Transplantation of Human Organs and Tissues Ordnance in 2007, and South Africa's Human Tissue Act of 1982. Internationally, the United Nations and the World Health Organization have spearheaded the creation of treaties and initiatives to end the world organ trade. The United Nations passed the Protocol to Prevent, Suppress and Punish Trafficking in Persons in 2000.

Though it was primarily angled against human and sex trafficking, Article 3 of the protocol notes that exploitation includes the “removal of organs”. The UN's Optional Protocol on the Sale of Children (2000) and the UN Convention on the Rights of the Child (1989) also recommend that the “sale of children for the purpose of transferring their organs” should be criminalized by member states. The WHO has arguably been even more vocal in its commitment in creating a unified and international response.

It's Guiding Principles on Human Organ Transplantation (1991) explicitly advises that organs be donated lawfully, with full consent from the donor, without monetary payment or purchasing, done under clinical and professional medical conditions, and donations should never come from a minor unless allowed by national law. More recently, the World Health Assembly, the governing body of the WHO, issued the Istanbul Declaration on Organ Trafficking and Transplant Tourism (2004).

Transplant Tourism, much like medical tourism, is a means by which persons avoid their own country's organ transplant regulation by pursuing medical treatment or procuring organs in another country. This not only undermines waitlists and safety regulations, but it often abuses marginalized and oppressed persons in order to gain the necessary organs. The UNODC is the only United Nations office focused on the criminal justice element of human trafficking.

Thus, resolution 55/25, which included the Protocol to Prevent, Suppress and Punish Human Trafficking as well as the Protocol against the Smuggling of Migrants, is put into effect largely by the actions of the UNODC. Reaching into every continent and with 20 field offices from which to operate, the UNODC primarily achieves its goals by partnering with countries' federal agencies and NGOs. Joint projects have also been conducted between the UNODC and INTERPOL, the African Union, and EUROPOL. Unfortunately, the great vice of international conventions and protocols is that they bear no power until their sentiments are enacted within a state's own legislation. There have been stories of triumph against the lucrative Organ Trade Rings.

India's Central Bureau of Investigation arrested Amit Kumar, the leader of one of the world's largest kidney trading rings, in 2008. His apprehension, though, simply illuminated for the world how large the network had grown. Clients streamed in from Greece, Turkey, the Middle East and even the United States to fulfill their organ needs. In South Africa, St. Augustine's Hospital was found guilty of 102 counts of illegal kidney transplants, and members of the Mexican Knight's Templar cartel have been prosecuted for the kidnapping and removing organs from minors. But all of these cases make the reality of organ trafficking clear — with legislation blatantly intended to snuff it out, the trade has simply moved underground to evade prosecution.

Nepal is well known as one of the main hubs for illegal organ donors. Whole towns have had their populations' kidneys swindled from them, most often by Indian gangs who lure poor farmers into trading their kidneys for frugal exchanges of rupee. Nepal passed a groundbreaking law in 2007 called the Human Trafficking and Transportation (Control) Act 2064 meant to not only punish the criminals involved in the organ trafficking, but also provide rehabilitation and compensation to those who fell victim to these traffickers. Sapana Pradhan, one of the authors of this Act, has noted though that the toughest challenge is the installment and enforcement of bilateral agreements between Nepal and its neighbors to allow for joint investigations and legal assistance.

The topic of Organ Trafficking has come before the UNODC as a result of a necessity for international action and legal implications. This committee will need to address all of the sub-issues of the black market organ trade in order to develop a comprehensive solution to this decades-old problem. Diplomacy will become extremely important as this committee attempts to create coherent propositions that address all aspects of the problem and do not violate any individual nation's right to self-govern. The international community urges the UNODC to combat organ trafficking head-on with strong solutions!

References:

1. UNA-USA MUN society, sample background guide
2. WHO report, “the state of international organ trade”, www.who.int/bulletin/ volumes/85/12/06-039370/en/
3. UNODC: http://www.unodc.org/unodc/index.html

Written by: Sayed Qudrat Hashimy - International Law Student
E-mail: Sayedqudrathashimy[at]gmail.com , Mobile No.+91 900 8813333