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The World Health Organisation (WHO) has warned against a plan by an American organisation to buy kidneys from Kenyans.
The WHO and several experts dealing with the Global Kidney Exchange programme has been targeting Kenya and other poor nations to provide kidneys to the US.
“We are opposing the proposed Global Kidney Exchange plan to solicit living donors from poor countries such as Kenya, Mexico, the Philippines, India and Ethiopia,” said Dr Francis Delmonico, of the WHO’s Advisory Organ Donation and Transplantation, and Dr Nancy Ascher, President of the Transplantation Society.
Opento abuse
The experts note that the project could be open to abuse. “Vendors will be readily solicited to sell their kidneys despite the Global Kidney Exchange disclaimer that ‘commercial interest should be carefully ruled out in such kind of exchange with careful selection’.”
Kenya comes into the international picture because in the past it has featured prominently as a human trafficking hub in Eastern Africa. Additionally in July the Health Act 2017 came into force making it legal and much easier for a Kenyan to donate an organ, including kidneys, to non-relatives.
The new law allows Kenyans in either a written will or oral statement, before witnesses, to donate their bodies or body parts to persons or institutions of their choice. “This is a positive development,” says Ephantus Maina of the Happy Kidney (HAKI) Foundation, because it will allow many people on the waiting list to get donations in a shorter time.
But the country will first need to put in place a strong mechanism that will protect well-meaning donors from organ traffickers, Maina says. Such a mechanism should ensure doctors do not coerce patients into untimely removal of organs.
The new law comes with a hefty fine of up to Sh10 million, or 10 years in jail or both for those turning lifesaving organs into an underhand cash cow.
But the law is unlikely to deter the trafficking of organs and if anything, it is probable that trade in human body parts may increase, Maina says.
Before the new law, the exchange of body organs had only been legal among relatives. However, there have been cases of Kenyans receiving or donating kidneys to non-relatives especially in India.
In one case widely reported in the Indian press in 2013, a 33-year-old Kenyan woman and a 33-year-old male tailor from the Indian state of Rajasthan became the first patients in the world to undergo an international kidney swap.
A sister of the Kenyan woman donated her kidney to the Indian tailor while his wife donated hers to the Kenyan lady at a time it was illegal in both countries to undertake such a swap. The proposed Global Kidney Exchange programme argues that millions of people are dying of kidney disease in poor countries because they cannot afford transplants even when organs are available.
On the other hand many are also dying in developed countries for lack of transplant kidneys which they can afford if available.
Readily solicited
“This juxtaposition between countries with funds but no available kidneys and those with available kidneys but no funds prompts us to propose an exchange programme using each nation’s unique assets,” says proponent Dr Michael A Rees of the University of Toledo, US, and the Alliance for Paired Donation.
Rees in a brief appearing in the International Journal of Transplantation of the American Society of Transplantation says developed countries will open their advanced health care systems to the poor in exchange for their kidneys.
The exchange programme has suggested it will be over sighted by the WHO and The Transplantation Society (TTS), an international NGO.
“That contention is not correct, both the WHO and TTS oppose the introduction of this Global Kidney Exchange programme,” says Dr Delmonico.
The WHO advisor says the proposal by the exchange programme is highly unethical and must be rejected.
“Vendors will be readily solicited to sell their kidneys despite a disclaimer that commercial interest will be kept out.” It is estimated that a kidney could cost up to Sh12.57m ($150,000) in the black market.
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