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Philippine plan to sanction use of poor citizens to be donors for transplant tourists under fire.

A Philippine plan calling for an Administrative Order that would sanction foreign patients to go to Manila to receive a kidney transplant from a live donor recruited from the country's poor population is being fiercely challenged by the international transplant community.

In a letter from The Transplantation Society (TTS) and the International Society of Nephrology (ISN) to the Secretary of Health of the Philippines, Presidents Nicholas Tilney, MD, and Eberhard Ritz, MD, called upon the Secretary to postpone the Administrative Order. If the Filipino government issues the Administrative Order, the Philippines would become the first country in the world to officially sanction the use of poor citizens as living non-related donors for international patients from Asia, the Middle East, Europe and the United States.

The Transplantation Society considers it important to distinguish medical tourism from transplant tourism. Frank Delmonico, MD, TTS Director of Medical Affairs and WHO Advisor for human transplantation told Transplant News that it is well-known that medical tourism now exists in a global market of medical care.

"If a patient can undergo a surgical procedure that is less costly in a foreign country that still provides excellent care, insurance companies may find this opportunity very appealing for their patients," Delmonico said. "However, transplant tourism is different than medical tourism because it involves the use of another person in that surgical procedure as the donor source of an organ. The individual who provides a kidney for the transplant tourist is virtually always a poor person who has no alternative to provide resources for themselves or their family but to sell a kidney. The media stories regarding the illegal trafficking in India last week have made that evident once again."

Transplant tourism is contrary to the 2004 World Health Assembly Resolution that calls upon member states "to take measures to protect the poorest and most vulnerable groups from transplant tourism and the sale of tissues and organs, including attention to the wider problem of international trafficking in human tissues and organs."

The TTS and ISN announced this week that they will convene an International Summit on Transplant Tourism and Organ Trafficking in Istanbul, Turkey on April 30 to May 2, 2008. Representatives from nearly all member states of the United Nations that have transplant services have been invited to the Summit. Others to be invited will include stakeholders, such as ministry officials, representatives from the WHO, members of the Global Alliance in Transplantation (GAT), and internationally renowned ethicists.

The more than 150 invitees will spend 2 days in works groups to draft a set of principles and definitions pertinent to transplant tourism, organ trafficking and commercialism. They will also address ethical practices of both deceased and living donation that can serve as approaches to combat organ trafficking.

The Istanbul meeting is intended to produce a reference document of transplantation practice for the World Health Assembly to consider in combating transplant tourism and organ trafficking.
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Author:Warren, Jim
Publication:Transplant News
Date:Feb 1, 2008
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