DoH Order: ‘Regulating or Legalizing Organ Trade?’

The Health Alliance for Democracy (HEAD) warned that the administrative order (AO) issued by the DoH March 24, which is supposedly aimed at eradicating the thriving black market of kidney trade would only pave the way for the virtual legalization of organ trade under the pretext of “management and regulation”.

Vol. VIII, No. 8, March 30-April 5, 2008

After issuing a temporary ban on kidney transplants involving foreigners, Health Secretary Francisco Duque signed an order on March 24 that calls for the creation of a government board that will oversee kidney donations and transplants, ensure proper care of donors and make underground transactions on kidney trade more transparent and ethical.

But the Health Alliance for Democracy (HEAD) warned that this administrative order (AO) supposedly aimed at eradicating the thriving black market of kidney trade would only pave the way for the virtual legalization of organ trade under the pretext of “management and regulation”.

The AO prioritizes Filipino patients over foreigners in the allocation of locally available kidneys for transplants, and mandates authorities to set specific limits. The order was sought after various media stories reported that foreign patients come here in search of kidney donors. Many foreigners look for donors in the Philippines after some countries, like India, Pakistan, and China have passed laws controlling the selling of organs. A 1991 Philippine law only regulated transplants of kidneys and other organs from brain-dead donors.

“We must scrutinize not only what is written but also what is not written in order to arrive at the real nature of this order,” said HEAD secretary-general Dr. Gene Alzona Nisperos.

Though aimed at stopping the trade of kidneys and illegal organ trafficking, Nisperos said that nowhere in the text of the AO are “kidney sale” or “trade and commerce of kidneys” defined or clarified. On the other hand, he said that although the term “gratuity” was used, he said it was so vague since the text does not mention anything on what the Department of Health (DOH) regards as “acceptable compensation” for the donor.

Meanwhile, the Catholic Bishops Conference of the Philippines (CBCP) has criticized the increasing “organ sale, especially of kidneys” in the Philippines as “a practice that is perhaps apparently permitted by some physicians, Kidney Transplant Teams, and hospital authorities.”

Moreover, Nisperos said the order does not stipulate how the DoH would stop kidney trade outside the creation of a board.

“The lofty guiding principles and general policy statements contained in the DOH order are rendered inutile in the absence of clear-cut parameters and limits that should be set in very clear, unconditional terms to actually stop the trade of kidneys and other human organs. Otherwise, what are they really talking about?” said Nisperos.

Moreover, he added that the AO delineates not only between Living-Related Donors (LRDs) and Living Non-Related Donors (LNRDs) but also between “Directed Kidney Organ Donor” and “Non-Directed Kidney Organ Donor”, which was not present in the superseded AO (AO 124 series 2002).

“Ninety percent of kidney transplantations here are from living donors, of which 68 percent are from LNRDs. This is a whooping 56 percent increase from 2002 and confirms the overwhelming demand for organ donors,” added Nisperos, “This is where exploitation is rampant, as most LNRDs come from the ranks of the poor and marginalized.”

Nisperos said that “Directed Kidney Organ Donor” refers to “someone who has a specific recipient in mind to donate to.” This, he said, debunks the initial impression that kidney donations will now be more equitably allocated and where Filipino recipients “shall be given priority in the donor allocation.” “Directed Kidney Organ Donor” means that the donor designates the recipient, which he said, further cultivates a pro-rich bias and rampant abuse of the poor.

In the Philippines, numerous reports have came out on kidney trading involving dirt-poor people and prisoners who sell their organs for paltry sums to syndicates catering mostly to foreign clients.

In 2007, the Philippine Renal Disease Registry (PRDR) reported that the prevalence of kidney/renal diseases has been on an increasing trend, especially the end-stage renal disease (ERSD). According to the PRDR, one Filipino develops chronic renal failure every hour or about 120 Filipinos per million populations per year. But only a small number of those needing kidney transplants could avail of the procedure because kidneys are scarce and the procedures cost so much. The rate of death due to end-stage renal disease has been in the top ten list of the mortality of the DoH.

HEAD believes that the DoH order not only “intentionally misdirects public attention but also preconditions the public to accept LNRDs with directed organ donation, which will still benefit
foreign medical tourists and rich Filipino patients.”

“The truth is that only non-directed kidneys organ donations will be centralized and ‘belong to the
community…that will be allocated fairly among recipients,’” said Nisperos. (

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