(This is part of a special report on the transplant trade)
Aug 6 The clandestine nature of human organ trafficking makes it difficult to assess; but here are five hotpots identified by the World Health Organisation.
-- The world's most populous country is also the top host country for transplants, but recently tightened regulations may change this. In July 2006 China banned the sale of human organs. In July 2007, it said it would restrict organ transplants for foreigners and give priority to sick Chinese.
-- About two million people in China need transplants each year, but there are only around 20,000 operations because of shortages of hearts, kidneys and other organs, according to local reports. Criticised for taking organs from executed prisoners, China says all prison donors have given consent.
-- Pakistan, currently thought to be the world's second biggest centre for the organ trade, has no legal framework on transplantation, although a draft law that could allow organ donations from the deceased was passed in Feb. 2007.
-- Selling kidneys to brokers has become commonplace in villages in the poorer parts of the country, with up to 1,500 "transplant tourists" visiting Pakistan in recent years, according to WHO estimates.
-- Eygpt has no transplantation laws or legal recognition of brain death -- although it agrees to the need for both to regularise donations, the WHO says. High rates of liver disease have boosted demand for liver transplants as well as kidneys.
-- Egypt's commercial living kidney donors are typically male (95 percent), with a median age of 33. Some 78 percent reported a deterioration in health after selling their kidneys, 81 percent spent the money earned within five months, and 94 percent said they regretted donating, the WHO reported.
-- All transplants, including those on foreigners, must be approved by Colombia's national health agency, and a 2004 law calls for available organs to be offered to Colombians first.
-- However, several Web sites offer new livers and kidneys in Colombia within 90 days, and the country's relative proximity to the U.S. has helped establish it as a destination for transplant and other medical tourists seeking cheap operations.
-- A 1991 act allowed for the international sharing of organs and tissues. While the official Philippine Organ Donation Program recommends live donors undergo counselling and medical evaluations, a lucrative backdoor kidney trade has flourished.
-- Experts have called for health insurance systems to stop reimbursing "transplant tourists" to slow the trade. Kidney patients from the United Arab Emirates who are sent to the Philippines for a transplant, for example, could have health insurance cover the $95,000 fee, $10,000 of which goes to the donor.
Sources: Reuters, World Health Organisation
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