September 05, 2008	Friday	Ramazan 04, 1429

KARACHI, Sept 4: Nephrologists and urological surgeons, who had a role in the promulgation of the Transplantation of Human Organs and Tissues Ordinance 2007, have expressed concern over media reports about a move for changes in the legal instrument which, according to them, significantly helped check commercial transplant of kidneys.

Representatives of the Transplantation Society of Pakistan (TSP), Pakistan Society of Nephrology (PSN) and Pakistan Association of Urological Surgeons (PAUS) in a joint statement said: “There is a move to subvert the transplant ordinance by proposing amendments to deface the ethical legislation.”

“Any change in the ordinance promulgated by former president Pervez Musharraf, which has also been given protection through the 17th constitutional amendment, will push the country back to the era when commercialisation of transplants was common, and Pakistan was among the few countries maligned for their organ bazaars, lacking ethics and encouraging exploitation of the poor in the country,” said the secretary-general of the TSP, Dr Anwar Naqvi, on Thursday.

However, retired major-general A. Q. Usmani, the administrator of the Human Organ Transplantation Authority, maintained that he had seen a document related to the proposed amendments and he would like to say that there would be no drastic or adverse changes, if made at any stage, in the existing provisions of the ordinance and a complete ban on the sale or purchase of kidneys or any other human organs would continue.

It has been learnt that a private bill tabled by some parliamentarian, suggesting some changes in the 2007 human organ transplantation ordinance, has now been sent to the standing committee of parliament on health for a detailed discussion and recommendations.

The medical professionals in their statement opposed the amendments in the ordinance enforced about a year back and claimed that since the introduction of the ordinance transplantation from living donors had increased.

Highly appreciating the ordinance, representatives of the TSP, PSN and PAUS said the law also facilitated donation after brain death and with the permission of the next of kin organs of a person could be donated to save about 12 human lives, while adhering to decent ethics and without exploiting the weaker sections of society. They said they feared that organ bazaars might flourish again if the proposed amendments to the law were made.

According to the associations of the medical professionals, before the introduction of the ordinance, Pakistan had become a laughing stock of the transplant world when it earned the dubious title of ‘The cheapest organ bazaar of the world’.

“Poor vendors from Sargodha and other areas in Punjab were exploited to sell their kidneys for Rs100,000 to Rs150,000 whereas the wealthy foreign recipients paid up to Rs2.5 million for the transplant package. Beneficiaries were the middleman and private transplant centres, while the commercial transplant business had a turnover of Rs1.5 billion a year, involving the vulnerable people who sold their kidneys in a highly disgraced situation”, claimed the professionals.

Moreover, after the promulgation of the ordinance, the traffic of foreigners coming for transplantation had fallen to a trickle.

When contacted by Dawn, Dr Anwar Naqvi said the existing legal provisions available under the 2007 ordinance were reasonably good and appealed to the policy makers to help Pakistan reap the fruits of technology from ethical transplantation and deceased donor transplantation for all vital organs.

Answering a question, he said transplantation from living donors had increased remarkable in the country, and also cited the example of the institution he belonged to, saying that the increase was from 150 transplants to over 400 transplants a year at the Sindh Institute of Urology and Transplantation, Karachi.

Talking to Dawn, HOTA administrator Gen Usmani said that the matter pertaining to some amendments in the ordinance and giving it the status of an act approved by parliament had been handed over to the standing committee on health for discussions involving all the stakeholders after the approval by the federal health minister and the health secretary.

No changes would be made in haste, the retired general said, adding that there were some minor things, as pointed out in the private bill, that needed deliberations. The proposed changes would not undermine the sprit of the ordinance, he said.

He said all major stakeholders, including medical professionals such as Prof Adib-ul Hasan Rizvi of the SIUT, were being taken on board on the issue and he understood that the process of improving the ordinance and replacing it with an act would definitely take some time.

“Till the time any follow-ups are observed by the health standing committee and the respective legislation committee in regard to the proposed legislation, there would be no leniency in the subject of ethical transplantations based on the living related donations,” he said.

Replying to a question, he said the impression that the number of transplants taking place in the medical institutions of the country had come down in the wake of the ordinance was not correct.

“Against a figure of 2,000 transplants, including 1,500 foreign patients, carried out per year, the 20 public and 23 private sector medical institutions registered with HOTA have performed more than 431 translations after the implementation of the ordinance.

“The number of foreigners visiting Pakistan for organ transplantations has remarkably been low, but the transplant rate of the local patients was almost the same as in the past,” added Gen Usmani.