THE world healthcare community has united for concerted action against “transplant tourism” – the trafficking of people as a source of human organs for transplantation. The effort involves more than 150 healthcare professionals, officials, scientists, ethicists and legal scholars from 78 countries and 20 international organizations who attended the May 2 Summit on Organ Trafficking and Transplant Tourism in Istanbul, Turkey. Transplant tourism, which depends on organ sales and undermines countries' efforts to meet the health needs of their own populations, has taken the dimensions of organized crime akin to drug trafficking, involving doctors, quacks and agents in several countries. Organ commercialism, which targets vulnerable populations (such as illiterate and impoverished persons, undocumented immigrants, prisoners, and political or economic refugees) in resource-poor countries, has been condemned by international bodies such as the World Health Organization for decades. Yet in recent years, as a consequence of the increasing ease of Internet communication and the willingness of patients in rich countries to travel and purchase organs, organ trafficking and transplant tourism have grown into global problems. For example, as of 2006, foreigners received two-thirds of the 2000 kidney transplants performed annually in Pakistan. The July 5 issue of the leading medical journal, The Lancet, highlights the Declaration of Istanbul on Organ Trafficking and Transplant Tourism, an important affirmation of ethical principles and practices adopted by the summit. A commentary, authored by the 32-member Steering Committee of the Istanbul Summit, describes how the policies advocated by the Declaration will help to combat transplant tourism. The Istanbul Declaration proclaims that the poor who sell their organs are being exploited, whether by richer people within their own countries or by transplant tourists from abroad. Moreover, transplant tourists risk physical harm by unregulated and illegal transplantation. Participants in the Summit concluded that transplant commercialism and tourism and organ trafficking should be prohibited. And they also urged their fellow transplant professionals, individually and through their organizations, to put an end to these unethical activities and foster safe, accountable practices that meet the needs of transplant recipients while protecting donors. The commentary points out that countries from which transplant tourists originate, as well as those to which they travel to obtain transplants, are just beginning to address their respective responsibilities to protect their people from exploitation and to develop national self-sufficiency in organ donation. The authors expect that the Declaration will reinforce the resolve of governments and international organizations to develop laws and guidelines to bring an end to wrongful practices. The Declaration said: “The legacy of transplantation is threatened by organ trafficking and transplant tourism. The Declaration of Istanbul aims to combat these activities and to preserve the nobility of organ donation. The success of transplantation as a life-saving treatment does not require-nor justify-victimizing the world's poor as the source of organs for the rich.” The Declaration of Istanbul has been endorsed by The Transplantation Society and the International Society of Nephrology, which sponsored the Summit meeting. __
