ORGAN trade was legal in Pakistan and flourished openly in the country until last year when the country's Transplantation of Human Organs and Tissues Ordinance was passed. It is unclear whether the Ordinance is adequate but according to Dr. Farhat Moazam, professor and chairperson of the Center of Biomedical Ethics and Culture at the Sind Institute for Urology and Transplantation (SIUT), Karachi, “It is a step in the right direction.” Moazam, who was part of a nearly two-decade long campaign by professionals, civil society and the media against a strong pro-organ trade lobby, told Inter Press Service, however, that the Ordinance “needs to be strengthened in some areas and also implemented honestly and transparently if it is to work.” In 2003, SIUT estimated that around 2,000 kidney transplants were done in Pakistan every year, Moazam told IPS. Eighty percent were from unrelated donors, and, of these, almost two-thirds were done on patients from outside Pakistan. “Development of deceased donor programs at least in some of the major institutions to supplement living organ donation is absolutely essential to address the needs in Pakistan,” said Moazam. “But this will require raising public and professional awareness, and education.” In Pakistan, only the SIUT has carried out deceased kidney transplants, and of the 20 such transplants only six were from deceased people. The Ordinance makes it mandatory for institutions doing transplants to register and be monitored, prohibits and provides punishments for commercial dealings in human organs as well as donation by Pakistani citizens to “citizens of other countries”. However, “donation” by non-related individuals is permitted if it is “voluntary”, a term Moazam views as “vague” and prone to abuse. She also notes that since spouses may donate, “sham marriages are inevitable in an androcentric society”. Finally, the same problems of corruption in giving permission for non-related “donations” exist as in the Indian law. “In my opinion, organ trafficking involves societal and global issues that must be discussed within the broader paradigm of global injustices,” Moazam told IPS. “It must be a debate about communities of one kind of people being systematically exploited by communities of other kinds, both internationally and intranationally.” __
