25 Apr ORGAN TRANSPLANTATIONS RULES IN INDIA

THIS ARTICLE COVERS ‘DAILY CURRENT AFFAIRS’ AND THE TOPIC DETAILS OF “ORGAN TRANSPLANTATIONS RULES IN INDIA”. THIS TOPIC IS RELEVANT IN THE “ POLITY and GOVERNANCE” SECTION OF THE UPSC CSE EXAM

Why in the News?

Recently, the central government has issued a set of instructions to the states regarding NOTTO (National Organ and Tissue Transplantation Organisation).

The Ministry of Health and Family Welfare amended the national guidelines for organ transplantation to permit individuals aged 65 and above to register for receiving an organ for transplantation from deceased donors.

About the recent guidelines issued by the Central Government

• The updated guidelines have eliminated the age restriction of 65 years for patients seeking organs from deceased donors. Additionally, there has never been an age limit for living donor transplants, where family members donate organs such as kidneys and livers.
•  NOTTO ID Generation: The instructions aim to ensure the generation of a NOTTO(National Organ and Tissue Transplant Organization) ID for both the donor and recipient in both living-donor and deceased-donor transplant scenarios.
• Compulsory Swift Identification: While a NOTTO ID is obligatory for the allocation of organs in deceased-donor transplants, it should also be promptly generated within a maximum of 48 hours after the transplant surgery for living-donor transplants.
• Inquiry and Oversight: The Union Ministry of Health has directed state authorities to investigate instances of organ commercialization and take appropriate actions against any violations found. State governments are tasked with devising a system for regularly inspecting all transplant and retrieval centres.
• Addressing the Emergence of Commercial Trading: Organs from deceased donors are allocated anonymously to individuals awaiting transplants, whereas organs from living donors can only be donated if there is a close familial or emotional bond between the donor and recipient and if the donation is purely altruistic. The commercial trading of organs is strictly prohibited under Indian laws.

About National Organ and Tissue Transplant Organization

• The National Organ and Tissue Transplant Organization (NOTTO) is established at the national level under the Directorate General of Health Services, Ministry of Health and Family Welfare.
•  It serves as the primary centre for coordinating and networking nationwide activities related to the procurement and distribution of organs and tissues, as well as maintaining a registry of organ and tissue donation and transplantation across the country.

Organ transplantation statistics in india

According to the National Organ Transplant Coordination Centre (NOTCC), from 2010-2020, India witnessed 11096 total organ transplants out of which 7927 were kidney transplants, 3065 were liver transplants, 1438 lung transplants, 365 heart transplants, 232 pancreas transplants, 99 cornea transplants, 56 bone marrow transplants, 9 intestinal transplants, and 41 spleen transplants.

India ranks 7th worldwide regarding the number of living organ donors per million population. Between 2000-2020, the rate of increase in deceased donor organ transplants was 101%, whereas the rate of increase in living donor transplants during the same period was 93%.

The leading five states—Telangana, Tamil Nadu, Maharashtra, Gujarat, and Karnataka—comprise over 85% of the total organ transplantations.

Issues related to Organ transplantation in India

• • False NoCs Allegations: The allegations of fake NoCs (Non-Compensation Certificates) issued by Indian authorities to Bangladeshi citizens involved in organ transplantation raise serious concerns regarding regulation compliance. It implies that people might be motivated to donate organs illegally or under duress due to monetary incentives offered abroad, thereby compromising ethics and safety standards. 
  • Kidney Donation Scams: Reports of impoverished individuals from Myanmar who were allegedly compensated for donating kidneys in Delhi highlight another aspect of organ transplant fraud. This indicates that vulnerable populations may fall prey to illegal international kidney trade networks.
  •  Lack of Transparency: Inadequate transparency around organ donation and transplantation activities often leads to confusion and mistrust among donors, recipients, and society. 

• Legal and Ethical Challenges:

• Organ trafficking and commercialization: Despite strict laws against organ trafficking, instances of illegal organ trade still occur, driven by poverty, lack of awareness, and demand-supply gaps.
• Inadequate regulation: Enforcement of regulations governing organ transplantation, including donor screening, consent procedures, and transplant center accreditation, is inconsistent across states, leading to potential exploitation and malpractice.

• Donor Shortage:

• Lack of awareness: Many people are unaware of the importance of organ donation, and cultural or religious beliefs may discourage donation.
• Reluctance among families: Even if individuals are willing to donate, their families may oppose the decision due to misconceptions or emotional barriers.
• Limited deceased donation infrastructure: India has a low rate of deceased organ donation due to insufficient infrastructure, including a shortage of trained transplant coordinators, inadequate organ retrieval facilities, and logistical challenges in transporting organs.

• Infrastructure and Resources constraints:

• Regional disparities: Access to transplant centres and organ procurement facilities varies greatly across regions, with urban areas having better infrastructure than rural areas.
• High costs: Organ transplantation is expensive, making it inaccessible to many due to a lack of insurance coverage or financial resources.

•  Lack of Public Awareness and Education: There is a need for comprehensive public awareness campaigns to dispel myths and misconceptions surrounding organ donation and transplantation. 

Initiatives taken by India

Legislation:

• 1994 the Indian government enacted The Transplantation of Human Organs Act (THOA). 
• The Transplantation of Human Organs Rules followed in 1995 and underwent the last amendment in 2014, expanding the scope of donation to include tissues for transplantation. This act criminalized organ commercialization and legalized the concept of brain death in India, enabling deceased donation by procuring organs from brain stem-dead individuals.

Institution:

• The National Organ and Tissue Transplant Organization (NOTTO) is established at the national level under the Ministry of Health and Family Welfare. In addition to formulating policy guidelines and protocols for various functions, NOTTO coordinates all activities related to organ donation at the national level.

Way forward for India

• Strengthen Legislation: Establishing robust legislation and implementation frameworks governing organ donation and transplantation practice could mitigate many existing loopholes allowing illegal organ trading. 
• Raise Awareness: Conduct continuous educational drives targeting communities, especially disadvantaged sections of society, explaining the advantages of organ donation. Encourage media outlets to participate actively in spreading awareness using different platforms and modes, making sure everyone knows what is acceptable when it comes to organ donation and transplantation practices
•  Robust Medical Facilities and Training Programs: Building quality medical facilities equipped with state-of-the-art technologies and training skilled doctors and nurses dealing specifically with organ transplant surgeries could significantly reduce mortality rates and complications associated with organ transplant surgery.
• Financial Assistance Mechanisms: Develop comprehensive financial assistance programs catering specifically to the poor segments of society who want to undergo critical medical treatment, including organ transplant operations. 
• International Collaboration: Sharing best practices and technological advancements with countries known for their successful organ transplant management systems can prove beneficial. India ought to consider implementing the Spanish “presumed consent” model, wherein individuals are presumed to consent to organ donation upon death unless they have explicitly opted out during their lifetime.

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Prelims based Question

Q1. Consider the following statements:

1. Telangana, Tamil Nadu, Maharashtra, Gujarat, and Karnataka—comprise over 85% of the total organ transplantations.
2. Spain is the biggest country in terms of organ transplantations.

Choose the correct answer using the codes given below:

1. 1 Only
2. 2 Only
3. Both 1 and 2
4. Neither 1 nor 2

ANSWER: C

Mains based Question

Q1.How have legislative measures such as The Transplantation of Human Organs Act (THOA) and the establishment of institutions like the National Organ and Tissue Transplant Organization (NOTTO) impacted India’s organ donation and transplantation practices?

Vikas Agarwal