David Kilgour and I have concluded (first in a report released in July
2006 and updated in January 2007, and then in a book titled Bloody
Harvest released in November 2009) that Falun Gong practitioners have
been killed in China in the tens of thousands so that their organs
could be sold to transplant patients. I invite you to take a look at
our report, which is online , or read our book to see how we came to
that conclusion. Falun Gong is a simple set of exercises with a
spiritual foundation which started in China in 1992 and was banned in
1999.
This abuse in China has to be concern to the global community because
it is a grave human rights violation which should concern all
humanity, but also because the developed world has been complicit in
the abuse. When China shifted from socialism to capitalism, the state
withdrew funds from the health system.
Since 1980, government spending dropped from 36% of all health care
expenditure to 17%, while patients' out of pocket spending rocketed up
from 20% to 59%. A World Bank study reported that reductions in
public health coverage were worsened by increases in costs by the
private sector .
According to cardiovascular doctor Hu Weimin, the state funding for
the hospital where he was working was not enough to even cover staff
salaries for one month. He stated: "Under the current system,
hospitals have to chase profit to survive." Human Rights in China
reports: "Rural hospitals [have had] to invent ways to make money to
generate sufficient revenue".
Hospitals needed to find private funding to replace state funding.
Foreign sales of organs became the primary money maker. The Organ
Transplant Centre of the Armed Police General Hospital in Beijing for
instance stated on its website:
"Our Organ Transplant Centre is our main department for making money.
Its gross income in 2003 was 16,070,000 yuan. From January to June of
2004 income was 13,570,000 yuan. This year (2004) there is a chance to
break through 30,000,000 yuan."
The Chinese health system began the organ transplant business by
selling organs of prisoners sentenced to death. However, eventually,
despite the large number of death sentences and executions in China,
this supply became insufficient. So hospitals and prisons turned to
another source, Falun Gong practitioners.
For years, patients from developed countries came over in the
thousands to buy organs in China. The Government of China, in June
2007, ordered the hospitals to give priority to local patients . What
before was a foreign flow became a trickle. Transplant volumes today
are at traditional levels. So, with minor variations, are the
sources. However, the patient composition has changed dramatically.
We can not nonetheless say that because the patient composition is now
mostly local, Chinese organ transplant abuse has ceased to be an
international problem. If a pusher gets a client addicted heroin, the
pusher can not claim innocence because the client now grows his own
opium. If a bartender plies a client nightly with drinks and the
client becomes an alcoholic, the bartender can not later plead that
the client now uses only his own home made moonshine.
Learning from the Chinese experience and reacting now is more than
just shutting the barn door after the horses have escaped. Even the
trickle of foreign patients now justifies concern. As well, learning
from the experience helps us prevent its reoccurrence.
Moreover, there remains an international dimension of the problem in
other forms. Drug companies continue trials in China of
anti-rejection drugs. Chinese transplant professionals interact with
their colleagues abroad. They continue, for instance, to show up at
international conferences.
The contact Chinese transplant professionals have with their
colleagues abroad presents opportunities as well as problems. The
Chinese health system is now prepared to acknowledge that organ
transplants come mainly from prisoners, though they contest the
sourcing from Falun Gong prisoners.
Chinese health professionals also concede that sourcing organs from
prisoners is wrong and should cease. Deputy Health Minister Huang
JieFu, in a talk he gave in Madrid in March 2010, stated that executed
prisoners is "a source that does not comply with international ethical
and standard of practice".
This dual admission means the international community can press the
end of transplant abuse in China without meeting with denials and
intimidation, the typical Chinese government/party response to
concerns about other forms of human rights abuse. Regrettably, all
too many people are misled by Chinese party/state denials or cowed
into silence by Chinese official political and economic bullying. It
should in principle be possible to gather together a larger coalition
in support of ending an abuse in China the government of China
acknowledges exists and is wrongful than the abuses the party/state
covers up.
To deal with international organ transplant abuse in China, and
learning from the China experience, I propose these fifteen steps:
1. Parliaments should pass extraterritorial legislation banning
transplant tourism. Belgian senator Patrik Vankrunkelsven and
Canadian Member of Parliament Borys Wrzesnewskyj has each introduced
into the Parliament of his country extraterritorial legislation
banning transplant tourism. The proposed legislation would, when
enacted, penalise any transplant patient who receives an organ without
consent of the donor where the patient knew or ought to have known of
the absence of consent.
2. State health funding systems should not fund abusive organ
transplants abroad. Parliaments should prohibit private insurance
from funding abusive organ transplants abroad. Israel has passed
legislation which prevents private insurance companies for paying for
black market organ transplants.
3. International brokerage of organs should be prohibited. Israel has
such a law .
4. Doctors should not prescribe drugs which will be used during the
transplantation of a purchased organ. The Canadian Society of
Transplantation and Canadian Society of Nephrology released a policy
Statement on August 17, 2010 on organ trafficking and transplant
tourism containing that policy.
5. Doctors should have the right to choose not to provide medical
records to patients if they believe the information will be used in
support of an illegal transplant performed in an unregulated system
and that there is a significant risk of harm to the patient or organ
vendor. This is another element of the Canadian policy.
6. In non-emergency situations, doctors should have the right to
choose to defer care to another physician for a patient who may have
obtained an organ through transplant tourism. This is a third element
of the Canadian policy.
7. Pharmaceutical companies should not support directly or indirectly
the harvesting of organs from prisoners as part of the research and
marketing of anti-rejection drugs. The Swiss section of Amnesty
International on August 13, 2010 issued a statement stating that
position.
8. Pharmaceutical companies should adopt common guidelines approved by
independent experts to avoid complicity in abuse. This is another
element of the Amnesty International August statement.
9. Pharmaceutical companies should adopt a moratorium on clinical
testing of organ anti-rejection drugs in China. The global drug
company Novartis announced, according to a newspaper report published
August 15, 2010 , that it was adopting such a moratorium and would
work to unite all pharmaceutical companies on the issue.
10. Presentations of studies involving patient data or samples from
recipients of organs or tissues should not be accepted unless the
presenter can satisfy the host beyond a reasonable doubt that the
sourcing of the organ is not abusive. The Transplantation Society has
a policy like that, but which does not address directly the issue of
onus.
11. Collaboration with experimental studies should not be considered
unless the foreign collaborator can satisfy the local collaborator
beyond a reasonable doubt that no material is derived from abusive
organ sourcing. The Transplantation Society has a policy like that
too, but without reference to onus.
12. Local hospitals should not be training foreign transplant surgeons
unless the local hospitals are satisfied beyond a reasonable doubt
that the foreign doctors have not participated in and will not
participate in abusive organ transplant surgery. The major transplant
hospitals in Queensland, Australia have banned training Chinese
surgeons .
13. The Government of China should make transplant data publicly
accessible. The Chinese health system runs four transplant
registries, one each for liver, kidney, heart and lung. Three are
located in mainland China - kidney and heart in Beijing and lung in
Wuxi. The Liver Transplant Registry is located in Hong Kong. The
data on the Hong Kong registry used to be publicly accessible but is
no longer. The data on all sites is accessible only to those who have
registry issued login names and passwords.
14. The Government of China should make public death penalty
statistics. Right now China does not publish official death penalty
statistics and refuses to do so. At the United Nations Human Rights
Council Universal Periodic Review for China in February 2009, six
different countries - Canada, Switzerland, United Kingdom, France,
Austria, Italy - recommended that China publish these statistics. The
Government of China publicly and explicitly rejected this
recommendation.
From unofficial Amnesty International death penalty statistics, there
appears to be a massive discrepancy between sources of organs and
volumes of transplants. Publication of death penalty and transplant
statistics would either dissipate the appearance of discrepancy or
require an explanation for it.
15. The international transplant community should press China to end
abusive organ transplantation now, not sometime in the future.
Chinese government health officials indicate that, through the spread
of donations and an eventual enactment of a law allowing for sourcing
of organs from the brain dead cardiac alive, the practice of sourcing
organs from prisoners will cease. But in this area, ending the abuse
tomorrow is not good enough. The abuse should end immediately.
David Matas is an international human rights lawyer based in Winnipeg,
Manitoba Canada.