HEAD on New DOH Order: “Regulating or Legalizing Organ Trade?”

The much publicized administrative order by the Department of Health allegedly aimed at eradicating the thriving black market of kidney trade may yet result in the exact opposite: the legalization and facilitation of the sale of kidneys and other human organs.

Health Alliance for Democracy (HEAD) warned that this administrative order is a red herring that contains contradictory provisions and paves the way for the virtual legalization of organ trade under the pretext of “management and regulation”.
“We must scrutinize not only what is written but also what is not written in order to arrive at the real nature of this order.” according to Dr. Gene Alzona Nisperos, HEAD secretary-general.

The DOH has touted the AO as the order meant to stop the trade of kidneys and illegal organ trafficking. However, nowhere in the text of the AO are “kidney sale” or “trade and commerce of kidneys” defined or clarified. The term “gratuity” is used but is also vague since the text does not mention anything on what the DOH regards as “acceptable compensation” for the donor. Even in broad strokes, there is no description as to how the DOH seeks to stop kidney trade outside the creation of a board.

“The lofty guiding principles and general policy statements contained in the DOH order are rendered inutile in the absence of clear-cut parameters and limits that should be set in very clear, unconditional terms to actually stop the trade of kidneys and other human organs. Otherwise, what are they really talking about?” said Dr. Nisperos.

Moreover, the AO delineates not only between Living-Related Donors (LRDs) and Living Non-Related Donors (LNRDs) but also between “Directed Kidney Organ Donor” and “Non-Directed Kidney Organ Donor”, which was not present in the superseded AO (AO 124 series 2002).

“90% of kidney transplantations here are from living donors, of which 68% are from LNRDs. This is a whooping 56% increase from 2002 and confirms the overwhelming demand for organ donors.” Added Dr. Nisperos, “This is where exploitation is rampant, as most LNRDs come from the ranks of the poor and marginalized.”

Similarly, “Directed Kidney Organ Donor” means “someone who has a specific recipient in mind to donate to.” This debunks the initial impression that kidney donations will now be more equitably allocated and where Filipino recipients “shall be given priority in the donor allocation.” “Directed Kidney Organ Donor” essentially means that the donor designates the recipient, which further cultivates a pro-rich bias and rampant abuse of the poor.

Thus, HEAD believes that the DOH order not only intentionally misdirects public attention but also preconditions the public to accept LNRDs with directed organ donation, which will still benefit foreign medical tourists and rich Filipino patients, for as long as there is the erroneous notion that ordinary Filipino patients are given equal treatment. The truth is that only non-directed kidneys organ donations will be centralized and “belong to the community...that will be allocated fairly among recipients”.

In short, the current problematic, biased, and exploitative situation remains.
The new AO also creates several new layers machinery, including super-bodies that will implement this order. The Philippine Network for Organ Donation and Transplantation (PhilNETDAT), for example, has the authority and budget of an implementing body but has no clear composition, tenure, and accountability. It can be used by illegal organ traders and black market operators to enter the new processes and legalize their operations.

“The new DOH AO does not offer anything new to address the prevailing problems posed by kidney and organ trade. The DOH fails to confront this complex problem because of its own inherent biases and interests.” concluded Dr. Nisperos. “At best, the AO is just another deceptive government propaganda that should be junked altogether.”