About the crime

the trade in human organs

Organ trade constitutes the sale and purchase of organs for financial or material gain. The World Health Organization first prohibited payments for organs in its 1987 World Health Assembly Resolution. Despite an almost-universal ban on the trade in human organs, reports indicate its proliferation across the globe.

 

Facts and figures

  • Although reliable figures of the trade’s scope are lacking, the World Health Organization (WHO) has estimated that approx. 5000 illegal transplants are performed annually (WHO, 2007);
  • Based on the estimate of WHO, Global Financial Integrity has calculated that the organ trade ranks in the top 5 of the world’s most lucrative international crimes with an estimated annual profit of $840 million to $1.7 billion (May, 2017);
  • Only 16 convictions involving organ trade have been reported to the case law database of the United Nations Office on Drugs and Crime, which is far less than would be expected based on global estimates of the problem (UNODC, 2024).
  • The Organization for Security and Co-operation in Europe has reported 9 additional cases (OSCE, 2013).

 

The proliferation of the organ trade goes hand-in-hand with the increasing organ scarcity

  • The most frequently reported form of organ trade is the trade in living donor kidneys;
  • Approximately 10% of the world’s population suffers from chronic kidney disease (ISN, 2017);
  • An estimated 2-7 million deaths occur annually because patients suffering from kidney failure lack access to adequate treatment (ISN, 2017);
  • Roughly 300.000 patients are registered on kidney transplant wait lists worldwide (Council of Europe, 2021);
  • Only approx. one third of these patients receive a kidney transplant annually (Council of Europe, 2019);
  • The total number of transplants performed worldwide is estimated to be less than 10% of the global need;
  • Average wait times are 3-5 years and annual mortality rates are estimated to lie between 15-30%.
  • One study has reported that 15 million organs are needed every year to meet the demand for organs (Giwa et al., 2017)

 

Organ trade involves a wide array of activities and many terms are used to denote these, including organ trafficking, transplant tourism, transplant commercialism and human trafficking for the purpose of organ removal. While laws do not always separate organ trade (payments for organs) from trafficking (exploitation), we use this distinction in our research. We utilize the 'human organ trade' as an umbrella term to denote the trade's various activities.

the need for empirical, data-driven research

Many claims are made about the organ trade in the absence of empirical research data. This has strengthened popular notions of the organ trade as an underground, mafia-like crime that exists separately from the medical industry. Common myths surrounding organ trade include generalized depictions of the trade as a crime against humanity (Malek-Hosseini, 2017; Francis & Francis, 2010) and an act of neo-cannibalism and bio-piracy involving 'rogue' doctors (Scheper-Hughes, 2011). These claims have supported a successful lobby by international (transplant) organizations in denoting all forms of trade as "trafficking" and in strengthening laws against virtually all forms of organ trade (Efrat, 2014)

While studies demonstrate that organ trade can constitute serious organized crime (De Jong, 2017; Ambagtsheer, 2017) and that it can involve physical force -even torture (Columb, 2020) and the execution of prisoners (Robertson & Lavee, 2022) - these reports are not generalizable to the organ trade as a whole. Emerging scholarly work points out that organ trade involves a variety of practices which can be placed along a spectrum ranging from excessive exploitation to voluntary, mutually agreed benefits (Ambagtsheer, 2017). These varieties warrant a varied, data-driven response.

This is why we maintain an (empirical) distinction between (allowing) payments for organs and exploitation (human trafficking) throughout our research. We view these acts as separate activities and we do not necessarily regard (allowing) payments for organs as a crime under all circumstances. We also do not regard payments for organs as a form of  'trafficking'.

On this website, we describe the various forms of organ trade separately:

 

As a response to the myths and claims about the organ trade, we highlight empirical work for each form of organ trade under the sub-headings, 'empirical studies'. All publications listed under these headings, for each type of organ trade, describe the data sources and explain how data was collected.

 

Sources

  • UNODC. (2024). United Nations Office on Drugs and Crime. Case Law Database. At: http://www.unodc.org/cld/index-sherloc-cld.jspx
  • Robertson, M. P. and J. Lavee (2022). "Execution by organ procurement: Breaching the dead donor rule in China." American Journal of Transplantation 22: 1804-1812.
  • Council of Europe. (2019). Newsletter Transplant. International figures on donation and transplantation. European Directorate for the Quality of Medicines and Healthcare. Council of Europe. 
  • Giwa, S., Lewis, J.K., Alvarez, L.,  Langer R., Roth, A.E., Church, A.M,  et al. (2017). The promise of organ
    and tissue preservation to transform medicine. Nature biotechnology. Vol. 35, Issue 6, Pages 530-542.
  • Malek-Hosseini, S. A. (2017). "Statement of the Pontifical Academy of Sciences Summit on Organ Trafficking and Transplant Tourism." Int J Organ Transplant Med (IJOTM) 8(2).
  • ISN. (2017). International Society of Nephrology. Global Kidney Health Atlas. At https://www.theisn.org/
  • Ambagtsheer, F. (2017). Organ Trade. Erasmus University Rotterdam. At  https://repub.eur.nl/pub/99988
  • May, C. (2017). Transnational Crime in the Developing World. Global Financial Integrity. At https://gfintegrity.org/
  • Efrat, A. (2014). "Professional socialization and international norms: Physicians against organ trafficking." European Journal of International Relations: 1-25.
  • Office of the Special Representative and Co-ordinator for Combating Trafficking in Human Beings (2013). Trafficking in Human Beings for the Purpose of Organ Removal. Analysis and Findings. Organization for Security and Co-operation in Europe (OSCE). Vienna, Austria. At www.osce.org
  • Scheper-Hughes, N. (2011). "The Body of the Terrorist: Blood Libels, Bio-Piracy, and the Spoils of War at the Israeli Forensic Institute." Social Research 78(3): 849-886.
  • Francis, L. P. and J. G. Francis (2010). "Stateless Crimes, Legitimacy, and International Criminal Law: The Case of Organ Trafficking." Crim Law Philos 4(3): 283-295.
  • WHO. (2007). The state of the international organ trade: a provisional picture based on integration of available information. Bulletin of the World Health Organization, 85(12), 955-962.