Hold your applause for China’s organ donation reforms, human rights advocates say

Fang Hui shows off the scar after an operation where she received a portion of her sister's liver. China claims it ended the harvesting of executed inmates’ organs for transplants in January 2015. File 2013. (AP Photo/Ng Han Guan, File)

Chinese officials promised this week that they no longer harvest organs from executed prisoners, and their international medical guests seemed eager to believe them.

“Since 2015, I can guarantee that in our system, 100 percent are voluntary citizen donors,” Huang Jiefu, director of the China Organ Donation and Transplantation Committee, told reporters in Beijing at the first international organ donation conference hosted by mainland China, Reuters reported.

Doctors and surgeons from international organizations, including the World Health Organization (WHO) and Montreal-based nongovernmental organization The Transplantation Society (TTS), attended the conference from Monday to Wednesday.

“You are taking this country to a leading position within the transplantation world,” said Jose Nunez, an adviser to the WHO on organ transplants, according to the Associated Press.

Nunez and others commended the reforms touted by Huang since last year’s official ban on procuring organs from executed prisoners, a practice that many human rights advocates and members of the medical community fear promotes the death penalty, coercion and even extrajudicial executions.

“It’s been good to see that this debate is moving on beyond the first big issue, which was where were you getting your organs from,” said Philip O’Connell, former president of TTS, according to Reuters.

Yet just two months ago, while still president of TTS, O’Connell publicly rebutted state-run media assertions that The Transplantation Society’s decision to hold its annual International Congress in Hong Kong meant the global community had “truly accepted” China’s transplant program.

“I have to tell you that there remains, in many sectors, a deep sense of mistrust of your transplant programs,” O’Connell told the congress in August.

That skepticism is not unfounded.

After years of denial from government officials, Huang – then, vice minister of health – publicly admitted in December 2005 that China was harvesting organs from executed prisoners.

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In 2007, in an effort to curb illegal trafficking, the government banned transplants from living donors not related to the recipient. But according to a 2011 paper co-authored by Huang in the Lancet, 65 percent of all transplants in China were obtained from deceased donors, and more than 90 percent of those came from executed inmates. That means less than 42 percent of all donations were ethically acquired.

Despite China’s proclamations of having the largest donation system in Asia, third-largest in the world, many wondered how the government would fill the deficit left by the 2015 ban on prisoner organs. Not only is there a cultural stigma that discourages donations, but by its own figures China has one of the lowest rates of organ donation in the world.

To compare, the U.S. – with around 300 million people – reported 15,070 donors for nearly 31,000 transplants. China, with a population of more than 1.3 billion, reported 2,766 voluntary citizen donors in 2015 for about 11,000 transplants, according to the WHO.

But even those numbers have come under fire. A report published in June claimed that China’s official transplant numbers should actually be closer to 60,000 to 100,000 transplants year, with organs from prisoners – particularly those of conscience – filling the supply gap to meet the demand.

“Simply by adding up a handful of the hospitals that have been profiled in this [report], it’s easy to come up with higher annual transplant volume figures than 10,000,” the report said.

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So, when Beijing’s guests handed out verbal gold stars this week – like Marti Manyalich, president of the International Society for Organ Donation and Procurement, who said, “China, from what I have observed, fully abides by international standards,” – human rights advocates were quick to challenge their experience, calling them “delegates in rose-colored glasses.”

“Instead of providing conditions that allow transparent access and independent scrutiny, China used preselected, handpicked individuals from supportive organizations as a shield against real investigation,” Doctors Against Forced Harvesting wrote in a statement on Wednesday.

But perhaps the delegates aren’t playing into China’s narrative as naively as critics might assume. Perhaps they, whose approval China seeks, have chosen to adopt a strategy of influence.

“The options are that you completely isolate someone, which means that generally their practices get compounded, or you engage with them and you tell them your point of view and explain why it would be better for them to change,” said O’Connell, according to the AP. “That is, I think in simple terms, what we’re doing.”

Human rights lawyer and co-author of the June report, David Matas, contended that there are other better options, like empowering victims, addressing the public and leveraging approval for transparency.

“The notion that you can have an island of respect for human rights principles in the transplant profession amidst this raging sea of tyranny is a delusion,” said Matas in an interview with Humanosphere. “They’re not going to change just alone in the transplant field. The mass killings of prisoners of conscience for their organs is not just a transplantation problem. It’s a political problem deeply embedded within the Communist Party system.”

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About Author

Joanne Lu

Joanne Lu is a South Carolina-based writer and editor dedicated to global development, poverty alleviation and social justice. After a year in Rwanda, she now covers the Asia-Pacific and economics. Find her on Twitter @joannelu or email joanne@humanosphere.com.

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