What is the issue?
- Foreign nationals have been found to be receiving disproportionately more cardiac transplants over locals in India despite dearth of donors.
- Recently, a controversy has erupted in this regard, opening up a debate that could help in correcting the faultiness in our transplantation policy.
What are the problems in the India’s current transplant policy?
- India’s organ allocation program currently lacks transparency.
- While Tamil Nadu has one of the best “deceased donor programs” in the country, there are some concerns regarding alleged preferential allocations.
- Recently, the controversy has heated up due to a leaked communication from the head of the “National Organ and Tissue Transplant Organisation”.
- As public credibility is vital for the sustenance of any program, faith among the masses needs to be restored at the earliest.
Why are foreigners getting more transplants done?
- While there is a foreigner skew for recipients across organs (liver, kidneys etc...), the trend is pronounced in heart transplants.
- This is because, unlike others, heart transplant require a deceased donor, which is difficult to spot in countries that don’t have dedicated programs.
- So patients with advanced heart failure from countries that don’t have a deceased donor programme have no option but to try their luck in India.
- As most heart transplants are performed in corporate hospitals, the costs in India are well beyond a large majority of the local population.
- Hence, as affordability among foreign nationals is more, there is a clear skew that is visible among recipients.
What needs to be done?
- For ensuring credibility in the deceased organ donation program, mere calls for transparency in organ allocation won’t work.
- Rampant privatisation has led to a profit oriented approach to health and has thereby financially skewed organ transplants to the rich.
- We will have to ensure that organs will go to those who need them the most rather than to those who can pay for them.
- Subsidising transplantation cost (in private) and quota based organ allocation to public hospitals are some options that can be considered to ensure fairness.
- This would mean, public hospitals should step up their capacity to integrate with ‘deceased donor programmes’ to catch up with their private counterparts.
What is the way ahead?
- One of the reasons behind Europe’s high donation rates is public trust in their respective nationalised health schemes.
- To ensure that such aspects are mimicked in India, we need imbibe among the mass, the feeling of inclusiveness.
- As India has comprehensively embraced liberal markets (even in health), innovative policies are needed to ensure equity in health access.
- Thus far, Tamil Nadu has led the way in deceased donation and also has a good record of public medical institutional infrastructure.
- Hence, its model can become an all India template after some alterations.
Source: The Hindu
