Friday, September 28, 2007

Human Organ Transplantation Ordinance

Those involved in unethical practices have strong political backing
Public sector health care facilities to emerge as leaders in organ transplantation claims
Federal Health Minister

NIH at Islamabad to have central registry where details of all transplants done in Pakistan will be recorded
Human Organ Transplantation Ordinance has offered a lot but there is still room for improvement- Prof. Adeebul Hassan Rizvi

KARACHI: After the promulgation of the Human Organ Transplantation Ordinance 2007, sale and purchase of human organs the kidneys in particular will come to an end and public healthcare facilities will emerge as leaders in transplantation. This was stated by Federal Health Minister Mr. Naseer Mohammad Khan while addressing a press conference at NICVD campus on September 6th 2007. Federal Health Secretary was also present on this occasion. He also disclosed that a central registry is being established at National Institute of Health in Islamabad which will record the details of transplants being performed at different centers all over Pakistan. These centers will pass on the relevant information to this central registry within twenty four hours, he added.

The federal government will inspect and accredit all those healthcare facilities where transplantation will be permitted to ensure that they have the requisite trained manpower, surgical expertise and other facilities. From now onward only these designated health centers will be able to perform transplants. Those found involved in Kidney and other organ trade will get severe punishment including fine and imprisonment as mentioned in the said Ordinance, which has become effective with immediate effect. All these details are also being passed on to the Embassies so that those coming from overseas for transplants are fully aware of it. Pakistan had become an Organ Bazar and it was bringing lot of bad name to the country. We want to ensure that only ethical transplantation activities are permitted and transplantation tourism which promotes commercialization in this field is effectively checked. In the past the vested interested and agents have been depriving poor people of their kidneys and later on these donors were left at their own. Some members of the medical profession and hospitals were also involved in this unethical practice. Under the Ordinance the government will provide facilities for the welfare of the donors, provide them medical care and other facilities. Evaluation committee at each transplant center will select the donors carefully to make sure that there is no commercial transaction between the donor and recipients. Blood relations and those from the family will be preferred as donors. Donor banks are planned to be established.

Different committees including the monitoring and evaluation committee will be constituted at the federal and provincial level besides constitution of evaluation committees at the transplant centers which will have their own Ethics Committees. Hopefully all this will be accomplished in the next couple of weeks, he added. Under the new circumstances, kidney transplants in the private sector are likely to reduce significantly while it may pick up later when more and more centers fulfill the provisions laid down in the Ordinance. Efforts will be made to have more transplant centers in the public sector.

The Federal Health Minister’s attention was also drawn towards the fact that no action was being taken against the members of the medical profession involved in unethical medical practice and pharmaceutical companies involved in unethical marketing practices. At this he responded by saying that unfortunately all these doctors who indulge in unethical practices have very powerful political backing and at times it becomes very difficult to take any action against them. Same is true as regards the pharmaceutical companies but promised that the Federal Health Ministry was monitoring the situation and suitable measures will be taken. The Minister was reminded that whether it is the sale and purchase of kidneys related to Human Organ Transplantation, functioning of the Pakistan Medical and Dental Council, Recognition of private medical and dental colleges or supply of substandard drugs to PIMS at Islamabad, all these issues were first taken up by the Chief Justice of Supreme Court of Pakistan who issued directives on which the Federal Health Ministry had to act. Why the FHM does not take up these issues on its own? The Human Organ Transplantation Ordinance has been lying with the Senate for almost over ten years and even the present assembly is completing its term of five years but it never took up this issue. The government acted only when the chief justice gave the government a month’s notice which was to expire on September 3rd that the President issued the Ordinance on the last day. The Federal Health Minister could not come up with a satisfactory answer but hastened to add that the Senate has discussed it, later the Select Committee on Health in the National Assembly also approved it, it was passed by the cabinet and all this did take some time. When asked what will happen after four months when the Ordinance will relapse or will the National Assembly where this Ordinance has already been tabled, approve it in its next sitting, he did not give any assurance but added that efforts will be made to include this in the next session of the National Assembly agenda.

Prof. Adeebul Hasan Rizvi Director SIUT also joined in at the last minute. Replying to the various questions regarding Human Organ Transplantation Ordinance 2007, he remarked that the Ordinance has given us a lot and we must welcome it. However, he hastened to add that there is still lot of room for improvement. He hoped that continuous pressure by public, civil society in general and media in particular augers well for its implementation. I am very hopeful that the government will ensure implementation of the relevant provisions of the Ordinance in its letter and spirit. At the SIUT which only perform kidney transplants with live related donor kidneys, hundreds of people also get dialysis facilities absolutely free daily. That is why only a few people go to private hospitals for dialysis. If facilities in the public sector are improved and expanded keeping in view the disease burden, not many will go to the private hospitals, Prof.Adeeb Rizvi remarked. It is only when the public sector health care facilities are not enough, patients are forced to avail the facilities at the private hospitals, he added.

Preventive measures to reduce the disease burden of kidney diseases like use of healthy diet, reduction in weight, taking care of obesity, controlling diseases like diabetes mellitus, high blood pressure etc., which give rise to acute renal failure and end stage renal failure were also highlighted. Media was asked to play its role in educating the masses regarding preventive measures.

It may be mentioned here that the original draft of the Human Organ and Tissues Transplantation Ordinance 2007 had many lacunas and it was felt that this will in fact legalize the sale and purchase of human organs instead of checking this. Later the draft was amended to remove the objections raised by the transplant surgeons, members of the National Bioethics Committee and other members of the Civil Society.

- - - - - - - - - - - - - - - - - - - - - - - - - -

No comments: