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.
