Impact of legal measures prevent transplant tourism: the interrelated experience of The Philippines and Israel

Abstract

We describe the parallel changes that have taken place in recent years in two countries, Israel and The Philippines, the former once an "exporter" of transplant tourists and the latter once an "importer" of transplant tourists. These changes were in response to progressive legislation in both countries under the influence of the Declaration of Istanbul. The annual number of Israeli patients who underwent kidney transplantation abroad decreased from a peak of 155 in 2006 to an all-time low of 35 in 2011 while in the Philippines the annual number of foreign transplant recipients fell from 531 in 2007 to two in 2011. The experience of these two countries provides a "natural experiment" on the potential impact of legal measures to prevent transplant tourism.

The Doha Donation Accord Aligned With the Declaration of Istanbul

“…Furthermore, the number of related living donor kidney transplants has quadrupled over the last 12 months. The proportion of Qatari citizens in need of transplantation who choose to be waitlisted in Qatar has risen from 21% in 2010 to 73% this year, consistent with international findings that strengthening national programs discourages transplant travel (9).…”

The global diffusion of organ transplantation: trends, drivers and policy implications

“…The Philippines implemented an expanded anti-human trafficking law in 2009 21 . Parallel efforts to curb transplant tourism by major exporters of recipients have also influenced these trends 22 . In China, declining rates of deceased donor transplantation coincided with a shift away from donation by executed prisoners, the implementation of laws limiting transplant tourism, and the closure of transplant programmes that failed to comply with new regulations 23 .…”

Financial Incentives for Living Kidney Donors: Are They Necessary?

“…56 The removal of options to purchase organs at home or overseas is associated conversely with increased living related donation, as seen recently in Israel and Qatar. 57,58 Arguably, if the supply of kidneys from paid donors is sufficiently large, this could compensate for any crowding-out effect on altruistic living donation. 6,55 However, it is plausible that financial incentives for living donation might also negatively affect the public's willingness to participate in deceased donation due to change in its perceived social value or distrust in organ procurement programs.…”