Prime Minister Narendra Modi's push for organ donation needs nationwide support to create possibilities for new lives in a nation where donations are at an abysmal rate of 0.52 per million population.
This is a very significant move, especially at a time when India is leading some of the world's top health initiatives under G-20 programmes.
The Prime Minister probably wants to have a vote to boost the availability of transplant organs by making everyone a potential donor after death unless they - or their relatives - expressly object.
Consider the case of Switzerland, a very small nation compared to India, which has pushed a legal change through 60 per cent of voters in a referendum.
India is also working on a uniform policy to make the process easy and encourage people to adopt life-saving exercises. Already, the government has taken a decision to remove the age bar of less than 65 years for donating organs. The government has scrapped the clause in the National Organ and Tissue Transplant Organisation (NOTTO) guidelines as it violates the right to life.
The condition of state domicile for receiving organs has also been scrapped to allow people to register themselves anywhere in the country. Earlier, an organ recipient could register for a transplant only in their domicile state.
India should make donations mandatory - it is not a political decision. It is a decision for mankind. There is some realisation already in the country. In 2013, there were less than 5,000 cases of organ donations. In 2022 it stands at over 15,000.
Donations for transplants can work if the deceased person consents while alive. If their wishes are not known, it is left to relatives, who in most cases opt against organ donation. But organ donation is service to the nation, because when a person donates one's body, it makes it possible for eight to nine people to have a new life.
The government is making all-around efforts to push the organ donation drive. To create awareness about the need for organ donations, the government has also drafted a chapter to be included in the school curricula for the next academic year. School children need to know the importance of organ donation and initiate similar discussions at home to convince their parents.
People should not die waiting for an organ transplant. The public must know they can give a chance to the people who are on the waiting list. India must push for a system where people who do not wish to become organ donors after death must explicitly say so. It should not be a difficult task. Now those who have not made their wishes clear would be assumed to favour organ donation.
Let me say it explicitly because India is a very sensitive nation. Here, relatives would still be able to refuse it if they knew or suspected the person concerned would have chosen not to donate an organ. So, what should be done? I think the government should push a mechanism to handle such situations. It means in cases where no relatives can be contacted, not a single organ should be removed.
But it is still tough to achieve the moon. Not enough is done in India to create wider appreciation among the masses that after a brain stem death it is possible to harvest organs. The deceased organ donation programme needs a push because Indians continue to suffer from a peculiar mindset that prevents them from allowing organ harvesting from a dead body.
See how fast organs can be harvested from a dead body. Within a few hours, doctors can harvest a host of organs. Yet, it is appalled to see the humongous waiting list for organs in India. According to statistics from December 2022, an estimated 8,000 patients continue to die in India waiting for an organ transplant every month. Also, India has 400,000 registered patients waiting for a kidney transplant.
India must rise to the challenge. The huge gap between demand and supply has stretched the country's living donation programme. A brain-dead person can do wonders, donating - at a stretch - 20 organs and tissues, including heart, lungs, liver, kidney, intestines, pancreas, eyes, heart valves, skin, bone marrow, connective tissue, middle ear, and blood vessels.
India misses out on many opportunities for donations as it lacks systems and audits in tertiary care hospitals. The country must create green corridors in roads and make the process of shifting organs foolproof.
The process of organ retrieval, storage and transplantation is governed under the Transplantation of Human Organs Act and Tissues Act (THOA), 1994. It has been adopted by many states; some have not done it and continue to cause unnecessary confusion. It is essential for the Prime Minister to push for a single nation, single policy process for organ donation and transplant.
Slowly, yet steadily, change is taking place in India. The number of organ transplants has tripled from 4,990 in 2013 to 15,561 in 2022. Of this, only 837 in 2013 and 3,153 in 2022 are deceased organ transplants. This is encouraging, but not enough. That is because the lion's share of the organ harvest was kidney transplants - 11,423 in 2022. This is happening against an estimated 200,000 renal failures annually, thereby underscoring the importance of simplifying the process. It is a herculean task to get people to pledge their organs or volunteer a relative's organs. More than 200,000 Indians require organ transplants every year. But not even one in every 10 manages to get it.
I am reminded of the 1983 Bengali movie, Chokh (Eye) directed by Utpalendu Chakrabarty, which revolved around an eye transplant and how a rich mill owner tries to manoeuvre the medical system to get the eyes donated by a labour union leader sentenced to death. The poor come together to protest, arguing that a poor man's eyes must go to a poor man.
Organ transplants must be made inclusive. It should be like the first shots for the newborn. The Prime Minister must implement the pledge of organ donors, or else unscrupulous operators will make money by harvesting organs at mind-boggling rates.
V Vijayasai Reddy, MP (RS) is Chairman, Parliamentary Standing Committee on Transport, Tourism and Culture.
Disclaimer: These are the personal opinions of the author.
