Organ donation and organ trafficking: from dangerous anarchy to problematic equilibrium

After years of increasing dependence on the global organ market, high-income countries with previously high rates of outgoing transplant tourism have recently reduced the phenomenon to marginal levels. Along with other countries they have also promoted and increased recovery from non-commercial sources. Some of the low- and middle-income countries that used to be hot spots for organ trafficking and incoming transplant tourism are now showing some progress too.But things are still far from perfect. Organ trafficking and transplant tourism continue to exist, flourish and retain their hideous expressions even if they now tend to be confined mostly to low- and middle-income countries. Thus, as far as the Western perspective is concerned, the organ market and the non-commercial organ recovery enterprise seem to have reached a convenient balance: the former now complements rather than undermines the latter.This paper describes the current situation with respect to organ trafficking, explains its history, and analyses its implications for the powers in play. While it does not belittle the achievements that have been made in the struggle for a healthy and sustainable transplant practice worldwide, it warns that they remain incomplete, unstable and inequitably concentrated in the West.