Wednesday, 5 December 2018
Foreign Affairs, Defence and Trade Joint Committee; Report
On behalf of the Joint Standing Committee on Foreign Affairs, Defence and Trade, I present the report of the Human Rights Sub-Committee on the inquiry into human organ trafficking and organ transplant tourism, and I move:
That the Senate take note of the report.
I seek leave to incorporate in Hansard a tabling statement, which has been supported by the government in advance.
The statement read as follows—
Acting President, it is my pleasure as a member of the Human Rights Sub-Committee of the Joint Standing Committee on Foreign Affairs, Defence and Trade to present the Committee's final report for the inquiry into human organ trafficking and organ transplant tourism.
The development of human organ transplantation surgery over the past half century has been a blessing for hundreds of thousands of otherwise terminally ill patients all over the world. Since the first kidney was successfully transplanted in 1954, organ transplantation techniques and anti-rejection medications have rapidly developed. The act of organ donation is a tremendous demonstration of the power of compassion to transform the lives of many people.
Australia has a lot to be proud of in the field of organ transplantation. We are a world leader in successful transplant outcomes, and since the implementation of the Organ and Tissue Donation Reform program in 2008, our donation rate has more than doubled.
Australian researchers, doctors and surgeons have led the world in terms of liver transplantation techniques in particular. Australian surgeons have pioneered paediatric liver transplants, segmented liver transplants and, notably, in 2006 at the Royal Prince Alfred Hospital in Sydney, a world first kidney-liver-pancreas transplant was successfully undertaken.
In 2017, 1,675 Australian lives were transformed by 510 deceased and 273 living organ donors. There were 832 kidney transplants, 281 liver transplants, 206 lung transplants, 98 heart transplants, 51 pancreas transplants, and 1 small intestine transplant. Each of these transplants represents multiple changed lives — not only of recipients and donors, whether deceased or living; but their families, friends, neighbours and colleagues. Organ donation and transplantation touches entire communities.
Unfortunately for those Australians waiting for a new organ, demand for donor organs still outstrips supply. Around 1,400 Australians are currently waitlisted for a transplant. A further 11,000 are on dialysis, many of whom would benefit from a kidney transplant. It can take years for a suitable organ to become available, the average waiting time for a kidney transplant is 3 years. Approximately one person each week will die before they are able to receive an organ transplant.
This shortfall is common to many countries around the globe, even those with a donor program. But there are still countries who have no organ donation and transplant program whatsoever. It is this gap between the number of people requiring organ transplants and the limited supply of freely donated organs, which has generated a black-market trade in human organs throughout the world. With increased access to international markets thanks to cheap air travel, and the ease in which potential donors may now be located thanks to improvements in internet connections, organ trafficking has increasingly become a major problem for the international community.
In this illicit commercial market of organ trafficking and so called transplant tourism, desperate people, often facing certain death without a transplant, may travel far from their own countries to places such as Egypt, the Philippines, or Pakistan, paying tens of thousands of dollars and more, for an organ transplant where the donor is most likely in dire financial straits, possibly exploited and unable to give free and informed consent to donation. The recipient faces much higher risks of infection and insufficient post-operative care than they would receive here in Australia.
Organ trafficking, the unethical removal, transfer or commercialisation of human organs for transplantation outside legal frameworks poses severe risks for both organ recipients and donors. It is an illicit trade that changes over time with developments in transplantation surgery techniques, the availability of medical infrastructure, uneven economic development, migration patterns, demographic trends, socio-economic exclusion, and the evolution of national and multinational criminal networks.
This inquiry by the Human Rights Sub-Committee of the Joint Standing Committee on Foreign Affairs, Defence and Trade was prompted, in the first instance, by longstanding allegations by non-government organisations and individuals about alleged human organ harvesting and trafficking occurring in one specific country, but, it quickly became clear, especially through input from expert witnesses, that human organ trafficking is a broad international problem encompassing many countries around the world. The organ trade has evolved and continues to evolve under the influence of forces of demand and supply, technical and medical advances, as well as changes in national and international regulation and law enforcement.
The Sub-Committee has heard from medical practitioners, international bodies, government agencies, and human rights advocates. Their evidence was consistent: organ trafficking is a violation of the rights and dignity of people, and Australia must do more to stop people in our community travelling overseas to support it.
What has also come to light, is that judgements made about the extent and geographical focus of organ trafficking and transplant tourism a decade or more ago may have limited validity in relation to present trends and circumstances, and this report demonstrates that without the collection of accurate data and adequate analysis, solutions will be difficult to create.
The evidence indicates that past practices in China involved the use of organs taken from executed prisoners. Evidence from some submitters reveals that this practice has changed—this needs to be vindicated and monitored.
This report examines the global prevalence of human organ trafficking and the scope of Australian participation within this illicit trade. The report further considers international frameworks to combat organ trafficking and organ transplant tourism and specifically recommends that Australia sign and ratify the Council of Europe Convention against Trafficking in Human Organs.
The report further recommends that the Australian Government pursue a range of measures to strengthen Australia's involvement in international efforts to combat human organ trafficking, improve relevant data collection, support public health education programs, strengthen Australia's legal prohibitions on organ trafficking, and thoroughly investigate reforms that would enhance Australia's domestic organ donation program.
It should be noted that surveys show the majority of Australians - approximately 70 per cent – are willing to donate their organs and/or tissue when they die. In Australia, 90 per cent of families say yes to donation when their loved one is a registered donor.
Despite this apparent support for organ donation, and a majority of Australians believing that registering is important, only one in three Australians are registered as donors. While 71 per cent of Australians think it is important to talk about organ donation with their family, only half – 51 per cent – of Australians have held this discussion about whether they want to be a donor with their loved ones.
This report largely deals with measures that are aimed at suppressing human organ trafficking and transplant tourism. However, a comprehensive solution to this grim trade must involve increasing Australia's rate of organ donation and harnessing the goodwill and overwhelming support of the community to ensure Australians can receive a life changing organ transplant at home, without ever needing to consider entering the murky world of black market organ transplantation.
Compassion, not commerce is the key.