Tuesday, July 04, 2006

The Lucrative Kidney Market

Shahram Rafiizadeh, Rooz Online:
In 1968 Iranian physicians in Shiraz succeeded in performing the first kidney transplant. According to available statistics, there were between 60 to 80 kidney transplants a year in Iran prior to the 1979 revolution that toppled the monarchy. Since 1984 however and with the creation of the first training center for kidney transplants in Iran, this number has been steadily rising so that today there are about 1,800 such transplants in Iran, in the words of the Association for the Support of Kidney Patients. There are now some 25 such centers scattered around the country.

Even though Iran ranks fifth in the world in kidney transplants, according to officials at Iran’s ministry of health, experts estimate that the number of patients with kidney problems will rise to 40,000 people in the country in 5 years time. Critics argue that despite the 18,000 transplants, some 95 percent of donors are healthy individuals and not terminal patients.

During the 8-year Iran-Iraq war, kidney transplanting was a very serious problem in Iran because while there were many patients who needed a kidney, there were very few ‘relative’ donors. With the efforts of the government, non-relatives too were soon allowed to provide kidneys to patients and the government even provided monetary compensation and incentives to donors. Dr Faze says in this regard that in Iran the provision of donors who are alive and healthy is a unique situation as this has not led to a commercialization of the exchange, unlike other countries. This arrangement has even become known as the Iranian model in medical circles,” according to Dr Fazel. Dr Vladimir Lepakhin a World Health Organization official had said in February of 2005, “I am proud to make a reference to a system that has been designed and implemented by the Islamic republic of Iran in which kidney patients have access to kidneys belonging to non-relatives. In this fashion, Iran has succeeded in eliminating the long waiting period that exists for a kidney in other countries.”

But is this the whole picture? Officials from the Association for the Protection of Kidney Patients have repeatedly called on the government to stop compensating donors with a million Toman. Dr Mostafa Ghasemi, a doctor with the Association recently said that the government’s payment of this money has actually increased supply of donors to the extent of misbalancing the situation. According to him, donors did this for free in the past, and now those who would have done so gratis, expect monetary compensation. Furthermore, these donors are now demanding four times the amount, i.e. 4 million Toman per kidney.

Only 5 percent of donors are the terminally ill. Each kidney today is traded at 3 to 10 million Toman, which is obviously done discreetly. The ‘Iranian model’ has caught the attention of others outside Iran. There are no reports that there is a demand for Iranian kidneys from outside the country. And because there is an official ban on the export of kidneys, such deals take place secretly. An Iranian kidney is priced at about $20,000 in the black market. A recent rule by the Ministry of Health has stressed the illegality of such deals reminding those responsible that kidneys could only be traded between those of similar nationality, unless specifically approved by officials. Advertising the donation of kidneys is illegal in Iran and carries heavy penalties. READ MORE

An additional twist to this market is that drugs associated with kidney transplants and illnesses too have entered the black market now. Just recently, Gassemi announced that the non-importation of the principal kidney and dialyses drug into the country threatens the lives of thousand kidney patients. He added that Iranian officials had advanced the import of Cuban kidney drugs into the country, while in Cuba itself only 7 percent of patients used these drugs.
Another illustration of the terrible economic problems inside of Iran, people selling their kidneys to make ends meet.