Revisiting Transplant Tourism Regulations in the Philippines

Abstract

Introduction: With the harmonization of the Philippine regulations with the Istanbul Declaration in 2008, transplant tourism became illegal in the country and foreign transplant tourism was controlled in 2011. However, due to the challenges and believed complacency to monitor the practice resulted in undetected inbound and outbound transplant tourists in the Philippines. Weakness in the Philippine regulatory oversight makes the country appealing for exploitation by international and domestic criminal networks involved in trafficking in persons for organ removal. Thus, this research will investigate how to improve the regulatory implementation to control transplant tourism in the country. Materials and Methods : Case study method was used with 22 interviews among government officials, transplant surgeons, nephrologists and representatives of non-government organizations. NVIVO 11 software and thematic analysis were used in the data synthesis. Results and Discussion: There are 4 themes that emerged from the data and are made as the priority areas for improvement, namely: prevention, protection, prosecution, and partnership. By using the public health perspective, transplant tourism could be prevented in the Philippines if the demand for end-stage organ disease could be decreased through healthy lifestyle advocacy and the supply for transplantable organ could be increased through mandated choice, deceased donation, and kidney paired exchange within the Philippines. Philippine Health Insurance Corporation needs to subsidize the full transplant cost and lifetime immunosuppressant drugs of indigent Filipino kidney patients so they will not be lured to participate in global kidney exchange. The Philippine system to protect trafficked individuals is keen on women and children, and there is a need to put a protection system for male trafficked victims since most of the trafficked persons for organ removal in the Philippine are male. Commendable efforts have been done to prosecute trafficking perpetrators in the Philippines, however, no one has been prosecuted for trafficking in persons for organ removal. There is a need for a collaboration among the health professionals and the law enforcers and the development of a referral mechanism once there is a suspected case of trafficking in person for organ removal. A multidisciplinary partnership is needed, from the health personnel, law enforcers civil society, immigration and airport personnel, academe and professional societies. Collaboration among stakeholders at the international, national and local levels is also crucial. Conclusion: Unless the Philippine government addresses the existing undetected outbound and inbound transplant tourists in the Philippines, exploitation among vulnerable groups will continue. This is a call to improve the country’s regulatory implementation by considering the policy recommendations in this research.