Organ commerce rears its ugly head again

This week in Health Matters: Russia’s promise of ‘cancer vaccines’, gender blindspots in health policy and unlocking the mysteries of the brain.

This week in health: gender blindspots in health care, Russia’s promise of ‘cancer vaccines’ and unlocking the mysteries of the brain.

This nation has an embittered history with reference to illegal organ trade. Media in the 90s were rife with stories about organs being stolen from the poor or literally taken without significant compensation, to be used for those waiting for an organ transplant in hospitals. Localities in the southern capital of Chennai, which also has a flourishing private health care sector, came to be nicked ‘Kidneyvakkam’, because of a rampant trade in kidneys. Investigations revealed how people had been defrauded after being promised a lot of money for a kidney and how quality of life deteriorated rapidly for the poor who had been wrested of their kidneys. The change in the game happened thanks to the Transplantation of Human Organs and Tissues Act, known in short as the TOHA Act, passed in 1994. It criminalised organ trade, buying and selling of organs, and insisted that altruistic donation or relatives alone could attempt to provide an organ in a living donor case. Attempts to strike at the root of the problem, stringent enforcement, and the TOHA Authorisation Committee’s iron hand (in most States) in whetting unrelated donor transplants, resulted in many hospitals losing their licence and an extensive awareness post-the Act intended to head off the gullible from selling their kidney for money. While it is impossible to say with certainty, in a country of this size and diverse quality of governance, that it rooted out the problem in its entirely, it certainly made organ trade less fanciful at a commercial level. It was likely pushed underground, and the violations, ostensibly, few and far between. 

But no one was very surprised when a media investigation of an organ racket involving the people of Myanmar, broke in December last. The London-based The Telegraph alleged that Myanmarese were being brought into Delhi’s Apollo Indraprastha Hospital and being relieved of their kidney, for a consideration. Following this, the government ordered a probe. We did not hear of the results of the probe, but interestingly, last week, in a follow-up, Bindu Shajan Perappadan reported on the Health Ministry’s warning that there are possible commercial dealings in organ/tissue transplantation of foreigners in India. Health Secretary Apurva Chandra, in a written communication, alerted the Ministry of External Affairs of possible violations and asked for support to establish systems for monitoring the process. In an earlier letter he wrote to the Foreign Secretary, Mr. Chandra said: A recent media report has highlighted that in some cases the veracity of the documents to establish relationship between the donor and the recipient, their identity documents, proof of residence etc. cannot be established confidently and the same may not be genuine.

Time is of the essence here, any such organ racket must be nipped in the bud and measures taken to ensure that this incident does not lead to a spurt in other centres across the country. Stamping this out here, and now, using all the tools available to the government is an urgent issue that needs to be addressed. 

On the other spectrum of donations, Afshan Yasmeen reports that the family of a patient with Huntington’s Disease (HD) donated the brain to NIMHANS for research. Huntington’s Disease is a rare inherited disorder that causes progressive neuro-degeneration, and human understanding of the disease is limited to offering treatments for symptoms. Doctors at NIMHANS said this was the first brain donation at NIMHANS of a patient with HD. The patient had expressed her willingness to donate her brain after her demise for research, so doctors could figure out the disease better, and help others in the future, and her family complied. 

In vaccine news, interesting analyses are brewing on the efficacy of COVID-19 vaccinations and their side effects, but more on this, perhaps next week. This week, read on to catch the key points that former WHO chief scientist Soumya Swaminathan said on India’s performance (vis-a-vis) developed countries in vaccination against COVID-19, and Vipin M. Vashishtha asks: Does frequently updating COVID-19 vaccines have any benefits? A new study has found that updated vaccines improved neutralising antibody titres compared to non-updated formulations, but the matching problem persists. Now, what is the matching problem? Researchers update the composition of influenza vaccines every six months to match the strains of the virus that are circulating in the wild, so that the shots may provide protective immunity against the flu. But despite their best efforts, researchers rarely perfectly match the strains loaded in the vaccine with the strains circulating by the time the vaccines reach the market.

Naturally, let’s segue into the subject of infectious diseases. Last week we looked at Kyasanur Forest Disease, and sounded the alarm on new and reemerging infections, this week, regarding KFD, Seven more cases were reported on February 14. In Alaska, an elderly man was the first reported person to die of the recently discovered Alaskapox virus. Alaskapox, also known as AKPV, is related to smallpox, cowpox and mpox, health officials said. Symptoms can include a rash, swollen lymph nodes and joint or muscle pain. Only six other cases of the virus have been reported to Alaska health officials since the first one in 2015. All involved people were living in the Fairbanks area, more than 300 miles (483 kilometres) from the Kenai Peninsula, health officials said. All had mild cases and recovered without being hospitalised. It’s unclear how AKPV is transmitted but researchers say it may be zoonotic, meaning it can jump from animals to humans. The bulletin said that tests found evidence of current or previous infection in several species of small mammals in the Fairbanks area, including red-backed voles, and at least one domestic pet.