Statement of the minister of health of Egypt

egyptThe Declaration of Istanbul has provided an impetus for change in many environments. The following statement from the Minister of Health and Population in Egypt is an important perspective on the need for legislation in the advanced and advancing economies of the world. Egypt has remained one of the few advanced economies with transplantation but without legislation. As a consequence commercial trafficking in humans for the purpose of organ transplantation has flourished, to the detriment of both the patients in need of transplantation and those impoverished people from whom the organs are extracted. The Minister declared:

It is a true pleasure to share Egypt’s milestones on a highly important yet complex and multi-faceted matter, namely: the ethics of organ transplantation.

This issue does not merely have medical aspects, but also social, legal, and psychological dimensions. Despite its value and usefulness as a life-saving and transforming procedure, organ transplantation is sometimes abused and thus raises many ethical concerns. Largely, this is attributed to incidents of malpractices in the medical profession, illegal organ trafficking, commercial trade of organs and transplant tourism.

These condemned malpractices not only violate the principles of equity, justice and respect for human dignity, but also cause a general sentiment of fear and distrust in the whole conduct of organ transplantation.

In Egypt, as well as in many other countries, many would fear being declared dead prematurely or having their death hastened and their organs transferred without their consent. There is lack of awareness about laws and regulations governing the medical practices related to organ transplantation. The public needs to know the demarcation and defining lines between what is ethically and legitimately acceptable and what constitutes organ trafficking. The Egyptian Ministry of Health and Population has undertaken a number of initiatives putting into effect legal instruments governing organ transplantation.

Egypt has been working to terminate illegal practices associated with organ transplantation. Inspection measures have been strengthened and tough penalties against health facilities involved in organ trafficking imposed. Organ transplantation should be made available to all citizens regardless of gender, ethnicity, religion, or social and financial status, all forms of organ trafficking are to be explicitly criminalized and severely punished.

I am pleased to inform you that draft legislation on organ transplant has been prepared and discussed with various stakeholders. The draft law clearly and unequivocally bans all types of advertising or brokerage for the purpose of transplant commercialism or tourism. The proposed legislation seeks also to toughen penalties against all forms of malpractice by any member of the medical profession. In order to minimize the negative consequences of malpractice associated with organ transplant, Egypt endorsed a bill to control living as well as cadaveric transplantation.

At the institutional level, the Egyptian Ministry of Health and Population plans to establish a national transplant committee to supervise all national transplantation activities, to hold the national registry, and to ensure the adoption of high ethical and scientific principles in the field of organ transplantation. In this regard, we shall be guided by the conclusions of the Istanbul Declaration and the World Health Organization Guiding Principles on Human Cell, Tissue and Organ Transplantation. The determination of the medical and psychosocial suitability of the living donor should be guided by the recommendations of the Amsterdam and Vancouver Forums.

It is crucial that mechanisms for informed consent should incorporate provisions for evaluating the donor’s understanding of the donation procedures, including assessment of the psychological impact of the process, and to ensure that the donor is fully informed of the consequences of his or her decisions. Moreover, all organ donors should undergo psychosocial assessment by mental health professionals during screening tests.

I stress two major points.

• Firstly, organ trafficking and commercial organ transplantation do not happen in vacuum. Economic, social and poverty factors contributing to the unethical phenomena must be identified and addressed. In other words, fighting organ trafficking requires an integrated approach and concerted efforts by all relevant stakeholders.

• Secondly, the Egyptian Ministry of Health and Population takes seriously its responsibility to protect and preserve the life and health of every Egyptian citizen. This will be our mandate and guiding principle throughout all our organ transplantation-related activities.

In conclusion, our vision is clear, our resolve is strong and our momentum is unstoppable. With partnership and support, I am confident that our joint efforts will be successful and yield its intended results.

– His Excellency, Dr. Hatem El-Gabaly, Minister of Health, Egypt