The People's Assembly finally passed the organ transplant bill -- one of the most controversial pieces of legislation of recent years, Reem Leila reports The thousands of Egyptians in need of organ transplants received a ray of hope when, on 27 February, the People's Assembly (PA) voted overwhelmingly in favour of a draft organ transplant law. The controversial legislation, which by making organs available for transplant seeks to end Egypt's booming illegal trade in human organs had been under discussion for two years. The new law legalises all types of organ transplant operations, which will be performed in public hospitals and paid for from the public purse. Later, it is envisaged that selected private hospitals will join the scheme and be permitted to undertake transplant operations paid for by the patient. In an attempt to curtail the commercial trade in organs, transplants between Egyptians and foreigners are banned except in case of husband and wife. Even then, under the new regulation, they must have been married for a minimum of three years before surgery takes place. In the case of two foreigners -- donor and recipient -- wanting an organ transplant operation in Egypt, the bill stipulates that they must get the consent of their own government as well as the approval of the Egyptian authorities. "Thousands of Egyptians are in dire need of organ transplants. Now they will not be left to suffer, waiting for an almost certain death," said PA Speaker Fathi Sorour. The failure to reach consensus over a precise definition of death had stymied the progress of the new law. Now it is up to a committee of three experts, appointed by the Ministry of Health, to determine the organ donor's death after conducting 14 specific tests. Removing organs before the committee's approval will be treated as first degree murder. That the bill had already won the approval of Al-Azhar and the State Council effectively limited the scope of the debate compared to earlier discussions. Opponents used to argue that such a law would violate religious tenets and/or promote the trade in organs. "The religious debate stemmed from the medical debate and not vice versa. When the medical debate had been settled it became easier for religious scholars to assess the matter," said Sheikh Ibrahim Negm, official spokesman to the grand imam of Al-Azhar. Arguments that the new law would facilitate illegal transplants were effectively debunked in January when the World Health Organisation (WHO) issued a statement welcoming the legislation as a significant step towards ending illegal trafficking. The 18-article draft law, says Hamdi El-Sayed, chairman of the PA's Health Committee and head of the Doctors' Syndicate, will establish an independent body to manage the national organ bank, screen potential organ recipients and donors and monitor all transplant operations. In the case of live transplants the donor must be over 21. Mentally ill patients will not be allowed to donate their organs and "donors will have the right to revoke their decision at any point prior to the transplant procedure." The Doctors' Syndicate first proposed legal regulation of organ donations eight years ago, partly to stem the explosion of organ trafficking. El-Sayed anticipates a temporary decline in the number of available organs following the legislation's passage as authorities work to shut down commercial organ trading and attempt to convince the public of the merits of planned organ donation upon death. "We think the number of available organs will fall for the next three or four years because it is going to take time to convince people to donate after death. But consider that in Egypt road accidents cost 7,000 lives each year. If just half of the casualties were organ donors, each with six to eight vital organs, we could save at least 20,000 lives a year." "We are among four countries that have increasing rates of illegal organ transplants and organ tourism. Yet Egypt is the only one of these four that has still no framework regulating organ transplants." The WHO has declared that hundreds -- possibly thousands -- of poor Egyptians sell kidneys and livers every year to pay off debts and buy food, making the country a regional "hub" for organ trafficking. According to WHO estimates, there are 42,000 people in Egypt in need of organ transplants. Five government hospitals have been earmarked for transplant operations, a figure that official spokesman to the Ministry of Health Abdel-Rahman Shahin says could easily double in the next few years. Under the new bill doctors who perform illegal organ transplants could face up to 25 years in jail, the donor and recipient a maximum sentence of 10 years. Hospitals where illegal transplants take place could face closure and a fine of up to LE500,000.
