The new draft law regulating organ transplants has finally found its way to the People's Assembly after gaining the approval of the Shura Council, Reem Leila reports The controversial organ transplant bill expected to become law in the next few weeks could regulate organ transplants and curb Egypt's booming illicit trade in human organs. Thousands of Egyptians are in dire need of organ transplants, some waiting for an almost certain death. The government has finally received the approval of the Shura Council for a bill regulating organ transplants as well as that of the State Council and Al-Azhar. The bill has also won the preliminary approval of the People's Assembly (PA). Accordingly, the draft has been referred to the PA's legislative, health and religious committees for debate before final approval. Al-Azhar's approval of the draft law ends an ongoing debate. Opponents of the legislation argued that such a law would violate the tenants of religion and promote organ trade. It was this opposition that caused four previous draft laws to founder over the past five years. "The religious debate stemmed from the medical debate and not vice versa. Once the medical debate was settled, it became easier for religious scholars to settle the matter," Sheikh Ibrahim Negm, the official spokesman of the grand imam of Al-Azhar, said. Rights activists have said the new law could exacerbate organ trafficking and turn Egypt into a global market for organ trade. "This would only benefit the rich," said Hafez Abu Seada, secretary-general of the Egyptian Organisation for Human Rights, Egypt's leading human rights body. Abu Seada said by offering legal cover for organ transplants, the government was turning the poor into sources of human spare parts and offering the rich -- in Egypt and beyond -- a well stocked market for organs. Statistics of organ sales and transplants in Egypt do not exist because they are mostly performed clandestinely, but Abu Seada said his own research suggested hundreds of unlicensed transplants are conducted every year. He said some of the wealthier recipients concerned by the skills of local doctors took donors with them to China to have transplants. "Rich people from the Gulf also come here to buy organs. A law like this can greatly affect such a poor country," Abu Seada said. In the same context, the World Health Organisation (WHO) declared that hundreds and possibly thousands of poor Egyptians sell their 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 who are in need of organ transplants. In a statement published on 20 January, Hussein Gezairi, WHO's regional director for the Eastern Mediterranean, said approval of the law was "a wonderful step that creates hope for thousands of patients who have been waiting a long time for life-saving transplant operations. "It is also a significant step towards ending illegal organ trafficking, which usually results in operations conducted in unsafe conditions and harms both donor and patient," Gezairi stated. "Patients have waited too long for this law. Tens of thousands of Egyptians are in bad need of legislation that enables them to have organ transplants," Gezairi added. The organ transplant draft law, which is expected to gain PA approval in April, assigns an independent committee of three experts in various medical fields to unanimously confirm a donor's death after conducting 14 specific tests. The committee will also be in charge of approving the waiting list of patients requiring an organ transplant, according to the severity of their condition. The draft will regulate the transplant of human organs between Egyptians, ban the commercial trade in human organs and limit such operations to hospitals authorised by the Ministry of Health. MP Akram El-Shaer, a member of the Health Committee who is also affiliated to the Muslim Brotherhood (MB), expressed his opposition to the new law. El-Shaer cited Sheikh Abdel-Aziz bin Baz, the former grand mufti of Saudi Arabia, who issued a fatwa in Saudi Arabia in 1986 indicating that organ donations are not against Sharia. "But when he learned from doctors that the heart of the person from whom the organs are taken will still be beating, he revoked his fatwa." El-Shaer said he was unsure whether the committee "will undergo these tests honestly." Head of the Doctors' Syndicate Hamdi El-Sayed, who also heads the PA's Health Committee, says death can either be determined by the complete arrest of the body's circulatory and respiratory functions or by the complete stop of all brain functions. The latter, however, is a relatively new conception. In earlier times, death was determined by particular physical observations such as a drop in body temperature, the relaxation of the legs or the leaning of the nose. But in light of the advances made in medicine, doctors cannot continue to rely on third or fourth century definitions of death, El-Sayed said. In cases of brain death, waiting for the observable signs of death would mean being too late to harvest the needed organs. "We are among four countries that have increasing rates of illegal organ transplants and organ tourism," El-Sayed said. "Yet Egypt is the only one of them without any framework regulating organ transplants." Meanwhile, he added, 18 Muslim countries, including Saudi Arabia, already have organ transplant laws in place. Looking ahead, El-Sayed had another concern. "I am sure that when we manage to pass the law in the PA our main challenge will be changing cultural perception." The official spokesman of the Health Ministry Abdel-Rahman Shahin highlighted the importance of the draft law and the role it will play in eliminating organ tourism and regulating organ transplants to benefit those who "need them the most -- not the ones who can pay the most." Illegal organ transplants have consequences linked to "poverty, social and economic problems and the culture of a whole community," Shahin said. He said new regulations have been created and are currently being implemented until the law is finalised by the PA. Since January, it has been obligatory for both the donor and recipient to receive approval from the Ministry of Health and the Doctors' Syndicate before performing organ transplants.
