CAIRO, 7 February 2010 (IRIN) - A controversial organ transplant bill expected to become law in the next few weeks could regularize organ transplants and curb Egypt's booming illicit trade in human organs, experts say.
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 the World Health Organization (WHO).
The bill, which is causing controversy among medics, clerics and rights activists, says organs donated from live donors will be restricted to "family members of the fourth degree", and that the removal of organs without official authorization would be considered first-degree murder and be punishable by death.
Official authorization for organ removal will come from a three-person panel to be established by the Higher Committee for Organ Transplants, a Ministry of Health-affiliated body.
For dead patients, the law stipulates that the panel reach consensus on whether or not the potential donor is dead - an issue on which there is much contention.
Dead or alive?
The consensus in the medical profession is that if a person's entire brain is dead, the person is dead, even though their heart may continue to beat for a short time. This provides an opportunity to obtain organs while they are still in good condition for transplantation.
Some Muslim clerics and MPs say a person's heart must stop before he or she can be pronounced dead.
"Apart from this, the law is totally against Islamic law, because man doesn't have the right to donate his or her body, which is God's after all," said Mohamed Awadeen, a professor of Islamic law at Al-Azhar University. "The advocates of the new law are lying. Organ donors won't lead a normal life later on. A man needs kidneys to live normally."
However, Mohamed Sayed Tantawi, Grand Sheikh of al-Azhar University, Sunni Islam's most respected institution, has previously endorsed a brain dead standard.
Law for the wealthy?
Some rights activists have said the new law could exacerbate organ trafficking and turn Egypt into a global market for the organ trade.
"This would only benefit the rich," said Hafez Abu Saeda, secretary-general of the Egyptian Organization for Human Rights, Egypt's leading human rights organization. He said by offering legal cover for organ transplants, the government was turning the poor into sources for human spare parts and offering the rich - in Egypt and beyond - a well stocked market for organs.
Statistics for organ sales and transplants in Egypt do not exist because they are mostly performed clandestinely, but Abu Saeda said his own research suggested hundreds of unlicensed transplants happen every year.
He said some of the richer recipients who did not trust 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 be a great affliction in such a poor country," Abu Saeda said in a recent discussion in Cairo on the law.
"The approval of this law is 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 under unsafe conditions and harms both donor and patient," Hussein Gezairy, WHO regional director for the Eastern Mediterranean, said in a statement on 20 January.
WHO estimates there are 42,000 people in Egypt in need of transplants.
"Patients have waited too long for this law to come out," Mahmud el-Motini, a leading liver transplant specialist, told IRIN. "Tens of thousands of Egyptians are in bad need of legislation that enables them to have organ transplants."