The Rise of the Red Market

How the best intentions of the medical community accidentally created an international organ-trafficking underground.

BY SCOTT CARNEY | MAY 30, 2011

On the night of Jan. 11, Turkish police officers burst into a villa in Istanbul’s Asian quarter and arrested a 53-year-old transplant surgeon named Yusuf Sonmez. Interpol had been looking for Sonmez since 2008, when a Turkish man collapsed in the airport in Pristina, Kosovo, and reported that his kidney had been stolen. The incident led to an investigation by European Union prosecutors, who uncovered an international organ-stealing and smuggling ring of alarming scope. Sonmez and eight co-conspirators, prosecutors alleged in December, had lured poor people from Central Asia and Europe to Pristina, harvested their organs, and sold them at up to $100,000 a pop to medical tourists from Canada, Germany, Israel, and Poland. The clinic where Sonmez did his work, a separate report by the Council of Europe alleged, was part of an even vaster organ-smuggling network — one which, incredibly, even involved Kosovo’s prime minister, Hashim Thaci.

The trafficking operation was grisly, but hardly unusual. The World Health Organization estimates that approximately 10 percent of the world’s organ transplants originate on the black market; as a rule of thumb, that figure seems to hold true across the trade in human body parts. And while occasional law enforcement successes like Sonmez’s arrest do happen, for the most part no one is really seriously attempting to shut down a market that is not just lucrative, but, many would argue, inevitable.

It would be an understatement to say that the last century has been a golden age for medical science. The average human life span today is almost a 30 years longer than it was in 1900. We’ve seen the advent of once-unthinkable innovations such as antibiotics, blood transfusions, and the surgical wizardry of organ transplants. These once-miraculous feats depend on a supply infrastructure that those of us outside the medical profession rarely think about. We take it for granted that if we get into a car accident that the local hospital will have blood on hand for a lifesaving transfusion. If our kidneys fail, we expect a spot on the transplant list. If we are infertile, we expect to have access to someone else’s sperm or eggs, or — if we can afford it — the services of a surrogate mother to bring a child to term.

Of course, every kidney, cornea, or pint of blood has to come from somewhere — or, more precisely, someone. Forget the image of grass-skirt-wearing cannibals on tropical islands; no society has had as insatiable an appetite for human flesh as the developed world of the 21st century.

Because the idea of a marketplace in which body parts are bought and sold makes us squeamish, the growth in demand for human materials has been accompanied by an effort to build an ethically justifiable system for supplying them. Organs aren’t supposed to be bought and sold; rather, they are donated by altruistic individuals, and we pay for the services necessary to acquire them rather than for the organ itself.

There’s just one problem with this picture: It’s a fiction. Regulation of the supply of human tissue is haphazard at best; in most cases, people looking to acquire an organ have only the assurances of doctors and social workers to persuade them that everything is aboveboard and ethical. And the very provisions we’ve built into the system to bring it in line with the ethical norms of medicine and charity have made it easy for criminals to reap outlandish profits buying and selling human flesh.

Half a century ago, the world was relatively comfortable with open commerce in human products. The rollback of that business, and the institution of the system we have today, began with blood. As of the mid-1960s, blood-collection clinics in the United States were amassing 6 million pints of blood a year, for which they paid about $25 apiece at the time to donors. The model was a holdover from World War II, when blood was badly needed for the war effort. But as the collecting centers became as common as cash-for-gold franchises in skid rows across the United States, they began to present problems for the medical system. Because poorer and accordingly less healthy people were more likely to sell their blood for a quick buck, paid blood collection led to higher rates of hepatitis transmission.

In the 1970s, a British social anthropologist named Richard Titmuss proposed a new system, one that would remove the risk of coercion and problematic incentives by eliminating payments to blood donors. In addition, the blood would be depersonalized — marked with an identifying bar code rather than a name — so that the recipient would feel indebted to the overall system of blood donation rather than a single individual. Officially, at least, blood was transformed from a product into a gift.

via The Rise of the Red Market – By Scott Carney | Foreign Policy.