Mains Paper 2: Health
Prelims level : Indian Organ Donation Day
Mains level : Organ donation awareness and eliminating the loopholes
Organ donation day is observed with the primary objective of promoting
organ donation and transplantation so that a number of persons suffering
from organ failure.
Such as the kidneys and liver, can get a new lease of life using organs
gifted by others who have lost their lives (such as in road accidents or
Indian Organ Donation Day is observed by the Government of India on
It also needs to reflect on certain negative perceptions that appear to
be growing and undermining the altruistic donation mindset of donor
In Kerala from 76 deceased donors in 2015 to eight in 2018 due to a
The scandal that private hospitals were declaring persons brain dead
when they were not really so, in order to retrieve their organs and profit
The underlying factor is the highly privatised health-care system in
India and the growing trust gap between patients and doctors trapped in the
profit-seeking business of tertiary care; seeking second and third opinion
on patient treatment is commonplace today.
While an organ comes free, as donated to society, transplanting it to
another person costs anywhere between ₹5 lakh and ₹25 lakh, including profit
to the hospital.
The reality that a majority of accident victims who become donors are
lower middle class and below, while the majority of organ recipients are
from the small number of persons who can afford transplant surgery and
costly lifetime medication thereafter.
The cost factor is the key reason why more than three quarters of
donated hearts and lungs do not get taken.
Need to spend more in public hospitals:
Very few public hospitals in the country do kidney transplants and less
than five do liver and heart transplants.
In a country where public spend on health care remains an abysmal 1.2%
of GDP — less than a third of what even some developing countries spend.
The priority should be on spending the limited allocation on areas that
would benefit the greatest number of persons.
World Health Organisation Consultative Group in its 2014 report points
to a study in Thailand which finds that money spent on dialysis can save 300
times more healthy life years if spent on tuberculosis control.
It considers expansion of low- and medium-priority services before
near-universal coverage of high priority services as an “unacceptable
trade-off” and does not include dialysis or organ transplantation even in
the lo-priority category.
A given amount, if spent on organ failure prevention will save many more
lives than if spent on organ transplant.
Faultlines and solutions
Only steps to moderate are possible in these deep-rooted societal fault
One usual approach is to regulate hospitals through acts and rules. \
In the 25th year of the Transplantation of Human Organs Act, 1994 , it
is time to revisit its effectiveness.
Substitution of bureaucratic procedures for hospital and transplant
approval by self-declaration and mandatory sample verification involving
civil society will improve compliance — as proved in other countries — and
will also help get more hospitals involved.
Further amendment is needed to ensure full State autonomy in this area,
avoiding the Central government’s interference in organ distribution, which
is now demotivating many hospitals.
All State organ distribution agencies need to make their operations
Steps such as making online organ distribution norms and the full
details on every organ donation will help build public confidence in the
India figures in the top 10% of unequal countries in the world and among
the top 10% of high proportion population spending more than a tenth of
their income on health.
This must also be considered in light of the fact that the organ comes
totally free to a hospital from a donor.
One approach could be to mandate that every third or fourth transplant
done in a private hospital should be done free of cost to a public hospital
This will amount to cross-subsidisation, with the hospital, the doctor
and the recipient footing the bill for free surgery to the section of the
population that donates a majority of organs.
This may not please present stakeholders in this field but they need to
avoid the tendency to sweep inconvenient issues under the carpet and discuss
seriously how to address the trust gap and inequality that are factors
impacting family consent for organ donation.
Q.1) With reference to the ninth edition of the International Diabetes
Foundation (IDF) Diabetes Atlas, consider the following statements: 1. India continues to be home to the second-largest number of adults with
2. Diabetes is among the top 10 causes of death, with people under the age of 60
accounting for almost half the deaths.
Which of the statements given above is/are correct? (a) 1 only
(b) 2 only
(c) Both 1 and 2
(d) Neither 1 nor 2
Q.1) To addressing the trust gap and inequality that are impacting family
consent for organ donation is crucial. Comment.