HARI SREENIVASAN: Here in the United States, nearly 4,000 people a year die waiting for a kidney. And while it’s illegal almost everywhere in the world to traffic in organs, there is a thriving global market. Yesterday, I spoke with Kevin Sack of The New York Times who’s been investigating the global organ trade.
So you’ve been looking at this for a year. What did you find?
KEVIN SACK: Well, we found that there’s organ trafficking really all over the world. I don’t know that there’s a country that’s necessarily immune, including the United States. We had a prosecution here a couple of years ago, the first prosecution of organ trafficking in this country.
So it happens everywhere and obviously it’s just because there’s this huge demand for kidneys. People are desperate to get these organs and to save their lives.
HARI SREENIVASAN: You focused on Israel, and you said that they actually have a disproportionate influence on the global demand. How is that? Explain.
KEVIN SACK: Well, it’s kind of remarkable but over the last 15 years just time after time when there have been prosecutions of organ traffickers, Israel always seems to have some role. Israelis are either the buyers or the sellers. Often they’re the brokers.
And it has a lot to do with a view among orthodox rabbis that brain death, which obviously is the optimal circumstance for organ donation, is not actually death, and as a result organ donation rates in Israel are very low and people have few places to go other than the black market.
HARI SREENIVASAN: And they are trying to take some steps to change that right?
KEVIN SACK: They are. They passed a law, a series of laws in 2008, and the numbers have improved. Significant decrease in the number of people who go out of the country.
HARI SREENIVASAN: You also looked at where they go and the supply side and you focused on Costa Rica. What’s the circumstance that people are selling their kidneys for?
KEVIN SACK: The way we decided to go about this to sort of illustrate how organ trafficking works is to trace a network from beginning to end, and this was a network in which Israeli brokers sent mostly but not exclusively Israeli recipients to Costa Rica, where a prominent nephrologist would connect them with kidneys sold by poor Costa Ricans.
HARI SREENIVASAN: So there was a price tag and what about the health outcomes and the surgeries?
KEVIN SACK: Well, there’s been some research — it’s not terribly conclusive — but the research that has been done suggests that people who go overseas for transplants have higher risk of injury and of organ failure and even of death and that certainly was the case with this pipeline that we examined. There were at least two Israelis who we found who got transplants in Costa Rica who had very poor outcomes.
HARI SREENIVASAN: And I imagine that some of these people are being taken advantage of the poor people who are selling their kidneys. But it also raises this larger question about the ethics of a marketplace. You tackle that in your story.
KEVIN SACK: Well, these folks have very few choices, and I think when many of us put ourselves in their circumstances of either having to buy an organ or face, say, five years on dialysis and perhaps even death before they would get to the top of the wait list.
I think people feel that they would do the same thing if it were them or a loved one and what it really reinforces is how deep the gap is between the supply of kidneys and the demand of them. The World Health Organization estimates that 10 percent of the need is supplied by the current availability of organs.
HARI SREENIVASAN: Kevin Sack of The New York Times, thanks so much.
KEVIN SACK: Thanks for having me.