Dr. James McDaid:

Many thanks to the committee for hearing our statements today. I am a transplant surgeon in Belfast. Organ transplantation saves many lives but there is a big problem with inequality of access to organs in addition to a lack of organs. That is a problem in both the developed and developing world. Kidney, liver, lung, pancreas and heart transplants were once experimental treatments but they are now very much mainstream in medical practice. There is a movement to incorporate tissue donations, such as face and arm transplants. In spite of successful moves to increase organ donation rates, waiting lists for organs in Ireland and throughout the world continue to grow.

In Ireland last year, 280 transplants were carried out. There are currently approximately 650 people on the waiting list. The committee will hear more about that from Dr. O'Seaghdha shortly. People die waiting for organs. Quality of life while waiting is often very poor because of the severe symptoms of end-stage organ failure, including renal, heart and liver failure. These difficult circumstances place enormous strain on families and patients and can give rise to relationship breakups, job loss and many other problems.

The waiting time for organs varies from country to country. Depending on the organ, it is typically between one to five years. Between 5% and 20% of patients die waiting for organs. This very poor outlook and the very poor quality of life drive many people waiting for organs to seek them from sources other than the deceased donor waiting list. For kidneys, live donation from a family member or friend is a possibility but this fails to meet excess demand for organs. Some people have sought to obtain transplants through organ trafficking or transplant tourism. Unscrupulous medical teams and middlemen brokers exploit vulnerable donors and recipients for selfish profit.

China has been a major hub for transplant tourism for several years. Other hotbeds for this criminal practice include Pakistan, Egypt and India. At present, with the considerable amount of people trafficking through Libya, vulnerable individuals are exploited and sent to Egypt in order to pay for passage across to Europe on boats. China is unique among all these countries in executing prisoners for the sale of organs. Members of several ethnic and faith groups have been imprisoned for their beliefs and callously executed for their use of organs in transplant operations. This arguably constitutes a crime against humanity and must be condemned in the strongest terms. China sent two surgeons to the Pontifical Academy of Sciences' Summit on Organ Trafficking and Transplant Tourism in February 2017, which I attended. They openly admitted to the unethical execution of prisoners for organs. They described efforts in China to reduce the number of these executions but highlighted the difficulties in policing the laws in such a massive country.

Ireland must take a very critical stance during diplomacy with China in light of its horrific human rights abuses. Transplant tourism must be considered a crime, with prosecution of all involved parties. Global attention needs to be drawn to this issue.