By Hassan Zaggi
Of recent, Nigeria as a country, suffered disrepute following the controversy over alleged illegal harvesting of body organs.
While some high-profile individuals are yet to recover from the consequences of alleged deals involving body organs in other countries, some health facilities and medical experts are currently regular visitors to the court of law within Nigeria trying to clear their names of alleged involvement in organ harvesting.
Ordinarily, organ harvesting and transplantation is a normal practice all over the world. Simply put, organ transplantation has become a critical aspect of modem medicine that gives a second chance at life to patients suffering from end-stage organ failure.
Following the rising cases of terminal illnesses globally, the need for the transplantation of some vital organs including kidney, liver, eye, tissue, bone marrow and many others have also increased in recent times.
However, in other countries of the world, organ harvesting and transplantations are done under strict regulation, guidelines and supervision. This is to avoid misuse, abuse and exploitation of innocent residents. Nigeria’s case is however different.
In order to correct the anomaly therefore, last week, experts and critical stakeholders representing various organisations, societies and groups converged in Abuja to validate the zero draft of Nigeria’s first Guidelines on Organ Donation and Transplantation.
The draft guidelines which were presented by the National Tertiary Health Institutions Standards Committee (NTHISC), encompasses critical areas such as Ethics, Kidney Transplantation, Liver Transplantation, Eye Tissue Transplantation, Bone Marrow Transplantation, and a chapter that addresses Gamete and Embryo donation, Storage and Surrogacy.
The NTHISC derived its powers from the National Health Act (NHA) 2014. It is saddled with the responsibility of regulating the activities of Tertiary Hospitals and the practice of Organ Transplantation in Nigeria.
Section 54 (3) of the National Health Act 2014, gave the NTHISC the powers as the authoritative body responsible for establishing criteria and procedures for approving organ transplant facilities nationwide.
In line with this mandate, at the end of all the processes and validation, the Committee will disseminate the Guidelines to all Tertiary Health Institutions and on the basis of compliance, the Committee will commence registration and certification of these facilities.
The aim is to entrench the culture of strict adherence to regulations and in tum, safety of organ donors and recipients in Nigeria.
Speaking at the opening ceremony of the meeting, the Chairman of NTHISC, Prof. Philip Abiodun, emphasized that his committee has the responsibility to give guidelines on all organ transplantation carried out in Nigeria and all the things that concern transplantation, not only organs but also tissue, cornea, bone marrow and the rest.
“We have seen that there is a lot of rubbish going on in the country. Some of these issues are bringing the name of this country to disrepute. We hear people harvesting organs illegally from different places, people selling organs. In order parts of the country before people die from accident, their organs have been harvested. People are being killed just to remove their organs.
“Therefore, we thought it is necessary to give guidelines and regulations about how transplantation can be done. That is why it is necessary to call this meeting so as to bring together societies and organisations that are involved to discuss it to help us put together guidelines, regulations on transplantation of organs and tissues. Once we bring out these guidelines which is our mandate in the NHA, anybody, institution or hospital that wants to carryout organ transplantation must apply and be certified to carry out any form of transplantation.
“We brought all relevant stakeholders including health professionals, the media, religious bodies to brainstorm and senior legal experts to help us look at what the law says so that at the end of the day, anybody who illegally carries out organ transplant will be made to face the law.
“Many of us have been involved in organ transplant nationally and internationally, we know what happens across the world, Nigeria is therefore not an exception, we have to follow the rule of law.
“Once we harvest all ideas from these stakeholders, we then put a robust guideline in place,” Abiodun explained.
On his part, the President, Transplant Association of Nigeria, Prof. Awobusuyi Jacob, encouraged Nigerians to report to the appropriate authority any illegal organ transplant in any part of the country.
He lamented that illegal organ transplantation may be going on in the country, but that nobody has come out to report, let alone handover such offenders to the police.
“Yes, recently, there was an incident in Abuja that was reported by the media but what our organization (Transplant Association of Nigeria) will want is that people should come forward and boldly accuse hospitals and doctors and state clearly that this is what has been done to me.
“This is because illegal organ trade is not condoned and is illegal as the name suggest. Its exploitative in nature. You cannot just take an organ from a young boy of 17 or 18 years who does not know what he is doing and then trick him to harvest his organ. That is exploitative to that child and we don’t condone that. We believe it’s not good.
“Also, an organ is not a commodity. It is not something you can easily buy. You cannot turn an organ into a commodity and start selling, that is ethically offensive to the medical practice.
“We believe that it’s something that we should fight. The media, the law enforcement organisations and other associations have a big role to play in this regard. We need to educate the public,” he said.
Prof. Jacob however, noted that kidney transplantation in itself is not a bad thing, “but to turn it to a commodity and purchasing it is what we frown at. We must come together to stop this illegal trade of organs.”
Responding to questions from journalists, the Director of Hospital Services, Federal Ministry of Health, Dr. Jimoh Salawudeen, noted that the time has come for Nigeria to have a standard that will be used to check and monitor health institutions to ensure they are always doing the right thing when it comes to the issue of organ transplantation and donation.
He regretted the manner and way organ transplantation and donation is being carried out in Nigeria indiscriminately and illegally. This, according to him, is the importance of having guidelines and standards that will streamline and checkmate activities relating to organ transplant and donation.
Dr. Salawudeen explained that: “When you look at the NHA, the body that is responsible for regulating or setting standards for all National Tertiary health institutions where this issue of organ donation and organ transplantation takes place is this particular body-the NTHISC.
“That is why the body sets up a particular committee to bring out guidelines so that whoever is going to be involved in organ donation and organ transplantation irrespective of whatever it is, whether it is kidney, liver or bone or blood whichever one it is, should be able to have guidelines that they need to follow. And so, if somebody breached those guidelines, then there will be move for punishment which is dictated by the NHA 2014.”
On how soon the guidelines will be completed and begin operation, Dr. Salawudeen disclosed that: “We have already gotten the zero draft of the guidelines. This gathering is to validate it, allow other experts who are already seated here to look at it the second time after which once the Minister signs it and Mr President, and is approved, its becomes a policy.
“I am looking at next month (December) at least, these guidelines will be rolled out and everybody will be forced to comply with the guidelines and may be one or two months after, we start monitoring to ensure compliance.”
Mechanism for compliance
He explained that there are mechanisms in place to ensure compliance by health facilities across the country.
According to him: “Yes, there is mechanism for compliance. The mechanism to ensure that people comply very well in accordance with this is leveraging the membership of the committee with various regulatory bodies who are statutory members of the committee and the team from the Federal Ministry of Health who will be carrying out monitoring and evaluation of whatever is going on in the health institutions across the country.”
He further revealed that most tertiary health institutions have been asked to go digital so that through real time, the health ministry can monitor whatever is going on.
For example, Dr. Salawudeen said, “the surgery that you do, we now have a dashboard in the ministry which we have started using whereby whatever you do in your institution, it will be easy for the Minister or the Permanent Secretary to see it. So, if we see that you have done organ transplant three or four times, we can as well go to find out whether you have followed protocols or not.”
He further revealed that the Federal Ministry of Health will also engage other organisations in assessing performances and following of standards.
“Most likely, we will make use of some consultants among us to carry out some of these activities, so that in line with international best practices, we ensure that people are complying irrespective of where ever they are in the country,” he disclosed.
Another regulatory body to take care of private institutions
In order to ensure that the private sector is carried along, another regulatory body will be set up to monitor activities in the private health facilities across the country. Dr. Salawudeen explained that, “if you look at the Committee that is bringing out these guidelines- they are National Tertiary Health Institutions Standard Committee- meaning that they can only function in tertiary institutions. What about the private institutions? Are they also tertiary? If they don’t have the status of a tertiary, it will be difficult to monitor them.
“Now, a kind of a regulatory body is coming on board where the two will work together to find out what is going on in the private sector in regards to this issue of organ transplant. Even this transplant itself cuts across.
“If you are in the private setting, there are rules, guidelines and mechanism through which we can find out what you are doing to be able to see that you comply with the rules and international best practices.”
With this noble step taken by the Federal Ministry of Health to ensure that issues around organ donation and transplantation are properly regulated, Nigerians are keenly waiting to see the rollout and subsequent implementation of the guidelines.
Nigerians will not only be carried away by the implementation but will also be interested with the level of compliance by actors in both the government and privately owned health facilities.
The Federal Government through the Federal Ministry of Health must muscle the political will and the courage to allow the weight of the hammer (law) fall on any individual, group or health facility that failed to comply with the guidelines.
It must be stated clearly and loudly too, that organ transplantation and donation require high-level expertise and sophisticated technology. Therefore, for the donor and the recipient to survive and continue to live a healthy live, the expertise and the technology used must not be compromised.
The Federal Government through the Federal Ministry of Health must ensure strict compliance to the guidelines and also ensure that no step is compromised or left unchecked.
It is time, indeed, to sanitise the practice of organ transplantation and donation in Nigeria so that it can align with international best practices.
Nigerians are watching!
