By Carolina Lenzo and Tori Curbelo
Just like sex and labor trafficking, organ trafficking is the illicit trafficking of humans in a trade fueled by high demand and low supply. It’s referred to as the trafficking of human beings for the purpose of organ removal, abbreviated as THBOR.
As with sex and labor trafficking, people often ask whether the crime affects individuals here in the United States. The answer is yes. In 2011, a resident of Brooklyn, Levy Izhak Rosenbaum, served just 2.5 years in prison for the first federal conviction of profiting from the illegal sale of human organs. In return for brokering three illegal organ transplants for three New Jersey-based customers, Rosenbaum received illegal payments upwards of $120,000 each.1 The organs were bought by Rosenbaum from desperate, vulnerable, and poor citizens of Israel for just $10,000. Transplants took place at respected American hospitals, including Albert Einstein Medical Center in Philadelphia.2 Although this case is currently the only federal conviction for this crime, the practice is more commonplace; in fact, LifeWay has served women in the past who were trafficked for the purpose of removing their organs.
There are many reasons why organ trafficking is particularly under-detected and under-discussed in the United States, largely because of US law. Organ trafficking is recognized as a form of human trafficking in the United Nations’ Palermo Protocol (which established a definition of human trafficking now accepted globally and by the US), but the United States’ federal human trafficking law, the Trafficking Victims Protection Act (TVPA), does not address it. Transferring organs for profit is addressed in a separate federal law, the National Organ Transplant Act (42 U.S. Code § 274e – Prohibition of organ purchases).3 Organ trafficking’s exclusion from the Palermo Protocol has implications for prevention, protection and prosecution efforts. Elizabeth Pugliese’s article, for instance, argues for an alignment of the federal law and the Palermo Protocol so that federal human trafficking resources can be used to address organ trafficking, and survivors can have access to protection and services. According to the International Criminal Police Organization (INTERPOL), the lack of awareness around organ trafficking by law enforcement agencies and the deficiency of communication between medical and police fields leads to an absence of organ trafficking reporting. The annual revenue of organ trafficking is estimated at anywhere from $840 million to upwards of $1.7 billion.4
The United Nations also points out that there is a distinction between “trafficking organs” and “trafficking persons for the purpose of organ removal,” which makes tackling the crime also difficult.5 Establishing an illegal organ transfer is one thing, but proving that a person was exploited for their organs by means of fraud or coercion is extremely difficult to prove. In the case of Rosenbaum, for instance, his lawyer argued that all parties consented. True consent, however, is difficult to determine in these circumstances.
Worldwide, hubs of this practice include Iran, China, India and the Philippines. In Iran, organ selling is legal — a practice that further places vulnerable folks at risk.6 The issue with legalizing an industry for organ transfer is similar to the issue of legalizing commercial sex; it raises the question of what happens when enough people are not willingly consenting to provide their organs. We argue that were it made legal, traffickers would utilize tactics such as manipulation, lies, violence and fraud to obtain what they need to make a profit because they fear no legal ramifications or consequences. Below are quotes from an organ trafficker as well as survivors:
“I feel bad for them, I always give them their money, but there are other brokers who would agree with you on a price, then disappear after the surgery without paying you,” he said. “This happens at least 40% of the time.”7
“They took my passport and clothes,” she said. “Then they drugged me. When I was awake, I found myself alone. I was in pain and there was blood on my side coming from a bandage. I had no idea what was happening.”8
“‘The foreman told me that the meat will grow back,” Pariyar said. “Then I thought, If the meat will regrow again, and I get about $30,000, why not?” “What if I die?” Pariyar remembers asking the foreman. The foreman assured Pariyar that nothing would happen. He was given good food and clothes and was even taken to see a movie. Then he was escorted to a hospital in Chennai, a southern state of India.”9
In China, human rights groups have advocated against the government for extracting organs of executed prisoners to source its supply of transplantable organs. The country’s organ-procurement laws and frequent use of the death penalty are consistent with the economic profit potential of organ trafficking.10 In India, before 1994, organ transplants were legal, and some states in India have poor and loose medical ethics and regulations, making the use of illegally procured organs in medical operations easy and unregulated.11
Before 2008, in the Philippines organ trafficking and illegal organ acquisition were endorsed by the Filipino government. The federal government’s Philippine Information Agency government condoned kidney transplant options, costing about $25,000, that exploited vulnerable donors who received less than $2,000 for their organs.12
The lack of international condemnation of this practice, coupled with lucrative financial incentives, has unfortunately added to why organ trafficking is often not acknowledged. There have been efforts from legislators to continue to build on existing legislation in the United States. Introduced in 2005, the Stop Organ Trafficking Act aimed to prohibit the export of United States devices “intended for use in organ transplant surgery” to countries and entities pinpointed as potential trafficking of persons for the purpose of organ harvesting. The bill also stops the authorization of visas and passports of individuals known to be involved in organ trafficking. The State Department would also be required to create a report on organ trafficking, which could create a larger awareness of its practice.13 It is our job to take action and prevent this illicit practice.
1. Learn more about the United States legislation against organ trafficking by reading the STOP Organ Trafficking Act: https://www.congress.gov/bill/116th-congress/house-bill/2121/text?r=6&s=1
2. Test your knowledge on trafficking persons for organ removal. Take the quiz!
1 “NBC: Brooklyn Man Sentenced 2 1/2 Years in Fed Organ Trafficking Case,” NBC 4 New York, July 11, 2012
3 National Organ Transplant Act, November 19, 1984, https://www.congress.gov/bill/98th-congress/senate-bill/2048
4 International Organ Trafficking: In Brief, Congressional Research Service, December 22, 2021.
5 Trafficking in Persons for the Purpose of Organ Removal: Assessment Toolkit, United Nations Office on Drugs and Crime, 2015,
6 “Iranian Model of Paid and Regulated Living-Unrelated Kidney Donation,” Ahad J. Ghods and Shekoufeh Savaj, Clinical Journal of the American Society of Nephrology,
Vol. 1, Issue 6, November 2006, https://cjasn.asnjournals.org/content/1/6/1136.
7 “Opinion: Tracking down organ traffickers and their victims,” Seán Columb, Thomson Reuters Foundation News, September 23, 2020, https://news.trust.org/item/20200923161904-x3ozy/
9 “Nepal’s Organ Trail: How traffickers steal kidneys,” Sugam Pokharel, CNN, July 15, 2015, https://www.cnn.com/2014/06/26/world/asia/freedom-project-nepals-organ-trail/index.html.
10 China’s Practice of Procuring Organs from Executed Prisoners: Human Rights Groups Must Narrowly Tailor Their Criticism and Endorse the Chinese Constitution to End Abuses, Joan E. Hemphill, Washington International Law Journal, Vol. 16, no. 2, March 1, 2007.
11 Life and crimes of a kidney don,” Sandeep UnnithanDamayanti Datta, India Todau, February 14, 2008.
12 Commercial Organ Transplantation in the Philippines, Leigh Turner, Cambridge University Press, April 1, 2009.
13 International Organ Trafficking: In Brief, Congressional Research Service, December 22, 2021.