Human organ trade ‘has reached epidemic proportions, but is largely silenced’ – this is the assessment of the Nigerian human rights lawyer Frank Titier. He characteristically tells DW: “You would expect the public disapproval to be much greater, but it is not.”

The think tank Global Financial Integrity (GFI) based in Washington focuses on corruption, illicit trade and money laundering. GFI estimates that the profit per year from the organ trade ranges from $840 million to $1.7 billion (€755 million to €1.5 billion).

Organ donation and transplantation are established medical procedures that are vital to the care of patients with insufficient organs. Procedures can be very successful if conducted with informed consent and transparency. However, there is concern that organ transplants in Africa are often “driven primarily by poverty rather than the noble motive of saving a life or helping a person’s health status,” Titié notes. “There are medical staff, especially doctors, who are unscrupulous.”

“How much does my kidney cost?”

The sale of human organs is illegal throughout Africa. In 2022, however, the Kenyatta National Hospital in Nairobi forced to publish a post on Facebook with the caption “We don’t buy kidneys!”. This was because the hospital had recorded the question “How much are you giving for my kidney?” as the most frequent.

According to Willis Okumu, a senior researcher at the Institute for Security Studies, not all “irregular” transplants are forced. During an investigation into the organ trade in Eldoret, a city in western Kenya, Okumu found willing sellers: young men agreed to sell their kidneys for “quick money”. “They were not coerced in any way,” Okumu says, adding that donors were offered “up to $6,000.”

Donors rarely receive significantly larger sums of money. He recalls seeing “several young people with scars on their stomachs” – signs that they had undergone this procedure. They did not appear to fear prosecution as the authorities struggled to enforce the law. Most of them had bought a motorcycle or built a new house, for example. Donors were also recruiting other young men to donate their kidneys to supply a growing black market outside Kenya.

Increase in organ trafficking

Although the details of the illegal world of organ trafficking are unclear, experts believe that Egypt, Libya, South Africa, Kenya and Nigeria are the most affected countries in Africa. The reasons for this are complex, as regulations on transplants and organ donation vary from region to region. The United Nations Office on Drugs and Crime (UNODC) uses the term transplant tourism. UNODC has also expressed concern that illegally transplanted organs from vulnerable populations are being funneled to wealthier recipients.

The fact that wealthier patients sometimes want to procure organs illegally is also linked to the glaring shortage: According to the Global Observatory on Organ Donation and Transplantation, less than ten percent of medically necessary transplants take place worldwide.

In Africa, there are particularly few medical centers that perform legal transplants. In a 2020 report, the World Health Organization (WHO) counted only 35 kidney transplant centers across the continent. This insufficient capacity is attributed to lack of accessibility, limited expertise and financial support.

A sophisticated business

Okumu believes the Kenyan city of Eldoret is part of a larger syndicate of international human traffickers. The young men he met “talked about doctors who didn’t speak Swahili and were of Indian descent.” Therefore, it must be an international business.

Last year, a London court convicted a Nigerian senator, his wife and a doctor. They had jointly targeted the kidney of a young man from Lagos. It was the first judgment under British modern slavery laws to punish those suspected of conspiring to harvest organs.

However, Nigerian human rights lawyer Titie also warns of the “close link between human trafficking and organ harvesting”: organ traffickers could also resort to so-called “baby factories” in Nigeria – syndicates that kidnap girls and young women, they make them pregnant against their will and sell the babies on the black market.

For the lawyer, it is clear that local medical centers also have a responsibility not to exploit vulnerable people: “What happens when medical staff, especially doctors in elite hospitals in Abuja and Lagos, tell their rich patients that they have nothing to worry about for nothing?” They will surely find a poor person to sell the instrument they need.

Edited by: Kostas Argyros