Syllabus: GS2/Issues Related To Health
Context
- Recently, the Prime Minister of India, through his Mann Ki Baat address, has repeatedly highlighted the importance of organ donation, giving renewed momentum to the organ donation movement in India.
About Organ Transplantation/Donation
- It is a surgical procedure in which an organ, tissue or a group of cells are removed from one person and surgically transplanted into another person.
- One person can save up to 8 lives by donating heart, lungs, liver, kidneys, pancreas and intestines.
- In India, the organ transplantation is one of the lowest in comparison with the western nations.
- India’s organ donation rate remains under 1% relative to the population.
- India ranks third globally in organ transplantation.
India’s Milestone in Organ Transplantation
- India has achieved a significant milestone in organ donation and transplantation under the National Organ and Tissue Transplant Organization (NOTTO).
- Key Achievements:
- Transplants increased from less than 5,000 in 2013 to nearly 20,000 in 2025 – a fourfold rise.
- Around 18% of transplants are now from deceased donors.
- Over 1,200 families donated organs of their loved ones in 2025.
- More than 4.8 lakh citizens registered for organ donation through an Aadhaar-based verification system since September 2023.
- India has developed expertise in complex transplants such as Heart, Lung, and Pancreas.
- India leads globally in hand transplants, performing the highest number worldwide.
- It reflects improvements in governance, technology integration, and public trust.
National Organ and Tissue Transplant Organisation (NOTTO)
- It is a National level organization set up under the Directorate General of Health Services, MoH&FW.
- It develops policy guidelines, conducts training, monitors transplant activities, maintains a national databank, and coordinates inter-regional organ allocations.
Role of NOTTO
- Real-time organ allocation system enabling inter-state cooperation.
- Expansion of the National Organ & Tissue Transplant Registry ensuring transparency and traceability.
- Capacity building of SOTTOs (State) and ROTTOs (Regional) organizations.
- Standardized transplant protocols aligned with global best practices.
- Digital integration for donor and patient registration.
- Promotion of Green Corridors for rapid organ transport across states.
Key Laws and Rules Governing Organ Transplantation in India
- Transplantation of Human Organs Act (THOA), 1994: To regulate removal, storage, and transplantation of human organs for therapeutic purposes.
- To prevent commercial dealings in human organs.
- Key Provisions:
- Legal recognition of brain death;
- Allows organ donation from living donors (near relatives);
- Establishment of Authorization Committees for approval in cases of non-near relatives; and
- Strict prohibition of organ trade with penal provisions.
- Transplantation of Human Organs (Amendment) Act, 2011:
- Major Changes: Expanded scope to include tissues (renamed as Transplantation of Human Organs and Tissues Act – THOTA).
- Broadened definition of ‘near relative’ (includes grandparents and grandchildren).
- Mandatory registration of hospitals conducting transplants.
- Stronger penalties for commercial organ trade.
- Provision for swap transplantation (paired exchange).
- Transplantation of Human Organs and Tissues Rules, 2014: These Rules operationalize the Act.
- Key Features:
- Brain death certification (by a board of medical experts).
- Consent process for deceased donation.
- Registration and regulation of transplant hospitals.
- Establishment of a national registry and allocation system.
- Guidelines for Authorization Committees.
- Transparency and documentation requirements.
- Key Features:
- Brain Death Certification: It was defined under THOTA, 1994. It requires certification by a board of four medical experts, including treating physician, neurologist/neurosurgeon, medical administrator, and another registered medical practitioner.
Technology-Enabled and Ethical Ecosystem
- India’s transplant ecosystem is increasingly:
- Digitalized: Aadhaar-based verification and online registries.
- Transparent: Standardized allocation protocols.
- Efficient: Improved coordination between hospitals and authorities.
- Ethical: Emphasis on fairness and preventing organ trade.
- The system demonstrates good governance through accountability and citizen-centric service delivery.
A People-Centric Movement: Drivers of Change
- The organ donation movement has evolved into a mass social initiative. It includes public awareness campaigns, engagement of Panchayati Raj Institutions, youth and school outreach programs, participation of district and block-level administration, hospital readiness and improved organ retrieval systems.
- Families are increasingly viewing organ donation as a final act of compassion, transforming grief into hope.
Challenges Ahead
- Despite progress, challenges remain, like:
- Low deceased donor rate compared to developed countries.
- Regional disparities in transplant infrastructure.
- Need for sustained public awareness.
- Ethical vigilance against commercialization.
Road Ahead
- The Government aims to increase deceased organ donation rates, expand transplant infrastructure in underserved regions, deepen digital integration and national coordination, and sustain mass awareness campaigns.
- The success of NOTTO reflects India’s commitment to placing human dignity, compassion, and equity at the centre of public health policy.
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