Taking On The "Red Market"

Organ transplants, once the cutting edge of modern medicine, have become virtually routine procedures. According to a UN World Health Organization report, over 66,000 kidney transplants, 21,000 liver transplants and 6,000 heart transplants were performed globally in 2005, and that number continues to increase.

In many developed nations, however, donor shortages, long wait times, and high cost have given rise to a vast international market for kidneys and other organs, producing the twin phenomena of organ trafficking and so-called transplant tourism-collectively known as the "red market". The former, while still widespread, is now widely banned across many jurisdictions (including the European Union). The latter, however, remains largely unregulated, with only two developed countries (Spain and Israel) banning its citizens from travelling abroad to acquire organs illegally.

It is this latter growing phenomenon of (typically) wealthy westerners travelling to developing countries like China, India, the Philippines, and Pakistan for relatively inexpensive kidneys and other organs that is the focus of Nigerian-born UAlberta PhD candidate Terry Adido's research, and of his recently submitted thesis-completed under the supervision of CN Professor of International Trade Law Linda Reif and Katz Group Chair in Health Law Professor Gerald Robertson. The goal of his work, he explained, is to push for the prohibition of this morally dubious trade.

Commerce or Exploitation?

Adido's research, among other things, seeks to clarify what we mean by the notoriously hard-to-define term "exploitation".

"There's no general consensus, either in law or generally speaking, on what constitutes 'exploitation'," he asserted.

"In the case of transplant tourism, people have defended it on the grounds that it's a business transaction where the vendors make autonomous decisions to sell their organs and receive something of value in return. However, the fact that the donors are overwhelmingly poor and vulnerable, and that the benefits received do not meet their needs and leave them in a worse state then they were before selling their organs, makes a strong case for it being an inherently exploitative trade."

The trade, Adido explained, follows a model similar to child sex trafficking. So-called organ brokers typically recruit poor, indebted people from rural villages, who travel to hospitals in large cities for surgery and typically earning far less than the other parties involved in the practice. In some cases brokers even target individuals in other countries (often in Sub-Saharan Africa, Eastern Europe and South Asian countries like Nepal), who then fly these people to the destination country for transplants. Key source countries for transplant tourists include the United States, Canada, Australia and Japan, as well as Saudi Arabia and other Arab Gulf states.

Adido argues that change will only come when the wealthy tourist countries crack down on the trade, as many have now done in the case of child sex tourism.

"I believe that existing child sex tourism laws which use extraterritorial criminal laws to prosecute nationals who engage in child sex tourism can be used as a model for curbing this industry," he said.

"The wealth and power imbalance between the source and the destination countries is such that the impetus has to come from the source countries. Israel and Spain have already set an international example on this front, and my hope is to help bring about greater awareness around this issue in the hope that other countries, including Canada, will follow suit."

Just Desserts

Adido, who is set to receive his PhD in November 2017, further deepened his expertise this summer through participation in the Academic Council on the United Nations System (ACUNS) Workshop, held from August 4 to 13, 2017 in Santo Domingo, Dominican Republic. Beyond his graduation this year, he hopes to continue researching health-related issues of international law.

"I've always been drawn to law as a means of better protecting vulnerable people," said Adido.

"Having grown up in a developing country surrounded by a great deal of poverty, I feel I can truly relate to the challenges faced by the people being exploited in the transplant tourism trade and other similar trades, and bring that perspective to the international forum."

In addition to his scholarly acumen and passion for social justice, Adido is perhaps best known as a kitchen magician with a passion for fine baking who made a big splash on CTV's MasterChef Canada earlier this year with his signature spiced pumpkin roulade served with pumpkin-maple truffles and salted caramel-maple sauce. With a PhD nearly under his belt, a UN workshop forthcoming, and a budding career as celebrity chef in the offing, Adido is quite the hot item.