II 

117TH CONGRESS 

1ST SESSION S. 602 

To combat forced organ harvesting and trafficking in persons for purposes 

of the removal of organs, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 4, 2021 

Mr. COTTON (for himself and Mr. COONS) introduced the following bill; which 

was read twice and referred to the Committee on Foreign Relations 

A BILL 

To combat forced organ harvesting and trafficking in persons 

for purposes of the removal of organs, and for other 

purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Stop Forced Organ 

5 Harvesting Act of 2021’’. 

6 SEC. 2. STATEMENT OF POLICY. 

7 It shall be the policy of the United States— 

8 (1) to combat international trafficking in per9 sons for purposes of the removal of organs; 


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1 (2) to promote the establishment of voluntary 

2 organ donation systems with effective enforcement 

3 mechanisms in bilateral diplomatic meetings and in 

4 international health forums; and 

5 (3) to promote the dignity and security of 

6 human life in accordance with the Universal Dec7 laration of Human Rights, adopted on December 10, 

8 1948. 

9 SEC. 3. DEFINITIONS. 

10 In this Act: 

11 (1) APPROPRIATE COMMITTEES OF CON12 GRESS.—The term ‘‘appropriate committees of Con13 gress’’ means— 

14 (A) the Committee on Foreign Relations of 

15 the Senate; and 

16 (B) the Committee on Foreign Affairs of 

17 the House of Representatives. 

18 (2) FORCED ORGAN HARVESTING.—The term 

19 ‘‘forced organ harvesting’’ means the removal of one 

20 or more organs from a person by means of coercion, 

21 abduction, deception, fraud, or abuse of power or a 

22 position of vulnerability. 

23 (3) ORGAN.—The term ‘‘organ’’ has the mean24 ing given the term ‘‘human organ’’ in section 


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1 301(c)(1) of the National Organ Transplant Act (42 

2 U.S.C. 274e(c)(1)). 

3 (4) TRAFFICKING IN PERSONS FOR PURPOSES

4 OF THE REMOVAL OF ORGANS.—The term ‘‘traf5 ficking in persons for purposes of the removal of or6 gans’’ means the recruitment, transportation, trans7 fer, harboring, or receipt of a person for the purpose 

8 of removing one or more of such person’s organs, by 

9 means of— 

10 (A) coercion; 

11 (B) abduction; 

12 (C) deception; 

13 (D) fraud; 

14 (E) abuse of power or a position of vulner15 ability; or 

16 (F) transfer of payments or benefits to 

17 achieve the consent of a person having control 

18 over a person described in the matter preceding 

19 subparagraph (A). 

20 SEC. 4. AUTHORITY TO DENY OR REVOKE PASSPORTS. 

21 Section 4076 of the Revised Statutes (22 U.S.C. 212) 

22 is amended— 

23 (1) by inserting ‘‘(a)’’ before ‘‘No passport’’; 

24 and 

25 (2) by adding at the end the following: 


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1 ‘‘(b)(1) The Secretary of State may refuse to issue 

2 a passport to any individual who has been convicted of 

3 an offense under section 301 of the National Organ 

4 Transplant Act (42 U.S.C. 274e) if such individual, in the 

5 commission of such an offense, used a passport or crossed 

6 an international border. 

7 ‘‘(2) The Secretary of State may revoke a passport 

8 previously issued to any individual described in paragraph 

9 (1).’’. 

10 SEC. 5. REPORTS ON FORCED ORGAN HARVESTING AND 

11 TRAFFICKING IN PERSONS FOR PURPOSES 

12 OF THE REMOVAL OF ORGANS IN FOREIGN 

13 COUNTRIES. 

14 (a) INCLUSION OF INFORMATION IN ANNUAL COUN15 TRY REPORTS ON HUMAN RIGHTS PRACTICES.—The For16 eign Assistance Act of 1961 (22 U.S.C. 2151 et seq.) is 

17 amended— 

18 (1) in section 116 (22 U.S.C. 2151n), by add19 ing at the end the following: 

20 ‘‘(h) FORCED ORGAN HARVESTING AND TRAF21 FICKING IN PERSONS FOR PURPOSES OF THE REMOVAL

22 OF ORGANS.— 

23 ‘‘(1) IN GENERAL.—The report required by 

24 subsection (d) shall include an assessment of forced 

25 organ harvesting and trafficking in persons for purVerDate Sep 11 2014 04:00 Apr 03, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S602.IS S602

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1 poses of the removal of organs in each foreign coun2 try. 

3 ‘‘(2) DEFINITIONS.—In this subsection: 

4 ‘‘(A) FORCED ORGAN HARVESTING.—The 

5 term ‘forced organ harvesting’ means the re6 moval of one or more organs from a person by 

7 means of coercion, abduction, deception, fraud, 

8 or abuse of power or a position of vulnerability. 

9 ‘‘(B) ORGAN.—The term ‘organ’ has the 

10 meaning given the term ‘human organ’ in sec11 tion 301(c)(1) of the National Organ Trans12 plant Act (42 U.S.C. 274e(c)(1)). 

13 ‘‘(C) TRAFFICKING IN PERSONS FOR PUR14 POSES OF THE REMOVAL OF ORGANS.—The 

15 term ‘trafficking in persons for purposes of the 

16 removal of organs’ means the recruitment, 

17 transportation, transfer, harboring, or receipt of 

18 a person for the purpose of removing one or 

19 more of such person’s organs, by means of— 

20 ‘‘(i) coercion; 

21 ‘‘(ii) abduction; 

22 ‘‘(iii) deception; 

23 ‘‘(iv) fraud; 

24 ‘‘(v) abuse of power or a position of 

25 vulnerability; or 


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1 ‘‘(vi) transfer of payments or benefits 

2 to achieve the consent of a person having 

3 control over a person described in the mat4 ter preceding clause (i).’’; and 

5 (2) in section 502B (22 U.S.C. 2304)— 

6 (A) by redesignating the second subsection 

7 (i) (relating to child marriage status) as sub8 section (j); and 

9 (B) by adding at the end the following: 

10 ‘‘(k) FORCED ORGAN HARVESTING AND TRAF11 FICKING IN PERSONS FOR PURPOSES OF THE REMOVAL

12 OF ORGANS.— 

13 ‘‘(1) IN GENERAL.—The report required by 

14 subsection (b) shall include an assessment of forced 

15 organ harvesting and trafficking in persons for pur16 poses of the removal of organs in each foreign coun17 try. 

18 ‘‘(2) DEFINITIONS.—In this subsection, the 

19 terms ‘forced organ harvesting’, ‘organ’, and ‘traf20 ficking in persons for purposes of the removal of or21 gans’ have the meanings given those terms in section 

22 116(h)(2).’’. 

23 (b) ADDITIONAL REPORTS.— 

24 (1) IN GENERAL.—Not later than 30 days after 

25 the date on which each annual report required by 


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1 sections 116 and 502B of the Foreign Assistance 

2 Act of 1961 (22 U.S.C. 2151n, 2304), as amended 

3 by subsection (a), is submitted, the Assistant Sec4 retary of State for Democracy, Human Rights, and 

5 Labor (in this subsection referred to as the ‘‘Assist6 ant Secretary’’), shall submit to the appropriate 

7 committees of Congress a report that includes the 

8 following: 

9 (A) With respect to each foreign country, 

10 an identification of any agencies, instrumental11 ities, or officials of the country that are respon12 sible for forced organ harvesting or trafficking 

13 in persons for purposes of the removal of or14 gans. 

15 (B) A tiered ranking described in para16 graph (2). 

17 (2) TIERED RANKING.—The tiered ranking de18 scribed in this paragraph is a tiered ranking of all 

19 foreign countries as follows: 

20 (A) TIER 1 COUNTRIES.—The Assistant 

21 Secretary shall designate a country as tier 1 if 

22 the country has low levels of forced organ har23 vesting or trafficking in persons for purposes of 

24 the removal of organs and the government of 


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1 such country is making significant efforts to 

2 combat those practices. 

3 (B) TIER 2 COUNTRIES.—The Assistant 

4 Secretary shall designate a country as tier 2 if 

5 the country has— 

6 (i) low or intermediate levels of forced 

7 organ harvesting or trafficking in persons 

8 for purposes of the removal of organs and 

9 the government of such country is not 

10 making significant efforts to combat those 

11 practices; or 

12 (ii) intermediate levels of forced organ 

13 harvesting or trafficking in persons for 

14 purposes of the removal of organs and the 

15 government of such country is making sig16 nificant efforts to combat those practices. 

17 (C) TIER 3 COUNTRIES.—The Assistant 

18 Secretary shall designate a country as tier 3 

19 if— 

20 (i) the country has high levels of 

21 forced organ harvesting or trafficking in 

22 persons for purposes of the removal of or23 gans; or 

24 (ii) the government of such country is 

25 directly or indirectly supporting forced 


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1 organ harvesting or trafficking in persons 

2 for purposes of the removal of organs. 

3 (3) FORM.—The report required by this sub4 section shall be submitted in unclassified form. 

5 (c) INTERIM REPORTS.—In addition to the annual re6 ports required by sections 116 and 502B of the Foreign 

7 Assistance Act of 1961 (22 U.S.C. 2151n, 2304), as 

8 amended by subsection (a), the Secretary of State may 

9 submit to the appropriate committees of Congress at any 

10 time one or more interim reports with respect to the status 

11 of forced organ harvesting and trafficking in persons for 

12 purposes of the removal of organs in foreign countries, in13 cluding information about countries whose governments 

14 have begun or ceased to make significant efforts to combat 

15 those practices since the date on which the most recent 

16 annual report was submitted under such sections. 

17 (d) CONSIDERATION OF SIGNIFICANT EFFORTS.—In 

18 determining whether the government of a country is mak19 ing significant efforts to combat forced organ harvesting 

20 and trafficking in persons for purposes of the removal of 

21 organs under subsections (b) and (c), the Secretary of 

22 State shall consider— 

23 (1) the extent to which the country is a country 

24 of origin, transit, or destination for forced organ 


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1 harvesting and trafficking in persons for purposes of 

2 the removal of organs; 

3 (2) the extent of efforts by the government to 

4 combat forced organ harvesting and trafficking in 

5 persons for purposes of the removal of organs, and, 

6 particularly, the extent to which officials or employ7 ees of the government have participated in, facili8 tated, or condoned, or are otherwise complicit in, 

9 those practices; and 

10 (3) the measures that would be reasonable for 

11 the government to combat forced organ harvesting 

12 and trafficking in persons for purposes of the re13 moval of organs, considering the resources and capa14 bilities of the government. 

15 SEC. 6. REPORT ON UNITED STATES MEDICAL AND EDU16 CATIONAL INSTITUTIONS AT WHICH ORGAN 

17 TRANSPLANT SURGEONS FROM TIER 3 COUN18 TRIES ARE TRAINED. 

19 (a) IN GENERAL.—Not later than 180 days after the 

20 date on which each annual report required by sections 116 

21 and 502B of the Foreign Assistance Act of 1961 (22 

22 U.S.C. 2151n, 2304), as amended by section 5(a), is sub23 mitted, the Secretary of State, in consultation with the 

24 Secretary of Health and Human Services, shall submit to 

25 Congress a report on medical and educational institutions 


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1 and other entities in the United States at which organ 

2 transplant surgeons are trained. 

3 (b) ELEMENTS.— 

4 (1) IN GENERAL.—Each report required by 

5 subsection (a) shall include an identification of each 

6 medical or educational institution or other entity in 

7 the United States at which one or more organ trans8 plant surgeons described in paragraph (2) are 

9 trained as of the date on which the report is sub10 mitted. 

11 (2) ORGAN TRANSPLANT SURGEON DE12 SCRIBED.—An organ transplant surgeon described 

13 in this paragraph is an organ transplant surgeon 

14 who— 

15 (A) as of the date on which the report re16 quired by subsection (a) is submitted, is em17 ployed by or affiliated with an agency or instru18 mentality identified in the most recent addi19 tional report required by section 5(b) as being 

20 responsible for forced organ harvesting or traf21 ficking in persons for purposes of the removal 

22 of organs; and 

23 (B) is a citizen or national of a country 

24 designated as a tier 3 country in the most re25 cent additional report required by section 5(b). 


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1 SEC. 7. PROHIBITION ON THE EXPORT OF ORGAN TRANS2 PLANT SURGERY DEVICES TO CERTAIN ENTI3 TIES. 

4 Section 801 of the Federal Food, Drug, and Cosmetic 

5 Act (21 U.S.C. 381) is amended by adding at the end the 

6 following: 

7 ‘‘(v) PROHIBITION ON EXPORT OF ORGAN TRANS8 PLANT SURGERY DEVICES TO CERTAIN ENTITIES.— 

9 ‘‘(1) IN GENERAL.—Notwithstanding any other 

10 provision of this Act, a device that is intended for 

11 use in organ transplant surgery may not be exported 

12 to any entity that is identified in the most recent ad13 ditional report required by section 5(b) of the Stop 

14 Forced Organ Harvesting Act of 2021 as being re15 sponsible for forced organ harvesting or trafficking 

16 in persons for purposes of the removal of organs. 

17 ‘‘(2) COORDINATION WITH THE SECRETARY OF

18 COMMERCE.—The Secretary shall coordinate with 

19 the Secretary of Commerce to ensure compliance 

20 with paragraph (1).’’. 


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1 SEC. 8. IMPOSITION OF SANCTIONS WITH RESPECT TO 

2 FORCED ORGAN HARVESTING OR TRAF3 FICKING IN PERSONS FOR PURPOSES OF THE 

4 REMOVAL OF ORGANS FACILITATED BY TIER 

5 3 COUNTRIES. 

6 (a) LIST REQUIRED.—Not later than 180 days after 

7 the date on which each annual report required by sections 

8 116 and 502B of the Foreign Assistance Act of 1961 (22 

9 U.S.C. 2151n, 2304), as amended by section 5(a), is sub10 mitted, the President shall submit to Congress a list of 

11 each person that the President determines— 

12 (1) funds, supports, sponsors, or otherwise fa13 cilitates forced organ harvesting or trafficking in 

14 persons for purposes of the removal of organs; and 

15 (2) is— 

16 (A) an individual who is a citizen or na17 tional of a country designated as a tier 3 coun18 try in the most recent additional report re19 quired by section 5(b); or 

20 (B) an entity organized under the laws of 

21 such a country or otherwise subject to the juris22 diction of the government of such a country. 

23 (b) IMPOSITION OF SANCTIONS.—The President shall 

24 impose the following sanctions with respect to a person 

25 on the list required by subsection (a): 


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1 (1) PROPERTY BLOCKING.—The President shall 

2 exercise all of the powers granted by the Inter3 national Emergency Economic Powers Act (50 

4 U.S.C. 1701 et seq.) (except that the requirements 

5 of section 202 of such Act (50 U.S.C. 1701) shall 

6 not apply) to the extent necessary to block and pro7 hibit all transactions in all property and interests in 

8 property of the person if such property and interests 

9 in property are in the United States, come within 

10 the United States, or are or come within the posses11 sion or control of a United States person. 

12 (2) ALIENS INADMISSIBLE FOR VISAS, ADMIS13 SION, OR PAROLE.— 

14 (A) VISAS, ADMISSION, OR PAROLE.—In 

15 the case of an individual, that individual is— 

16 (i) inadmissible to the United States; 

17 (ii) ineligible to receive a visa or other 

18 documentation to enter the United States; 

19 and 

20 (iii) otherwise ineligible to be admitted 

21 or paroled into the United States or to re22 ceive any other benefit under the Immigra23 tion and Nationality Act (8 U.S.C. 1101 et 

24 seq.). 

25 (B) CURRENT VISAS REVOKED.— 


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1 (i) IN GENERAL.—The visa or other 

2 entry documentation of the individual shall 

3 be revoked, regardless of when such visa or 

4 other entry documentation is or was 

5 issued. 

6 (ii) IMMEDIATE EFFECT.—A revoca7 tion under clause (i) shall— 

8 (I) take effect immediately; and 

9 (II) automatically cancel any 

10 other valid visa or entry documenta11 tion that is in the individual’s posses12 sion. 

13 (c) EXCEPTIONS.— 

14 (1) EXCEPTION RELATING TO IMPORTATION OF

15 GOODS.— 

16 (A) IN GENERAL.—The authorities and re17 quirements to impose sanctions under sub18 section (b)(1) shall not include the authority or 

19 a requirement to impose sanctions on the im20 portation of goods. 

21 (B) GOOD DEFINED.—In this paragraph, 

22 the term ‘‘good’’ means any article, natural or 

23 manmade substance, material, supply or manu24 factured product, including inspection and test 

25 equipment, and excluding technical data. 


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1 (2) EXCEPTION TO COMPLY WITH INTER2 NATIONAL OBLIGATIONS.—Subsection (b)(2) shall 

3 not apply to the admission of an individual if the ad4 mission of the individual is necessary to comply with 

5 United States obligations under the Agreement be6 tween the United Nations and the United States of 

7 America regarding the Headquarters of the United 

8 Nations, signed at Lake Success June 26, 1947, and 

9 entered into force November 21, 1947, under the 

10 Convention on Consular Relations, done at Vienna 

11 April 24, 1963, and entered into force March 19, 

12 1967, or under other international agreements. 

13 (d) IMPLEMENTATION; PENALTIES.— 

14 (1) IMPLEMENTATION.—The President may ex15 ercise all authorities provided under sections 203 

16 and 205 of the International Emergency Economic 

17 Powers Act (50 U.S.C. 1702 and 1704) to carry out 

18 this section. 

19 (2) PENALTIES.—A person that violates, at20 tempts to violate, conspires to violate, or causes a 

21 violation of this section or any regulation, license, or 

22 order issued to carry out this section shall be subject 

23 to the penalties set forth in subsections (b) and (c) 

24 of section 206 of the International Emergency Eco25 nomic Powers Act (50 U.S.C. 1705) to the same exVerDate Sep 11 2014 04:00 Apr 03, 2021 Jkt 019200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6201 E:\BILLS\S602.IS S602

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1 tent as a person that commits an unlawful act de2 scribed in subsection (a) of that section. 

3 (e) UNITED STATES PERSON DEFINED.—In this sec4 tion, the term ‘‘United States person’’ means— 

5 (1) a United States citizen or an alien lawfully 

6 admitted for permanent residence to the United 

7 States; or 

8 (2) an entity organized under the laws of the 

9 United States or any jurisdiction within the United 

10 States, including a foreign branch of such an entity. 

Æ 


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