Lok Sabha Question No. 3000 (UNSTARRED), answered on 2024-12-13
Subject: Promotion of Organ and Tissue Donation
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Raju Bista

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 3000 TO BE ANSWERED ON 13 TH DECEMBER, 2024

## PROMOTION OF ORGAN AND TISSUE DONATION

## 3000. SHRI RAJU BISTA:

Will the Minister of HEALTHANDFAMILYWELFARE be pleased to state:

- (a) the steps taken/proposed to be taken by the Government to promote organ and tissue donation and transplant in the country during the last ten years;
- (b) the steps taken/proposed to be taken by the Government during the last ten years to make organ and tissue transplantation affordable;
- (c) the steps taken/proposed to be taken by the Government to eliminate organ and tissue trafficking since 2014; and
- (d) whether the Government has details of the organs and tissue donation and transplantation since 2014 and if so, the details thereof?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI PRATAPRAO JADHAV)

- (a) The Ministry of Health and Family Welfare has taken following steps to promote organ and tissue donation and transplant in the country during the last ten years:
- Implementation of National Organ Transplant program (NOTP), which aims to improve access to organ transplantation for needy citizens of the country by enhancing awareness about deceased organ donation, organizing an efficient mechanism for organ procurement and distribution for transplantation, strengthening public sector infrastructure, training of manpower etc. ;
- Under NOTP, a three-tiered network has been set up with dedicated institutions at three levels: one National Organ and Tissue Transplant Organization (NOTTO), five Regional Organ and Tissue Transplant Organizations (ROTTOs), and 21 State Organ and Tissue Transplant Organizations (SOTTOs). Currently, over 900 institutions and hospitals involved in organ/tissue transplantation, organ retrieval and tissue banking are linked with the network ;
- Activities are organized across the country for generating awareness, such as celebration of Indian Organ Donation Day annually, seminars, webinars, workshops,

debates, sports events, walkathons, marathons, nukkad natak, legal symposium, NOTTO Scientific Dialogue etc. ;

- The government engages with various stakeholders like Government Ministries and Departments, legal representatives, medical and paramedical professionals, corporates, police personnel, various NGOs, school and college students, communitybased organizations etc. to enhance awareness on Brain Stem Death and Organ Donation. Regular programs are organized with school children for imparting knowledge about organ donation. Special campaigns for improving awareness, pledge registration and competitions through MyGov have been conducted. NOTTO promotes organ donation through talks by experts and program officers on TV, Radio and other audio-visual media, social media, print media etc. ;
- Display boards on organ donation are exhibited outside ICUs and other strategic locations in the transplant/retrieval hospitals ;
- Angdaan Mahotsav was organized during the month of July, 2023 involving all Central Ministries and State/UT Governments wherein various awareness and organ donation pledging activities and competitions through MyGov platforms were undertaken. Organ donation is promoted every year through India International Trade Fair and it was recently promoted during the G-20 events. To improve the outreach of awareness till village level, organ donation was promoted during Sewa Pakhwada, Ayushman Bhava initiative, Viksit Bharat Sankalp Yatra etc. in the year 2023 ;
- In 2024, Angdaan Jan Jagrukta Abhiyaan has been initiated, wherein Organ Donation Month has been observed in July. Campaign activities have been carried out through Ministries/Departments of Union Government, State Governments, Medical colleges and Hospitals, NGOs, and other organizations. The 14th Indian Organ Donation Day was organized on 3rd August, 2024 wherein families of deceased organ donors were felicitated, and awards were distributed for exemplary contributions in the field of organ donation and transplantation. During the event, the Annual Report of NOTTO, Standard operative procedures (SOPs) for organ transport, and the NOTTO enewsletter were also released ;
- Awebsite (www.notto.mohfw.gov.in) has been launched, along with establishment of a 24x7 call-centre with a toll free helpline number (1800114770) to provide information, tele-counseling and to help in coordination for organ donation ;
- In September 2023, an Aadhar-linked digital web portal (notto.abdm.gov.in) has been launched to facilitate the registration of organ and tissue donation pledges. As on date, over 2 lakh citizens have pledged to donate their organs and tissues after death ;
- Under NOTP, grants are provided to States/UTs for the establishment of ROTTOs/SOTTOs, augmentation of infrastructure in public sector such as Organ Transplant/Retrieval Centers/Tissue Banks, hiring of Transplant Coordinators by Medical Colleges and Trauma Centers, maintenance of deceased donors, organ transport, post-transplant immune-suppressant medicines, awareness initiatives, training and capacity building programs etc. ;
- A grant of Rs. 10,000/- is provided for the dignified funeral of each deceased donor. States/UTs have also been requested to felicitate deceased organ donors and their family members by presenting a shawl, certificate and flowers as a mark of respect to

deceased organ donors at the time of donation, for which an additional grant of Rs. 1,000/- per donor is provided under NOTP ;

- For ensuring a uniform organ transport policy, the SOPs for organ transport were launched on 3rd August, 2024, on the occasion of 14th Indian Organ Donation Day.

(b) The Ministry of Health and Family Welfare has taken following steps to make organ and tissue transplantation affordable during the last ten years:

- Several tertiary-level institutions, including new AIIMS, AIIMS-like institutions, and super-specialty blocks within medical colleges have been established to strengthen the infrastructure for organ donation and transplantation in the public sector. Under NOTP, grants are provided to States/UTs to create and upgrade facilities for organ retrieval, transplantation, and tissue banking ;
- The kidney transplantation package has been included under Pradhan Mantri Jan Arogya Yojana (PM-JAY) scheme of Ayushman Bharat. Furthermore, under Rashtriya Arogya Nidhi (RAN), financial support of up to Rs. 15 lakh is provided to patients who are below poverty line for heart, lung, liver, kidney, and other organ transplants ;
- Under NOTP, financial support of up to Rs. 10,000/per patient per month is provided to transplant recipients towards immunosuppressant medicines.

(c) 'Health' and 'Law & Order' are State subjects. Thus, it is primarily the responsibility of the State Government / UT Administration to take action for prevention and control of organ trade and monitor the same. The Transplantation of Human Organs and Tissues Act (THOTA), 1994 provides for an appropriate authority to be appointed by every State for investigating any complaint or breach of any of the provisions of this act, or any of the rules thereunder. The State Appropriate Authority shall, for the purposes of this act, have all the powers of a civil court to try a suit under the Code of Civil Procedure, 1908(5 of 1908). However, the following steps have been taken by the Government to curb illegal organ transplants:

- NOTTO, a national apex level organization has been set up in pursuance of the mandate given to Central Government under THOTA 1994, for establishing a network for procurement and distribution of organs and tissues and to maintain a national registry for surveillance of organ donation and transplantation in the country. States/UTs have been requested to ensure that every hospital performing organ transplantation or retrieval needs to be linked to the website of NOTTO and data related to both deceased and living donors and recipients of transplants is required to be uploaded in the National Registry maintained by NOTTO. Further, each donor and recipient of human organ will have a unique NOTTO ID in cases of both deceased as well as living donor transplant and the same is to be generated by the concerned Hospitals.
- NOTTO, along with ROTTOs, SOTTOs and other institutions organize awareness programs across the country to disseminate information about provisions of The Transplantation of Human Organs and Tissues Act and rules, so that people are cognizant towards the Government recognized process of organ donation permitted
- by the law, along with the illegality and repercussions associated with indulgence in organ trade, in order to make it easy for them to comply with the provisions of law.
- All States/UTs have been advised to constitute an Advisory Committee as per provisions of the THOTA, 1994 to aid and advise the Appropriate Authority in discharging its functions of controlling illegal organ transplant activities.
- A letter was sent by Ministry of Health and Family Welfare to Ministry of External Affairs (MEA) after which, a note verbale has been circulated by MEA to all the Embassies/ Foreign Missions in India apprising them about the legal provisions of organ transplant Act in India so as to prevent illegal organ transplants involving foreigners. Rules for transplants involving foreigners have been shared with Ministry of External Affairs for dissemination to Indian Missions abroad and the same have also been displayed on ports and Airports.
- The specific rules, guidelines and legal requirements that regulate transplantation in India, have been disseminated to all foreign diplomatic missions based in India for their information and further dissemination to their respective citizens seeking transplantation treatment in India.

## (d) The number of organ transplants and donations in the country from 2014 to 2023 is as follows:

|   Year |   Total Organ Transplants |   Total Organ Donations |
|--------|---------------------------|-------------------------|
|   2014 |                      6916 |                    6294 |
|   2015 |                      8348 |                    7355 |
|   2016 |                      9022 |                    7687 |
|   2017 |                      9539 |                    8202 |
|   2018 |                     10340 |                    8961 |
|   2019 |                     12666 |                   11323 |
|   2020 |                      7443 |                    6812 |
|   2021 |                     12259 |                   11198 |
|   2022 |                     16041 |                   14300 |
|   2023 |                     18378 |                   16542 |

As per information provided by the States/UTs, the number of tissue transplants and donations in the country from 2018 to 2023 is as follows:

|   Year |   Total Tissue Transplants |   Total Tissue Donations |
|--------|----------------------------|--------------------------|
|   2018 |                       6403 |                     8996 |
|   2019 |                       7416 |                    11719 |
|   2020 |                       2578 |                     3831 |
|   2021 |                       5208 |                     5831 |
|   2022 |                       6050 |                     8918 |
|   2023 |                       2910 |                     6918 |