Questions for the future
p. 359-361
Texte intégral
1In this last part of the book, the authors examine future developments of these cannibal markets and possible ways to slow down their growth or even limit them to marginal phenomena. Beyond their specificities, we see in each of the areas discussed in this book that in some countries significant efforts are made to reduce the size of these markets. On the other hand, we should not overlook that beyond some statements made by the scientific community (see in particular the Declaration of Istanbul on Organ Trafficking and Transplant Tourism), NGOs or religious leaders (such as the Pope’s 2011 statement condemning the trafficking of organs), the general trend today is rather towards a rapid growth in these markets.
2Recognizing the existence of significant weaknesses in the international community’s ability to better control the situation, the World Health Organization (WHO) has defined a concept—medical products of human origin (MPHOs)1—that should facilitate harmonizing national and international legislative frameworks. The WHO Executive Board endorsed the concept on January 20152 and requested the Director General to “support the development of global consensus on guiding ethical principles for the donation and management of the mentioned MPHOs; good governance mechanisms; and common tools to ensure quality, safety and traceability.”
3Using the concept of “transnational medical practices” that “create markets in human beings, body parts, and substances for medical uses,” Carmel Shalev wonders how to move towards human-rights-based instruments to build a minimal global consensus on the non-commercial nature of the human body and its parts. Her chapter describes the key issues of concern and the major international legal instruments and guidelines that have emerged in response to the various challenges posed by the different medical market practices. Finally, she highlights the fact that the complex issues of transnational medically assisted reproduction have largely been neglected. She adds that cross-border third-party-reproduction practices raise singular and complex issues in respect of the rights of the children, which are beginning to be acknowledged and addressed.
4Meanwhile, Luc Noël discusses the concept of medical products of human origin (MPHOs), which he describes as a fundamental tool for professional, national and international governance. In addition, the author insists on the fact that a common biology and physiology enables a transnational movement of MPHOs between human beings transcending culture, race, gender, age, religion, and citizenship. However, he warns that in the absence of effective laws and regulations to protect communities and individuals, procurement and use of MPHOs could reveal the darker side of these cannibal markets: a consumption that may destroy and efface the donor.
5Finally Alexander Capron introduces the concepts of “cannibalized commodities” and “markets in human commodities” and asks some key terminological questions such as: What are cannibalized commodities? Which activities involve cannibalized commodities? He stresses that there is a need to understand how markets in human commodities work, and more particularly what roles the professions, governments, and international bodies can play in responding to the phenomenon of human commodification?
6Cannibal-market forces are very powerful because there is both a strong demand and an almost unlimited supply. On the one hand, it is an illusion to imagine an outright ban on those activities. Some countries would refuse and that would lead to the development of a black market that would be totally out of control. On the other hand, it is another dangerous illusion to leave such technologies in the hands of market-oriented international trade. This would lead to ethically unacceptable practices and costs that would contribute to the growth of social inequalities in health. So, what are the alternatives? Commercialization and misuses of technologies resulting from advances in medicine is a general phenomenon for which we used the metaphor of “cannibal market.” If these technologies have many aspects in common, they also have specificities. Therefore solutions must be sought both at national and international level, but also for each of the technologies that address specific issues.
Notes de bas de page
1 Medical Products of Human Origin (MPHOs) comprise all human derived donated material used for human application and include blood, organs, bone marrow, cord blood, corneas, tissues, reproductive cells and milk. These products have much in common: they are derived from a consenting donor; they carry risks of disease transmission; they may be distributed globally; and they are of unique and often irreplaceable therapeutic value.
2 World Health Organization (2015). Principles for global consensus on the donation and management of blood and other medical products of human origin. EB136/CONF./3. Geneva, 2015.
Auteur
PhD, is director for the Department of Service Delivery and Safety at the World Health Organization. He leads WHO’s efforts at strengthening the safety, quality, integration and people centredness of health services globally and manages WHO’s work in a wide range of programs, including health services integration and regulation, patient safety and quality, blood safety, injection safety, transplantation, traditional medicine, essential and safe surgery and emerging areas such as mHealth for health services and genomics. Dr Kelley worked for ten years in West and North Africa and Latin America, directing research on the Integrated Management of Childhood Illness in Niger. Recently, he was asked to lead the Infection Prevention and Safety and the Health System Recovery teams for WHO’s Ebola Response effort.
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