by Sunayana Singh

Organ donation and transplantation in India is seeing a rise in numbers from the time the program took off in India at the turn of the century, although it is still far from the country’s need. Many factors have contributed to the improvement in organ donation and transplantation in India, the transplantation act passed by the Indian government in 1994, availability of suitable facilities, technological advancements, trained and skilled experts in private sector for heart and liver transplants, well established kidney transplant units in government hospitals, and contribution by several non-government organizations (NGOs) towards organ donation awareness and training activities.

The law set out the rules and processes for all hospitals and regulatory authorities regarding both living and deceased organ donation and transplantation and has largely been effective in curbing the illegal organ trade.

There has been some informal support and collaboration between various NGOs with motivated volunteers, private hospitals with state-of-the-art facilities and highly skilled staff and government hospitals in developing organ donation and transplantation at government hospitals, generally in the form of honorary expertise and support staff.

A public-private partnership can help transform organ donation and transplantation scenario in the whole country. The solution for a better organ donation rate and a seamless process lies in bringing together the resources of the public and private sectors.

Such partnerships could take the following forms:

1. Partnerships between government and private hospitals to increase organ donation. Most government hospitals have a large bed strength, strong neurology and neurosurgery units and strong trauma service; however, the resource limitations may allow them to only focus on clinical services, rather than organ donation.

Government hospitals typically have few or no transplant coordinators in service. A PPP model may allow private hospitals to support government hospitals with manpower for organ donation.

In this model, one transplant hospital may have formal tie-up with smaller non-transplant hospitals and government institutes in their proximity. Transplant coordinators from the transplant hospital may support these hospitals with counseling, logistics and knowhow for organ donation. In addition, the Private-run hospitals can aid smaller units by setting up authorization committees within the hospital and brain death committees as well as help the hospital with the know-how on how to apply for a transplant license.

1. Transplant hospitals may help capacity building for organ donation and retrieval in government hospitals. Training programs for government hospital doctors and staff at private hospitals can help address the shortage of specialized doctors and staff for retrieval and transplant.
2. Expansion of transplant programs to tier-II cities, from manpower training to setting up processes. Smaller centers/cities cannot attract a transplant professional because of differences in reimbursement scales. Such professionals can devote part of their time to these centers in smaller cities.
3. CSR funds from private hospitals and organizations may be prioritized for setting up transplant facilities at government hospitals. The government sector cannot compete with the private sector in terms of salaries offered to its medical professionals.

CSR funds from corporate partners are spent towards hiring of specialized transplant surgeons to conduct surgeries in government hospitals, especially in cases where no transplant surgeon wishes to voluntarily be posted in a smaller city or town where transplants are possible.

1. Logistical Help. To further add to organ retrieval challenges, the allocation and timely delivery system is a massive task. It requires efficient coordination which is often difficult in remote regions. Organs are not retrieved from thousands of brain-dead patients, which could help many critically ill patients. The private sector is known for its advanced infrastructure and equipment. A public-private partnership can extend these facilities on a larger scale to even the remote regions in India with the help of air-ambulances, coordination with police and airlines, equipment for transport of organs and many other things.P
2. PPP as a module functions on a high volume and low margin as it is often supported by subsidiaries and incentives from the government. The relief schemes and incentives can help pour in the money back into the advancement of the medical setups or concessions for patients.

The private sector with its resources can help in streamlining the whole process from retrieval to transplant. The government hospitals especially in smaller cities often lack skilled personnel who can carry out the transplants and require support from these hospitals.This will not only bring facilities to smaller cities and towns but will also bring about affordable transplants. Organ transplant are an expensive affair with expenditure extending for post-transplant care as well. By bringing together these public and private sectors, transplant can be offered at affordable rates to a wider patient base who would otherwise have been left out.

Collaboration between the state-of-the-art hospitals and medical facilities of the private sector and the government medical infrastructures run by governments all over the country can help in furthering this cause. This combined with increased awareness with the help of the public and private sector can make organ donation and transplant an affordable and inclusive process.

Sunayana Singh, CEO ORGAN India

(DISCLAIMER: The views expressed are solely of the author and ETHealthworld does not necessarily subscribe to it. ETHealthworld.com shall not be responsible for any damage caused to any person / organisation directly or indirectly.)