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Illegal organ traffickers in Africa prey on world's poor

Cai Nebe | Ben Shemang in Abuja, Nigeria
September 18, 2024

Illegal organ trafficking is growing across Africa. The sophisticated operation is worth over $1 billion annually and targets the vulnerable. Lack of regulation and huge demand for organs drive the trade.

https://p.dw.com/p/4kjDT
An unidentified man in South Africa shows a scar resulting from an illegal kidney operation
An unidentified Brazilian man shows the scar after an operation to remove his kidney in Durban, South Africa, in 2023Image: picture-alliance/dpa

The rising trade of human organs "has reached an epidemic level, yet it is receiving much of public silence," Nigerian human rights lawyer Frank Tietie told DW.

"You one would have expected the level of public condemnation against it would have been much higher, but that's not the case." 

A report by Global Financial Integrity (GFI), a Washington, DC-based think tank focused on corruption, illicit trade and money laundering, estimated that between $840 million and $1.7 billion (€755 million and €1.5 billion) is generated annually from trafficking in persons for organ removal.

Two Brazilians who came to South Africa to sell their kidneys in Durban, South Africa (2003 file photo)
The human organ trafficking industry is driven by a high demand for organs and the severe shortage of legal organ donorsImage: epa/dpa/picture-alliance

Organ donation and transplantation are well-established medical practices that are important for sustaining patients with failing organs. The procedures can be highly successful when conducted with informed consent and transparency.

But there are concerns that often organ donation "is driven mainly by poverty rather than the noble motivation of trying to save a life or trying to help any person's medical condition," Tietie told DW.

"People are either selling their organs or certain medical personnel, particularly doctors, that are unscrupulous, usually affects the organs of their patients quite unknown to them." 

'How much for my kidney?'

The sale of human organs is illegal across Africa. However, in 2022, the Kenyatta National Hospital in Nairobi, Kenya, felt compelled to put out a Facebook post reading "We Don't Buy Kidneys!" after the medical institution said "How much for my kidney?" was their most inboxed question.  

But according to Willis Okumu, a senior researcher at the Institute for Security Studies, not all 'irregular' transplants are forced. While researchingthe organ trade in Eldoret, a city in western Kenya, Okumu found young men willing to sell their kidneys for "quick cash."

"They were not really being coerced in any way," he said, adding that donors were being offered "as much as $6,000."

To put that in perspective, a kidney recipient can pay over $150 000, according to a European Parliament document. 

Prisoners of the Nigerian Mafia

Okumu says, though, that donors rarely actually received that much money. He recalls seeing "a number of young guys with scars on their abdomens," showing they had gone through the procedure. They had no fear of prosecution, as it was difficult for authorities to enforce the law.

"Most of them, when they came back, they had investments or they had bought a motorbike or put up a new home," Okumu added, saying that donors became recruiters of other young men to donate their kidneys to feed a growing black market outside of Kenya.

Growth of an organ trade

Though details about the illicit world of human organ trafficking are unclear, it is believed that Egypt, Libya, South Africa, Kenya and Nigeria are the most affected countries in Africa. 

The reasons for this are complex, but because regulation of transplants and organ donation differs from region to region, the United Nations Office on Drugs and Crime (UNODC) has highlighted the issue of trafficking in persons for organ removal, commonly known as transplant tourism, and raised concerns that illicitly transplanted organs flow from vulnerable populations to wealthier recipients.

According to the Global Observatory on Organ Donation and Transplantation, less than 10% of required transplants are performed worldwide, which has led to some patients trying to obtain organs illegally.

There is also a comparatively low number of medical centers that perform legal transplants in Africa. For example, a World Health Organization (WHOpaper from 2020 listed just 35 kidney transplant centers for the entire continent. This type of insufficient capacity is blamed on lack of accessibility, limited expertise and inadequate financial support.

A medical professional holds a removed kidney
Kidneys are one of the most trafficked human organs, as donors can continue living after one is removedImage: Ute Grabowsky/photothek/picture alliance

A sophisticated operation

The illicit and lucrative nature of the trade means organ trafficking networks are highly organized. The skills needed to perform complex surgeries, both on the donor and recipient, the connecting of buyers and sellers, all while avoiding the attention of international law enforcement agencies, mean that organ traffickers involve members of the medical sector, local criminal groups  and even politicians.

Okumu believes what he saw in western Kenya is part of a larger syndicate of international human body parts traffickers. The young men he met "talked about doctors who could not speak Swahili and they were Indian by origin," leading him to conclude that the operation was international. 

A jury in London last year delivered guilty verdicts against Nigerian Senator Ike Ekweremadu, his wife, and a doctor for conspiring to exploit a young man from Lagos for his kidney.

The verdict was the first under the UK's modern slavery laws to convict suspects of an organ-harvesting plot.

Tietie, the Nigerian human rights lawyer, said that the prospect of financial gain from human organs has led to fears that so-called baby factories in Nigeria could also become targets for organ traffickers, highlighting "the close link between the trafficking of persons and organ harvesting."

Tietie emphasized that local medical centers also bear the responsibility not to prey on vulnerable people.

"What happens when medical personnel, doctors at very at elitist hospitals in Abuja in Lagos, actually hold themselves out to their rich patients and tell them not to worry, that they can arrange a poor trading boy to sell these organs?" he said.

New life: The long road to a donor organ

Edited by: Keith Walker

DW Africa's Cai Nebe smiles into the camera
Cai Nebe Producer, podcaster and reporter for DW Africa