Challenges to Global Health Governance from the International Trade in Organ Transplants

The internationalization of medical services—including organ transplantations—is driven by advances in technology and integration of trade. Patients in need of organ transplants began to seek these services outside their countries of origin in the 1980s and 1990s, and this practice expanded in the ensuing decades. While these transplants yielded benefits to some, abuses included human trafficking, preying on vulnerable populations, and negative outcomes in health equity. This case study of efforts to regulate the international transplant trade yields important findings for our understanding of global health governance. First, it provides support to the “globalization reformers” who maintain that if globalization’s benefits are to be widely distributed, institutional mechanisms must be enacted. Second, it provides another example of the externalities that occur when health concerns are absent, poorly represented, or weakened in trade negotiations. Finally, it demonstrates limits of a global health regime that lacks a centralized authority.