New Delhi, July 2 Policy changes are crucial to ensure equitable access to life-saving organ transplants for underserved and marginalised populations, according to a global study led by international researchers, including from India.
While solid organ transplantation has improved globally, many patients, particularly in low- and middle-income countries (LMICs), struggle to access these services.
The research, part of The Lancet's series promoting equitable access to life-saving organ transplantation treatments, highlights critical disparities in access to life-saving transplants, underscoring the need for equitable solutions across low- and middle-income countries.
It noted that advancements in organ preservation and improvements in immunosuppression have led to improvements in solid organ transplantation worldwide, but access remains a key concern for underserved and marginalised populations.
The study outlined a policy agenda to address disparities in access to transplantation and post-transplant care. These disparities are not just local issues, but global challenges that affect the lives of many.
"As we strive to advance global health, we must prioritise public investment and accountability, ensuring that innovative treatments are accessible to all, regardless of socio-economic status," said Dr. Vivekanand Jha, co-author and Executive Director, The George Institute for Global Health India.
Despite organ transplantation being a cost-effective therapy, challenges include a low donor pool and limited immunosuppressive medication resources.
While high-income countries, such as the US, Spain, and South Korea, report over 100 transplants per million annually, many regions in Africa, Asia, and South America remain below 20 per million.
The paper categorised India among countries with multiple transplant centres but facing significant challenges with funding and prioritisation.
“India faces challenges in public investment and care coordination despite existing frameworks,” revealed the study.
It further showed that in the country most transplants occur in private hospitals that are concentrated in urban areas, with no comprehensive national policy covering transplantation costs, despite available free dialysis in many states.
"India is poised to make significant advancements in transplant capabilities. Looking ahead, we must focus on ensuring that these life-saving treatments are accessible to every Indian, regardless of their location or income. This will require targeted public investment, comprehensive policy reform, and robust accountability mechanisms," Jha said.
The study stressed the need to establish a national organ transplantation registry with metrics to track access gaps; strengthen public sector transplant infrastructure and incentivise equitable service expansion.
It also urged for financial protection for recipients and living donors through national insurance policies; standardising transplant eligibility and organ allocation criteria for fairness and equity; and improving access to affordable post-transplant care, including immunosuppressive medication and telemedicine.
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