Organ trafficking and transplant tourism: the role of global professional ethical standards - the 2008 declaration of Istanbul

By 2005, human organ trafficking, commercialization, and transplant tourism had become a prominent and pervasiveinfluence on transplantation therapy. The most common source of organs was impoverished people in India,Pakistan, Egypt, and the Philippines, deceased organ donors in Colombia, and executed prisoners in China. Inresponse, in May 2008, The Transplantation Society and the International Society of Nephrology developed theDeclaration of Istanbul on Organ Trafficking and Transplant Tourism consisting of a preamble, a set of principles, anda series of proposals. Promulgation of the Declaration of Istanbul and the formation of the Declaration of IstanbulCustodian Group to promote and uphold its principles have demonstrated that concerted, strategic, collaborative,and persistent actions by professionals can deliver tangible changes. Over the past 5 years, the Declaration of IstanbulCustodian Group organized and encouraged cooperation among professional bodies and relevant international, regional,and national governmental organizations, which has produced significant progress in combating organ traffickingand transplant tourism around the world. At a fifth anniversary meeting in Qatar in April 2013, the DICGtook note of this progress and set forth in a Communique´ a number of specific activities and resolved to furtherengage groups from many sectors in working toward the Declaration’s objectives.

Guidelines for Reducing the Negative Public Health Impacts of Medical Tourism

Étude de cas / Case study

Comment faire face au trafic d’organes? Le point de vue du Declaration of Istanbul Custodian Group

The Declaration of Istanbul Custodian Group (DICG)was established in 2010 to promote the principles of theDeclaration of Istanbul on Organ Traffi cking and TransplantTourism, and to encourage and assist in their implementationin policy and practice throughout the world. In this paper,I review the work undertaken by the DICG and discuss theimportant and multifaceted role that health professionalsmust play in eff orts to combat organ traffi cking. The evolutionof transplant “tourism” and the shifting dynamics of theinternational organ trade present complex challenges, andhealth professionals are well placed to identify and developnew solutions to these persisting problems.

Caution: deceased donor organ commercialism!

In the past 3 years there have been attempts to counter the international campaignagainst a market in organs from the living. In parallel to these attempts,support for a market in organs from the deceased has gained some traction. Inthis article we describe the various forms of this phenomenon, analyze itsimplications, and call upon policy makers to take steps to halt its progress.

The long road from the kidney bazaar: a commentary on Pakistan’s progress towards self-sufficiency in organ transplantation

The dark history of transplant tourism in Pakistan demonstrates the hazards of unregulated cross-border markets in human organs. Trading on existing national and international social inequities, ‘transplant tourism’ offers dubious benefits for transplant recipients and attractive profits to those facilitating the industry at the expense of the world’s poor. The impact of Pakistan’s 2007 Transplantation of Human Organs and Tissue Ordinance and the sustained efforts of transplant professionals and societal groups led by the Sindh Institute of Urology and Transplantation, show that organ trading can be effectively discouraged and equitable programs of organ procurement and transplantation pursued despite multiple challenges. In this paper, the factors that have contributed to Pakistan’s progress towards self-sufficiency in organ transplantation are identified and discussed. The case of Pakistan highlights the need for countries to protect their own organ and tissue providers who may be vulnerable in the global healthcare market. Pakistan provides an excellent example for other countries in the region and throughout the world to consider when regulating their own transplantation programs and considering the pursuit of national self-sufficiency.

Medical travel and the sale of human biological materials: suggestions for ethical policy development

The international medical travel industry includes patients seeking to access human biological materials (HBM) including gametes, organs and stem cells. Of the various niche markets, ‘transplant tourism’ has earned global condemnation and efforts to eradicate cross-border trade in organs, while other markets continue to expand. This article reviews the ethical issues raised by medical travel for HBM, in particular those concerning trade in HBM. It argues that a more consistent approach to the regulation of cross-border trade is imperative to ensure that the perils of ‘transplant tourism’ are not replicated in other markets. In addition, it discusses the role of the self-sufficiency model in assisting the development of ethical and practical policies regarding the procurement and use of human biological materials at a national level, thereby minimizing demand for medical travel.

Transplant-Associated and Blood Transfusion-Associated Tropical and Parasitic Infections

Blood transfusion and transplantation may represent efficient mechanisms of spreading infectious agents to naive populations. In the developed countries, as a consequence of globalization, several factors such as international commerce, tourism, and immigration have acted as important features for the emergence or reemergence of infectious diseases previously referred to as tropical. This article reviews the relevant bacterial, protozoan and viral infections that are more frequently associated with blood transfusion and/or solid organ or marrow transplantation and may affect susceptible populations worldwide.

Australian waterfalls as tourism attractions

For a largely arid country with generally low relief, Australia has a remarkably large number and variety of waterfalls. Found mainly near the coast, close to where most of the population lives and near the major tourist resort areas, these landscape features have long been popular scenic attractions. As sights to see and places to enjoy a variety of recreational activities, waterfalls continue to play an important role in Australia’s tourism, even in seaside resort areas where the main attractions are sunshine, sandy beaches and surf. The aesthetic appeal of waterfalls and their value as recreational resources are recognized by the inclusion of many in national parks. Even here, demands of visitors and pressures from developers raise serious problems. This paper examines the way in which waterfalls have been developed and promoted as tourist attractions, demonstrating their importance to Australian tourism. It considers threats to the sustainable use of waterfall resources posed by power schemes and, particularly, by the tourist industry itself. Queensland’s Gold Coast is selected as a case study, and comparisons are made with other areas in which waterfalls have played important roles as tourist attractions, especially the Yorkshire coast of northeast England. The discussion draws largely on an examination of tourist literature from the nineteenth to the twenty-first century, including holiday brochures and guide books, as well as other published sources, together with field observation in various parts of the world

Destination Positioning Slogans - Analysis of Themes used by New Zealand Regional Tourism Organisations

A significant gap in the tourism and travel literature exists in the area of tourism destination branding. Although brands have been used as sources of differentiation in consumer goods markets for over a century, academic research attention towards destination branding has only been reported since the late 1990s. Three important components of the brand construct are brand identity, brand position and brand image. While interest in applications of brand theory to practise in tourism is increasing, there is a paucity of published research in the literature to guide destination marketing organisations (DMOs). In particular there have been few reported analyses of destination brand positioning slogans. The focus of this paper is on destination brand position slogans, which represent the interface between brand identity and brand image. Part of a wider investigation of DMO slogans worldwide, and in keeping with the conference location, the paper focuses on analysis of slogans used by New Zealand RTOs. The slogans are examined in terms of the extent to which they have been limited to ephemeral indifference. In other words, have they stood the test of time and do they effectively differentiate through a meaningful proposition? Analysis of the slogans indicates very few could be characterised as memorably distinctive. This reflects the complexity involved in capturing the essence of a multi-attributed destination in a succinct and focused positioning slogan, in a way that is both meaningful to the target audience and effectively differentiates the destination from competitors offering the same benefits.

Tourism Destination Preferences: A Longitudinal Analysis of Consumer Decision Sets

There have only been a small number of applications of consumer decision set theory to holiday destination choice, and these studies have tended to rely on a single cross sectional snapshot of research participants’ stated preferences. Very little has been reported on the relationship between stated destination preferences and actual travel, or changes in decision set composition over time. The paper presents a rare longitudinal examination of destination decision sets, in the context of short break holidays by car in Queensland, Australia. Two questionnaires were administered, three months apart. The first identified destination preferences while the second examined actual travel and revisited destination preferences. In relation to the conference theme, there was very little change in consumer preferences towards the competitive set of destinations over the three month period. A key implication for the destination of interest, which, in an attempt to change market perceptions, launched a new brand campaign during the period of the project, is that a long term investment in a consistent brand message will be required to change market perceptions. The results go some way to support the proposition that the positioning of a destination into a consumer’s decision set represents a source of competitive advantage.